Multimodal imaging findings including high-resolution 3D T2-weighted imaging for COVID-19 vaccine-associated axillary lymphadenopathy in a patient with breast cancer

Hiroaki Shimizu; Naoko Mori; Hainan Ren; Minoru Miyashita; Satoko Sato; Shunji Mugikura; Kei Takase

doi:10.1016/j.radcr.2022.04.044

Multimodal imaging findings including high-resolution 3D T2-weighted imaging for COVID-19 vaccine-associated axillary lymphadenopathy in a patient with breast cancer

Radiol Case Rep. 2022 Jun 10;17(8):2831-2836. doi: 10.1016/j.radcr.2022.04.044. eCollection 2022 Aug.

Authors

Hiroaki Shimizu^{1

2}, Naoko Mori¹, Hainan Ren¹, Minoru Miyashita³, Satoko Sato⁴, Shunji Mugikura^{1

5}, Kei Takase¹

Affiliations

¹ Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
² Tohoku University School of Medicine, Sendai, Miyagi, Japan.
³ Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
⁴ Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
⁵ Division of Image Statistics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.

Abstract

COVID-19 vaccines have received authorization worldwide. Vaccines are typically administered to the deltoid muscle, and axillary swelling/tenderness at the first dose (11.6%) and the second dose (16%) have been reported as secondary effects. Regional lymphadenopathy in the axilla and supraclavicular region has also been reported with a prevalence of 1.1% and is referred to as COVID-19 vaccine-associated lymphadenopathy (VAL). COVID-19 VAL mimics lymph node (LN) metastases on magnetic resonance imaging, ultrasound, and 18F-fluoro-2-deoxy-Dglucose positron emission tomography. Although several specific findings of VAL on clinical imaging have been reported, the difficulty in differentiating between VAL and LN metastases could lead to false-positive or -negative diagnoses. Here, we report a case of breast cancer with ipsilateral VAL with multimodal imaging including 3D T2-weighted imaging, a new magnetic resonance imaging technique, and discuss the future perspective for differentiating between VAL and LN metastases.

Keywords: Breast cancer; COVID-19; Lymph node metastases; MRI; Vaccine-associated lymphadenopathy.

Publication types

Case Reports