Unilateral axillary Adenopathy in the setting of COVID-19 vaccine

• Published in: Clinical imaging Vol. 75; pp. 12 - 15
• Main Authors: Mehta, Nishi, Sales, Rachel Marcus, Babagbemi, Kemi, Levy, Allison D., McGrath, Anika L., Drotman, Michele, Dodelzon, Katerina
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2021; Elsevier Limited; Published by Elsevier Inc
• Subjects: Breast; Breast cancer; Breast Imaging; Coronaviruses; COVID-19; COVID-19 Vaccines; Differential diagnosis; Disease control; Electronic health records; Etiology; Family medical history; Human papillomavirus; Humans; Immune response; Lymph nodes; Lymphadenopathy; Lymphatic system; Malignancy; Mammography; Medical records; Patients; SARS-CoV-2; Screening; Smallpox; Swine flu; Ultrasonic imaging; Unilateral axillary adenopathy; Vaccine; Vaccines; COVID-19; Unilateral axillary adenopathy; Screening; Vaccine; Breast imaging
• ISSN: 0899-7071; 1873-4499; 1873-4499
• DOI: 10.1016/j.clinimag.2021.01.016

With the recent U.S. Food and Drug Administration (FDA)-approval and rollout of the Pfizer-BioNTech and Moderna COVID-19 vaccines, it is important for radiologists to consider recent COVID-19 vaccination history as a possible differential diagnosis for patients with unilateral axillary adenopathy. Hyperplastic axillary nodes can be seen on sonography after any vaccination but are more common after a vaccine that evokes a strong immune response, such as the COVID-19 vaccine. As the differential of unilateral axillary adenopathy includes breast malignancy, it is crucial to both thoroughly evaluate the breast for primary malignancy and to elicit history of recent vaccination. As COVID-19 vaccines will soon be available to a larger patient population, radiologists should be familiar with the imaging features of COVID-19 vaccine induced hyperplastic adenopathy and its inclusion in a differential for unilateral axillary adenopathy. Short-term follow-up for unilateral axillary adenopathy in the setting of recent COVID-19 vaccination is an appropriate recommendation, in lieu of immediately performing potentially unnecessary and costly axillary lymph node biopsies. •Imaging features of new onset unilateral axillary adenopathy in recipients of COVID-19 vaccine are presented•Recognition of recent COVID-19 vaccine status as a cause of unilateral axillary adenopathy is clinically relevant•Short-term follow-up in the setting of unilateral axillary adenopathy and recent COVID-19 vaccine should be considered