Axillary Lymph Node Swelling Mimicking Breast Cancer Metastasis After COVID-19 Vaccination: A Japanese Case Report and Literature Review

Yoshimoto, Nobuyasu; Takura, Kohei; Yanagi, Akemi; Takayama, Seiji; Sakamoto, Masaki; Ishikawa, Ken; Katada, Takeyasu; Kawate, Akifumi; Takayama, Shoryu; Yamashita, Masakatsu; Yamamoto, Shinya; Yokoyama, Kioto; Kani, Hisanori

doi:10.21873/invivo.12800

Cited by 4 publications

(11 citation statements)

References 15 publications

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“…In our case, although there seemed to be no axillary lymph node swelling after the second vaccination (imaging was conducted 2 months after the second vaccination), swelling was observed after the third. We previously reported axillary lymph node swelling as a sideeffect of the first or second COVID-19 vaccination (19); therefore, this side-effect observed after the third vaccination can be considered similar to that after the first or second COVID-19 vaccinations.…”

Section: Discussionmentioning

confidence: 65%

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

Yoshimoto

Yanagi

Takayama

et al. 2022

In Vivo

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Background/Aim: COVID-19 has been a global pandemic for more than 2 years, and vaccination against COVID-19 using an mRNA vaccine is widespread. The COVID-19 vaccination can cause specific side-effects, such as axillary lymph node swelling; therefore, breast oncologists should pay attention to such occurrences. Initially, only two COVID-19 vaccinations were planned; however, in some countries third or fourth vaccines have been administered. Here, we present a female case who developed axillary lymph node swelling after her third vaccination. We have also reviewed the literature regarding this side-effect after a third or fourth COVID-19 vaccination. Case Report: A 64-year-old woman who came to our clinic regarding a mammography abnormality in her left breast. She had no palpable mass, but a left breast mass was shown by mammography, and ultrasonography and magnetic resonance imaging indicated a hamartoma. At 2 months after her second COVID-19 vaccination when she underwent these tests, she had no axillary lymph node swelling. We planned a follow-up after 6 months. At her next visit, by chance, she underwent ultrasonography 14 days after she received a third COVID-19 vaccination, and a swollen axillary lymph node was observed. Conclusion: Axillary lymph node swelling can occur after a third COVID-19 vaccination. Therefore, breast oncologists will have to consider this side-effect of COVID-19 vaccination when diagnosing breast tumors. Pneumonia caused by the novel coronavirus, called Coronavirus Disease 2019 (COVID-19), was first reported in Wuhan, China in December 2019 (1). Two years later and the pandemic has become global. During this pandemic, COVID-19 vaccines, such as the BNT162b2 vaccine (Pfizer) (2) and mRNA-1273 vaccine (Moderna) (3), have been developed rapidly, and in many countries, including Japan, vaccination with these vaccines has been performed. BNT162b2 and mRNA-1273 are mRNA vaccines and this is the first time this type of vaccine has been used in a clinical setting.When these vaccinations were started, clinical trials of BNT162b2 and mRNA-1273 (2, 3) were designed to administer two doses. However, this pandemic has continued for 2 years, and therefore booster vaccinations have been required to prevent COVID-19 infection because antibody levels to the virus decrease within several months. In Japan, the third vaccination started in December 2021 (4). Currently, a third vaccination is indicated for those who received a second vaccination more than 6 months previously, and further vaccination might be needed. Indeed, Japan is planning to administer a fourth COVID-19 vaccination (5).These vaccines have characteristic side-effects including fever, general fatigue, injection-site pain, and swelling (2). In addition, local lymph node swelling can also occur after these vaccinations (3). In cases of axillary lymph node swelling, breast oncologists should consider whether these swellings are metastases of breast cancer or a side-effect of the vaccine. Here, we present a case with axillary lymph node swel...

