Mediastinal Lymphadenopathy After Covid-19 Vaccine: Staging Dilemma in Oncology Patients

Trikannad, Anup; Vellanki, Sruthi; Kunapareddy, Girish

doi:10.1016/j.chest.2021.07.1337

Cited by 4 publications

(18 citation 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%

“…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%

“…Most cases of lymphadenopathy that were sent for pathological examination were diagnosed as reactive or negative for malignancy (28/37, 75.5%). Other histopathological findings were as follows: florid lymphoid hyperplasia in two patients (2/37, 5.4%); KFD in three patients [ 31 , 33 ] (3/37, 8.1%); granulomatous inflammation in two patients [ 18 , 42 ] (2/37, 5.4%); and metastases in two patients [ 18 ] (2/37, 5.4%). Further details are elaborated in the following sections.…”

Section: Resultsmentioning

confidence: 99%

“…Most of these patients were females (14/19, 73.7%). All patients had a prior history of malignancy, with a history of melanoma [18,40,42] [41] and renal cell carcinoma [35]. Most cases were associated with the Pfizer-Bio-Ntech vaccine, with equal proportions associated with the first and second dose (31.6%).…”

Section: Subclinical Lymphadenopathy Detected On Imaging (Sldi)mentioning

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: Subclinical Lymphadenopathy Detected On Imaging (Sldi)mentioning

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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“…Cystic fibrosis a hereditary condition, Infection with histoplasmosis, Chronic Obstructive Pulmonary Disease, and Coccidioidomycosis all have a role in the disease's etiology [ 13 ]. According to a case report by Trikannad A et al, there is also a risk of mediastinal lymphadenopathy following the COVID-19 vaccination [ 14 ]. There are no special precautions for the therapy of mediastinal lymphadenopathy in COVID-19 patients; nevertheless, imaging modalities on the chest of critically ill COVID-19 patients should be performed for the identification of lymphadenopathy and severe spreading chest infection.…”

mentioning

confidence: 99%

Mediastinal lymphadenopathy: A serious complication in COVID-19 patients

Khatri

Priya

Saleem

et al. 2022

Annals of Medicine &Amp; Surgery

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COVID-19-Vaccine-Pfizer-BioNTech

2021

Reactions Weekly

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Mediastinal lymphadenopathy: case reportA 57-year-old woman developed mediastinal lymphadenopathy during vaccination with COVID-19-Vaccine-Pfizer-BioNTech * . The woman, who had melanoma and had undergone excision procedure 30 years previously, was noted to develop raised brown lesion on her left rib, which progressively enlarged and became more pigmented over past 4 months. She therefore underwent excisional biopsy, which revealed non-ulcerated superficial spreading malignant melanoma. Subsequently, resection of metastatic melanoma was performed. Later, she received COVID-19-Vaccine-Pfizer-BioNTech [dosage and route not stated]. Three weeks later, PET/CT revealed increased uptake within multiple non-enlarged lymph nodes in the mediastinum, right axilla and right neck. Because of this metastases was suspected. Non-caseating granulomas, reactive lymph nodes and no signs of malignancy were seen in mediastinal fine needle aspiration of lymph nodes in stations 4 and 7. She was diagnosed with mediastinal lymphadenopathy, which was determined to be related to COVID-19-Vaccine-Pfizer-BioNTech.The woman was therefore initiated with unspecified adjuvant systemic therapy for 1 year [outcome not stated].

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Mediastinal Lymphadenopathy After Covid-19 Vaccine: Staging Dilemma in Oncology Patients

Cited by 4 publications

References 0 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

Mediastinal lymphadenopathy: A serious complication in COVID-19 patients

COVID-19-Vaccine-Pfizer-BioNTech

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