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Our case series is limited by the absence of a control group and the retrospective analysis that was conducted. Large-scale prospective studies and pharmacovigilance monitoring are warranted to clarify the risks of VZV reactivation for all available SARS-CoV-2 vaccines. It should be determined whether all SARS-CoV-2 share a similar risk for this adverse reaction and should some of them be relatively safer in this regard, consideration should be given when choosing a vaccine for individuals most at risk for VZV reactivation (e.g. elderly, immunosuppression).

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The contribution of a cellular immune response to tissue destruction in sclerosing lymphocytic lobulitis of the breast is not well understood. In this study, comparison of one case with two age matched control cases showed an increased frequency of activated perforin mRNA expressing cells at the site of tissue destruction in lobulitis. Along with the detection of tumour necrosis factor a (TNFa) mRNA expressing cells in the infiltrates, the striking association of perforin expressing activated cytotoxic cells with remaining gland parenchyma and the high level of perforin mRNA suggests activation of cytotoxic cells in situ. These findings are evidence that cell mediated cytotoxicity plays a significant role in the destruction of mammary gland tissue in sclerosing lymphocytic lobulitis. (J Clin Pathol 1997;50:310-313) Keywords: lymphocytic lobulitis of the breast; autoimmunity; TNFa; perforin cell mediated cytotoxicity is also suggested by the structural similarities between TNFa receptor p55 and Fas; both share a homology region supposedly involved in mediating an apoptotic signal.6In this report, we describe a case of a patient with insulin dependent diabetes mellitus who developed a sclerosing lymphocytic lobulitis of the breast. This inflammatory infiltration was associated with massive upregulation of the number of cells expressing mRNA for perforin and for TNFa.Case report A 27 year old woman with a 14 year history of diabetes mellitus type 1 presenting for a routine gynaecological examination was found with a firm lesion of 4 cm in diameter in the left breast. Although no obvious signs for malignancy were observed, the lump was surgically removed.Two women (27 and 28 years old), both normoglycaemic and without signs of diabetes mellitus, were chosen as controls. Breast surgery had been undertaken because of breast asymmetry and carcinophobia, respectively.