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Section: Discussionmentioning

confidence: 65%

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

Yoshimoto

Yanagi

Takayama

et al. 2022

In Vivo

Self Cite

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“…Breast radiologists are increasingly seeing patients with axillary adenopathy related to COVID-19 vaccination. COVID-19 vaccination can cause levels I–III axillary as well as cervical lymphadenopathy [ 16 , 17 ]. Au et al reported that a patient with colorectal cancer who had been receiving long-term PD-1 therapy experienced severe side effects related to immunotherapy after receiving the BNT16262 vaccine developed by Pfizer/BioNTech [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

CVSARRP: A framework to predict the risk of adverse to severe adverse reactions for 10855 diseases after COVID-19 vaccination

Jin¹,

Li²

2023

Heliyon

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“…In our research, surgical excision or CNB of C19-LAP-or SLDI-enlarged lymph nodes have been performed in 55 cases. 20,22,23,35,39,[41][42][43]47,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] The histological diagnoses were as follows: negative for neoplasia, reactive hyperplasia, and florid reactive hyperplasia (39 cases), 23,39,[50][51][52][53][54][55][56][57][58][59][60][61] progressive transformation of germinal centres (1 case), 54 atypical follicular hyperplasia with light chain-restricted germinal centres (1 case) 62 granulomatous reaction (2 cases), 50,63 metastases (4 cases), 20,22,50 Kikuchi-Fujimoto disease (KFD; 6 cases), [40][41]…”

Section: Covid-19 Vaccines and Lymphadenopathymentioning

confidence: 99%

“…The present study is a pooled review based on 14 report s [20][21][22][35][36][37][38][44][45][46][47]52,72 and one unpublished case observed by the authors. In total, 26 cases are reported, including 17 (65%) female patients, 8 (32%) male patients, and one patient whose gender was not reported, 21 with an age range of 27-70 years.…”

Section: Fine Needle Aspiration Cytology In Cases Of Sldi and C19-lapmentioning

confidence: 99%

“…An additional limit to the evaluation of the incidence of SLDI and C19-LAP is that patients were controlled for pre-existing morbidities and for staging or follow-up of neoplastic diseases by 18F-FDG PET-CT, in which SLDI is more likely to be detected. 24,25,47,55,66,76 The morphological features of post-vaccine lymphadenopathies depend largely on the nature of the vaccine. Calmette-Guerin LAP has been reported as caseating granulomatous inflammation not dissimilar from tubercular lymphadenitis.…”

Section: Post-vaccine Lymphadenopathymentioning

confidence: 99%

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COVID‐19 post‐vaccination lymphadenopathy: A review of the use of fine needle aspiration cytology

et al. 2023

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COVID‐19 vaccine‐associated clinical lymphadenopathy (C19‐LAP) and subclinical lymphadenopathy (SLDI), which are mainly detected by 18F‐FDG PET‐CT, have been observed after the introduction of RNA‐based vaccines during the pandemic. Lymph node (LN) fine needle aspiration cytology (FNAC) has been used to diagnose single cases or small series of SLDI and C19‐LAP. In this review, clinical and LN‐FNAC features of SLDI and C19‐LAP are reported and compared to non‐Covid (NC)‐LAP. A search for studies on C19‐LAP and SLDI histopathology and cytopathology was performed on PubMed and Google Scholar, on 11 January 2023. Reports on LN‐FNAC of C19‐LAP were retrieved. A total of 14 reports, plus one unpublished case of C19‐LAP observed in our institution, diagnosed by LN‐FNAC were included in a pooled analysis and compared to the corresponding histopathological reports. In total, 26 cases were included in this review, with a mean age of 50.5 years. Twenty‐one lymphadenopathies assessed by LN‐FNAC were diagnosed as benign, and three cases as atypical lymphoid hyperplasia; the latter were subsequently confirmed as benign (one by repetition of LN‐FNAC, two by histological control). One case of mediastinal lymphadenopathy in a patient suffering from melanoma was reported as reactive granulomatous inflammation, while one unsuspected case was diagnosed as metastasis from melanoma. In all cases, the cytological diagnoses were confirmed by follow‐up or excisional biopsy. The high diagnostic value of LN‐FNAC in excluding malignant processes was extremely useful in this context and may be particularly valuable when CNB or histological excisions are difficult to perform, as was the case during Covid lockdowns.

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Axillary Lymph Node Swelling Mimicking Breast Cancer Metastasis After COVID-19 Vaccination: A Japanese Case Report and Literature Review

Cited by 4 publications

References 15 publications

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

CVSARRP: A framework to predict the risk of adverse to severe adverse reactions for 10855 diseases after COVID-19 vaccination

COVID‐19 post‐vaccination lymphadenopathy: A review of the use of fine needle aspiration cytology

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