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

• Published in: Radiology case reports 2022-08, Vol.17 (8), p.2831-2836
• Main Authors: Shimizu, Hiroaki, Mori, Naoko, Ren, Hainan, Miyashita, Minoru, Sato, Satoko, Mugikura, Shunji, Takase, Kei
• Format: Article
• Language: English
• Subjects: Breast cancer; Case Report; COVID-19; Lymph node metastases; MRI; Vaccine-associated lymphadenopathy
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2022.04.044

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.