Unilateral axillary Adenopathy in the setting of COVID-19 vaccine

Clin Imaging. 2021 Jul:75:12-15. doi: 10.1016/j.clinimag.2021.01.016. Epub 2021 Jan 19.

Abstract

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.

Keywords: Breast imaging; COVID-19; Screening; Unilateral axillary adenopathy; Vaccine.

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Lymphadenopathy*
  • SARS-CoV-2
  • Vaccines*

Substances

  • COVID-19 Vaccines
  • Vaccines