Abstract
Introduction and importance
Vaccine-associated hypermetabolic lymphadenopathy (VAHL) after a COVID 19 vaccination is a common adverse event and also a diagnostic challenge especially in patients with a history of a malignancy.
Case presentations
A 47-year-old woman presented with enlarged lymph nodes in the right hilar, subcarinal, and right supraclavicular regions detected by computed tomography as a postoperative follow-up study of thyroid cancer. Fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) performed 3 weeks later revealed an FDG uptake in those swollen lymph nodes and in the novel lymphadenopathy in the left axilla and left subclavicular regions. Both biopsy specimens from the right supraclavicular and hilar lymph nodes revealed only multiple small granulomas with multinucleated giant cells without malignancy, consistent with sarcoidosis. The left axilla and subclavicular lymphadenopathy detected by the FDG-PET subsequently spontaneously regressed.
Clinical discussion
The coincidental occurrence of VAHL and lymphadenopathy in sarcoidosis patients could cause diagnostic confusion especially in those with breast cancer.
Conclusion
Sufficient attention should be paid both to the injection site and the time interval between the vaccination and imaging test in the era of nationwide mass vaccinations against COVID 19.
【저자키워드】 BHLbilateral hilar lymphadenopathy, bilateral hilar lymphadenopathy, VAHLvaccine-associated hyper metabolic lymphadenopathy, vaccine-associated hyper metabolic lymphadenopathy, EBUS-TBNAendobronchial ultrasound-guided trans-bronchial needle aspiration, endobronchial ultrasound-guided trans-bronchial needle aspiration, 【초록키워드】 Breast cancer, vaccination, Cancer, diagnostic, tomography, COVID 19, Computed tomography, Region, clinical, adverse event, Patient, Thyroid, sarcoidosis, FDG, Lymph node, malignancy, follow-up study, Confusion, specimen, injection, granuloma, regions, Occurrence, performed, postoperative, Fluorine-18, multinucleated giant cell, subclavicular, 【제목키워드】 COVID-19, Case report, Patient, coincidence, invasive,