Massive Cervical Lymphadenopathy Post-COVID-19 Vaccination

Abstract

The coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2. Rapid spread with rampant growth of cases and deaths brought forth an urgent need for novel therapies including vaccinations. The mRNA vaccines for COVID-19 disease have been implemented at an unprecedented scale in an effort to combat the unrelenting pandemic. Such a massive scale vaccination program is bound to coincide with adverse events related to treatment. We present a case of massive cervical lymphadenopathy in a 58-year-old male patient post-Moderna COVID-19 vaccination. Additional investigations did not identify malignancy and he was diagnosed with vaccine-related lymphadenopathy. Patient significantly improved with corticosteroid treatment within 2 days of admission. Lymphadenopathy is reported as the second most common local reaction to the Moderna vaccine. Promoting knowledge of this side effect, particularly in the setting widespread vaccination efforts, would allow for better management of cases, especially in relation to oncologic patients.

Short-Term Adverse Events and Antibody Response to the BNT162b2 SARS-CoV-2 Vaccine in 4156 Health Care Professionals

“…Our data confirm that female gender and younger age are significantly associated with adverse events, and this may reflect the more efficacious immune response observed in women for SARS [ 21 ] and other vaccines [ 22 ], particularly at a younger age. Among adverse events, lymphadenopathy has been observed in 78.4/100,000 subjects after the SARS-Cov-2 vaccination, more frequently axillary and unilateral [ 23 , 24 ]. This sign may require imaging when lasting for several weeks [ 25 ] or in patients undergoing oncological follow-up [ 26 ] and may lead, in some cases, to the diagnosis of hemophagocytic lymphohistiocytosis [ 27 ].…”

Bilateral Cervical Lymphadenopathy after mRNA COVID-19 Vaccination on Oral Squamous Cell Carcinoma Patient: A Case Report

“…According to Wolfson S. et al, the patients demonstrated LA as early as 1 day after the first dose of mRNA vaccine and as late as 71 days after the second dose [ 10 ]. Additionally, there are reports of ipsilateral CLA after mRNA COVID-19 vaccination [ 4 ]. mRNA vaccine-related LA may mimic metastatic lymph nodes, making the diagnosis difficult for oncologists.…”

“…There has been continuous development of vaccines against the coronavirus disease 2019 (COVID-19), and mRNA vaccines are being widely used in practice. However, critical side effects of mRNA vaccines, such as reactive lymphadenopathy, have been reported [ 1 , 2 , 3 , 4 , 5 ]. Although axillary LA is common after vaccine administration, those of the supraclavicular and cervical regions have also been found in some patients [ 1 , 2 , 3 , 4 , 5 ].…”

“…However, critical side effects of mRNA vaccines, such as reactive lymphadenopathy, have been reported [ 1 , 2 , 3 , 4 , 5 ]. Although axillary LA is common after vaccine administration, those of the supraclavicular and cervical regions have also been found in some patients [ 1 , 2 , 3 , 4 , 5 ]. mRNA vaccine-induced reactive LA may be misdiagnosed as lymphatic metastasis on imaging tests [ 6 ].…”

Coincidence of Sarcoidosis and a COVID-19 vaccine-associated hypermetabolic lymphadenopathy in a patient with a history of invasive breast cancer: A case report

“…VAHL after a COVID19 vaccination (BNT162b2/1273) is a common adverse event and the most frequently involved site is the axilla, followed by the supraclavicular, neck, and pectoral regions [14] , [15] , [16] , [17] , [18] . It poses a diagnostic challenge in the FDG-PET with which both the benign and malignant nature could reveal a hyper metabolic lymphadenopathy.…”