Unilateral lymphadenopathy associated with COVID‐19 vaccination

Kado, Soichiro; Iwabuchi, Satoshi; Kajii, Eiji; Ohtsuki, Mamitaro

doi:10.1002/cia2.12217

Cited by 4 publications

(16 citation statements)

References 8 publications

(14 reference statements)

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“…After excluding 74 articles for the reasons stated in Figure 1 , and with the addition of 5 articles identified from the reference lists of articles, 39 articles were included in this review and 21 COVID-19 studies were included in the pooled analysis. A total of 25 studies [ 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] were relevant to the COVID-19 vaccine and 14 studies [ 7 , 8 , 9 , 10 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ] were related to non-COVID-19 vaccines.…”

Section: Resultsmentioning

confidence: 99%

“…The 25 studies were published by authors from countries including Germany [ 18 ] ( n = 1), Israel [ 22 , 37 ] ( n = 2), Japan [ 26 ] ( n = 1), Portugal [ 20 ] ( n = 1), Qatar [ 31 ] ( n = 1), Singapore [ 32 , 33 ] ( n = 2), South Korea [ 27 , 30 , 39 ] ( n = 3), Spain [ 23 , 24 , 41 ] ( n = 3), Switzerland [ 21 ] ( n = 1), the United Kingdom [ 36 ] (UK) ( n = 1), and the United States of America [ 25 , 28 , 29 , 34 , 35 , 38 , 40 , 43 ] (USA) ( n = 8). Most studies are case reports ( n = 12, 48.0%), followed by case series ( n = 9, 36.0%), retrospective studies ( n = 3, 12.0%), and not reported in one study (4.0%).…”

Section: Resultsmentioning

confidence: 99%

“…Findings from the pooled analysis are summarized in Table 1 . Pooled analysis of 21 studies [ 18 , 20 , 21 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] included 37 patients with a mean age of 47.8 ± 19.1 years old, of which 23 were female (23/37, 62.2%). The largest proportion of patients (9/37, 24.3%) had no prior medical history, followed by 21.6% (8/37) with a history of melanoma, and 18.9% (7/37) with a history of breast cancer.…”

Section: Resultsmentioning

confidence: 99%

“…Additional clinical symptoms aside from lymphadenopathy were reported in these cases. Overall, six patients (6/37, 16.2%) experienced fever [ 25 , 30 , 33 , 34 ], while four patients (4/37, 10.8%) also reported pain [ 26 , 27 , 28 , 29 ]. The other described symptoms included fatigue or malaise (2/37, 5.4%), myalgia (2/37, 5.4%), dysphagia (1/37, 2.7%), chills (1/37, 2.7%), and other symptoms such as vomiting (2/37, 5.4%).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 15 studies reported pathological findings of C19-VAL. There was a total of eight case reports [ 20 , 25 , 26 , 27 , 30 , 31 , 32 , 34 ], five case series [ 21 , 24 , 28 , 29 , 33 ], one retrospective study [ 22 ], and one study type was not reported. Our findings are summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Pathological Findings in COVID-19 and Non-COVID-19 Vaccine-Associated Lymphadenopathy: A Systematic Review

