Journal: Current Problems in Cancer. Case Reports
Article Title: Lymphadenopathy after the third Covid-19 vaccine
doi: 10.1016/j.cpccr.2021.100127
Figure Lengend Snippet: 62-year-old woman with a history of metastatic breast cancer. Each row represents PET/CT exams from top to bottom, dating from January, April, July, and September 2021. Each column represents axial PET, CT, fused PET/CT, and coronal MIP images from left to right. Initially, in January, the patient presented with a right scapular hypermetabolic bone lesion (green arrows), which later biopsy-proven as metastasis from breast cancer. MIP images show a mildly metabolic new nodule in the left lung (purple arrow). In April, two weeks after COVID-19 vaccine, the scapular lesion improved (green arrows) following treatment with chemotherapy, but there were new hypermetabolic right axillary lymph nodes (blue arrows). Lung nodule was stable (purple arrow). In July, the lymphadenopathy completely resolved, consistent with vaccine-related reactive lymphadenopathy, and there was further decreased size and metabolic activity of the scapular lesion (green arrow). The lung lesion was slightly more conspicuous (purple arrow). In September, while under chemotherapy, the right scapular lesion was more improved (green arrows). However, the known left lung nodule was increased in size (purple arrow), and there was new right axillary hypermetabolic lymphadenopathy (blue arrows). Chart review showed that the patient had her third vaccine one day ago; thus lymph nodes were more compatible with vaccine-induced reactive lymph nodes. Wedge resection of the lung nodule confirmed osteosarcoma metastasis.
Article Snippet: At the time we were writing this paper, on October 11, 2021, FDA approved the emergency use authorization for the Pfizer-BioNTech COVID-19 Vaccine single booster dose, to be administered at least six months after completion of the first two doses in individuals 65 years of age and older; individuals 18 through 64 years of age at high risk of severe COVID-19; and individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19, such as health care workers, teachers, daycare staff, grocery workers and those in homeless shelters or prisons. ( ).
Techniques: Positron Emission Tomography-Computed Tomography, Activity Assay