<scp>COVID</scp>‐19 post‐vaccination lymphadenopathy: Report of cytological findings from fine needle aspiration biopsy

Tan, Nicholas Jin Hong; Tay, Kai Xun Joshua; Wong, Soon Boon Justin; Nga, Min En

doi:10.1002/dc.24863

Cited by 15 publications

(22 citation statements)

References 16 publications

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“…KFD very uncommonly occurs following vaccination, with only rare reports in the literature describing its occurrence after influenza vaccination [7], human papillomavirus vaccination and Japanese encephalitis virus vaccination [8]. A literature search yielded only one case report of KFD following COVID-19 vaccination at the time of writing [3], with many other papers describing cytologic or histologic findings of reactive follicular hyperplasia or reactive lymphadenopathy [9][10][11][12][13][14]. Table 1 details the key features of published cases of lymphadenopathy post COVID-19 vaccination, which also had cytologic and/or histologic follow-up.…”

Section: Discussionmentioning

confidence: 99%

Kikuchi–Fujimoto Disease Post COVID-19 Vaccination: Case Report and Review of Literature

et al. 2021

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With the rapid development of various coronavirus disease 2019 (COVID-19) vaccines in a bid to counter and contain the COVID-19 pandemic, unusual and uncommon side effects of COVID-19 vaccination have been increasingly reported in the literature. Ipsilateral lymphadenopathy is a fairly common side effect of vaccination of any kind, with its etiology most commonly related to reactive lymphadenopathy. However, Kikuchi–Fujimoto Disease (KFD) or necrotizing histiocytic lymphadenitis is rarely observed post-vaccination, with only one other case of KFD post COVID-19 vaccination reported to date. We report two more cases of KFD post COVID-19 vaccination in the Asian population, highlighting the clinical course and salient clinical, radiological and histologic findings. In addition, we provide a literature review of the existing cases of lymphadenopathy post COVID-19 vaccination with cytologic and/or histologic correlation.

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Section: Discussionmentioning

confidence: 99%

Kikuchi–Fujimoto Disease Post COVID-19 Vaccination: Case Report and Review of Literature

et al. 2021

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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%

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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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“…According to daily practice, nodes with aggregate positivity were further investigated by US or mdc CT, at least [26]. This approach avoided undue further investigations for most of patients and unnecessary invasive procedures [27] for those supposed positive. In fact, 84% of patients suspected positive on PET scan resulted to have benign features on co-recorded CT images.…”

Section: Discussionmentioning

confidence: 99%

Challenging Axillary Lymph-Nodes on F-18-FDG, F-18-Choline and Ga-68-DOTATOC PET/CT in Cancer Patients throughout Covid-19 Vaccination Era

Storto

Giordano

Gallicchio

et al. 2022

Preprint

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Objectives: unexpected detection of axillary lymphadenopathy (AxL) in cancer patients (Pts) represents a real concern during COVID-19 vaccination era. Benign reactions may take place after vaccine inoculation, confounding image interpretation in patients undergoing F-18-FDG, F-18-Choline and Ga-68-DOTATOC PET/CT. It may simulate loco-regional metastases/disease. To assess PET/CT findings after COVID-19 vaccination in cancer patients and the consequent impact on their management. Methods: we evaluated 333 patients undergoing PET/CT (257 F-18-FDG, 54 F-18-Choline and 23 Ga-68 DOTATOC) scans after first vaccination with mRNA vaccine (Pfizer-BioNTech). Uptake index (SUVmax) of suspected AxL was defined significant when the ratio >1.5 as compared to the contralateral inoculation site. Besides, co-registered CT (Co-CT) features of target lymph-nodes were evaluated. Nodes with aggregate positivity were further investigated.Results: overall, the prevalence of apparently positive lymph-nodes on PET scans was 17.1% during vaccination era. 107 Pts had undergone PET/CT before COVID-19 pandemic and only 3 shown reactive lymph-nodes with a prevalence of 2.8% (p<0.001 as compared to vaccination era). 84.2% exhibited benign characteristics on Co-CT images and only 9 Pts needed additional appraisal. Conclusions: the correct interpretation of images is crucial to avoid unnecessary management changes and to rule out invasive procedures in cancer Pts undergoing diagnostics. An accurate anamnestic interview and the precise assessment of nodes’ Co-CT characteristics when performing PET/CT may help to address the diagnostic hypothesis.

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COVID‐19 post‐vaccination lymphadenopathy: Report of cytological findings from fine needle aspiration biopsy

Cited by 15 publications

References 16 publications

Kikuchi–Fujimoto Disease Post COVID-19 Vaccination: Case Report and Review of Literature

Kikuchi–Fujimoto Disease Post COVID-19 Vaccination: Case Report and Review of Literature

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

Challenging Axillary Lymph-Nodes on F-18-FDG, F-18-Choline and Ga-68-DOTATOC PET/CT in Cancer Patients throughout Covid-19 Vaccination Era

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