Chua

Takano

2022

JCM

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COVID-19 vaccine-associated lymphadenopathy (C19-VAL) is increasingly encountered with the widespread use of the vaccine in controlling the outbreak. We aim to characterize the pathological findings of COVID-19 and non-COVID-19 vaccine-associated lymphadenopathy (NC19-VAL). A search for studies that reported pathological findings in vaccine-associated lymphadenopathy on PubMed and Google Scholar was performed on December 11, 2021. C19-VAL studies were pooled for analysis. These studies were split into clinical lymphadenopathy (CL) and subclinical lymphadenopathy detected on imaging (SLDI) for subgroup analysis. A total of 25 studies were related to COVID-19 vaccines, and 21 studies were included in the pooled analysis. The pooled analysis included 37 patients with a mean age of 47.8 ± 19.1 years old, and 62.2% were females. The mean duration from last vaccination to development of CL/SLDI was 14.5 ± 11.0 days. Most were diagnosed as reactive or negative for malignancy (28/37, 75.5%), followed by Kikuchi–Fujimoto disease (KFD) (3/37, 8.1%), florid lymphoid hyperplasia (2/37, 5.4%), and granulomatous inflammation (2/37, 5.4%). Metastases were reported in two patients with a history of malignancy (2/37, 5.4%). Cases with florid lymphoid hyperplasia and KFD were younger than those with reactive changes. A total of 14 studies were related to non-COVID-19 vaccines. Caseating granulomatous inflammation was reported in BCG vaccine-associated lymphadenopathy, while other vaccines were associated with reactive lymphoid hyperplasia, florid post-vaccinal reactions, and KFD. Although most C19-VAL cases were reported as reactive or negative for malignancy, other diagnoses included florid lymphoid hyperplasia, KFD, and granulomatous inflammation. Metastases were reported in lymphadenopathy of patients with a history of malignancy, who had been incidentally vaccinated. In conclusion, C19-VAL can yield different histopathological diagnoses when sampled, most of which require clinical and radiological correlation for optimal patient management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Pathological Findings in COVID-19 and Non-COVID-19 Vaccine-Associated Lymphadenopathy: A Systematic Review

Chua

Takano

2022

JCM

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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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Distinguishing Axillary Lymphadenopathy after COVID-19 Vaccination from Malignant Lymphadenopathy

Yamanaka,

Tanaka,

Miyagawa

et al. 2024

JCM

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Objectives: To study the differences between malignant hypermetabolic axillary lymphadenopathy (MHL) and COVID-19 vaccine-associated axillary hypermetabolic lymphadenopathy (VAHL) using clinical imaging. Methods: A total of 1096 patients underwent Positron Emission Tomography-Computed Tomography (PET-CT) between 1 June 2021 and 30 April 2022 at Ehime University Hospital. In total, 188 patients with axillary lymphadenopathy after the COVID-19 vaccination were evaluated. The patients were classified into three groups such as VAHL (n = 27), MHL (n = 21), and equivocal hypermetabolic axillary lymphadenopathy (EqHL; n = 140). Differences in lymph node (LN) swellings were statistically analyzed using clinical imaging (echography, CT, and 18F-FDG PET). Results: MHL included a higher female population (90.5%) owing to a higher frequency of breast cancer (80.9%). Axillary LNs of MHL did not show any LN fatty hilums (0%); however, those of VAHL and EqHL did (15.8 and 36%, respectively). After the logistic regression analysis of the patients who had axillary lymphadenopathy without any LN fatty hilums, the minor axis length and ellipticity (minor axis/major axis) in the largest axillary LN, SUVmax, and Tissue-to-Background Ratio (TBR) were useful in distinguishing malignant lymphadenopathies. A receiver-operating characteristic (ROC) analysis indicated that a cut-off value of ≥7.3 mm for the axillary LN minor axis (sensitivity: 0.714, specificity: 0.684) and of ≥0.671 for ellipticity (0.667 and 0.773, respectively) in the largest LN with the highest SUVmax and TBR were predictive of MHL. Conclusions: Axillary lymphadenopathy of the minor axis and ellipticity in LN without fatty hilums may be useful to be suspicious for malignancy, even in patients who have received COVID-19 vaccination. Further examinations, such as 18F-FDG PET, are recommended for such patients.

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Unilateral lymphadenopathy associated with COVID‐19 vaccination

Cited by 4 publications

References 8 publications

Pathological Findings in COVID-19 and Non-COVID-19 Vaccine-Associated Lymphadenopathy: A Systematic Review

Pathological Findings in COVID-19 and Non-COVID-19 Vaccine-Associated Lymphadenopathy: A Systematic Review

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

Distinguishing Axillary Lymphadenopathy after COVID-19 Vaccination from Malignant Lymphadenopathy

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