COVID-19 Vaccine-Associated Lymphadenopathy in Breast Imaging Recipients: A Review of Literature

Aleman, Roxanne T; Rauch, Julia; Desai, Janvi; Chaiban, Joumana

doi:10.7759/cureus.26845

Cited by 2 publications

(2 citation statements)

References 40 publications

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“…days following vaccination. The pain regressed on average 7 days after vaccination [23,24,25]. Primarily case reports were published [13,26,27].…”

Section: Studies On Lymphadenopathy With a Focus On The Covid-19 Vaccinementioning

confidence: 99%

“…Nach Beginn der COVID-19-Impfungen klagten viele der Geimpften, insbesondere jüngere Menschen [22], in den folgenden Tagen über eine häufig schmerzhafte Schwellung der axillären LK. Die Schmerzen waren im Mittel 7 Tage nach Impfung rückläufig [23,24,25]. Dazu wurden überwiegend Fallberichte veröffentlicht [13,26,27].…”

Section: Studien Zur Lymphadenopathie Mit Fokus Auf Die Covid-19-impfungunclassified

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Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines

Wilpert,

Wenkel,

Baltzer

et al. 2024

Rofo

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Axillary lymphadenopathy (LA) after COVID-19 vaccination is now known to be a common side effect. In these cases, malignancy cannot always be excluded on the basis of morphological imaging criteria.Narrative review for decision-making regarding control and follow-up intervals for axillary LA according to currently published research. This article provides a practical overview of the management of vaccine-associated LA using image examples and a flowchart and provides recommendations for follow-up intervals. A particular focus is on patients presenting for diagnostic breast imaging. The diagnostic criteria for pathological lymph nodes (LN) are explained.Axillary LA is a common adverse effect after COVID-19 vaccination (0.3–53%). The average duration of LA is more than 100 days. LA is also known to occur after other vaccinations, such as the seasonal influenza vaccine. Systematic studies on this topic are missing. Other causes of LA after vaccination (infections, autoimmune diseases, malignancies) should be considered for the differential diagnosis. If the LA persists for more than 3 months after COVID-19 vaccination, a primarily sonographic follow-up examination is recommended after another 3 months. A minimally invasive biopsy of the LA is recommended if a clinically suspicious LN persists or progresses. In the case of histologically confirmed breast cancer, a core biopsy without a follow-up interval is recommended regardless of the vaccination, as treatment appropriate to the stage should not be influenced by follow-up intervals. For follow-up after breast cancer, the procedure depends on the duration of the LA and the woman’s individual risk of recurrence.Vaccination history should be well documented and taken into account when evaluating suspicious LN. Biopsy of abnormal, persistent, or progressive LNs is recommended. Preoperative staging of breast cancer should not be delayed by follow-up. The risk of false-positive findings is accepted, and the suspicious LNs are histologically examined in a minimally invasive procedure.

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“…days following vaccination. The pain regressed on average 7 days after vaccination [23,24,25]. Primarily case reports were published [13,26,27].…”

Section: Studies On Lymphadenopathy With a Focus On The Covid-19 Vaccinementioning

confidence: 99%

Section: Studien Zur Lymphadenopathie Mit Fokus Auf Die Covid-19-impfungunclassified

Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines

Wilpert,

Wenkel,

Baltzer

et al. 2024

Rofo

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COVID‐19 vaccine adverse events: Evaluating the pathophysiology with an emphasis on sulfur metabolism and endotheliopathy

du Preez,

Lin,

Maguire

et al. 2024

Eur J Clin Investigation

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In this narrative review, we assess the pathophysiology of severe adverse events that presented after vaccination with DNA and mRNA vaccines against COVID‐19. The focus is on the perspective of an undersulfated and degraded glycocalyx, considering its impact on immunomodulation, inflammatory responses, coagulation and oxidative stress. The paper explores various factors that lead to glutathione and inorganic sulfate depletion and their subsequent effect on glycocalyx sulfation and other metabolites, including hormones. Components of COVID‐19 vaccines, such as DNA and mRNA material, spike protein antigen and lipid nanoparticles, are involved in possible cytotoxic effects. The common thread connecting these adverse events is endotheliopathy or glycocalyx degradation, caused by depleted glutathione and inorganic sulfate levels, shear stress from circulating nanoparticles, aggregation and formation of protein coronas; leading to imbalanced immune responses and chronic release of pro‐inflammatory cytokines, ultimately resulting in oxidative stress and systemic inflammatory response syndrome. By understanding the underlying pathophysiology of severe adverse events, better treatment options can be explored.

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COVID-19 Vaccine-Associated Lymphadenopathy in Breast Imaging Recipients: A Review of Literature

Cited by 2 publications

References 40 publications

Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines

Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines

COVID‐19 vaccine adverse events: Evaluating the pathophysiology with an emphasis on sulfur metabolism and endotheliopathy

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