Dominguez Jennifer Ledezma, Eberhardt Steven C, Revels Jonathan W
Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM 87131, USA.
Radiol Case Rep. 2021 Jul;16(7):1660-1664. doi: 10.1016/j.radcr.2021.04.015. Epub 2021 Apr 12.
As more people receive coronavirus disease 2019 (COVID-19) vaccinations, the side effects of the vaccines will become more apparent. One reported side effect that has come to light is unilateral axillary lymphadenopathy ipsilateral to the vaccination site. In general, unilateral axillary lymphadenopathy has a broad differential including malignancy, infection, autoimmune disorder, and iatrogenic etiologies. We present a case of a previously healthy 38-year-old woman who received her first dose of Pfizer COVID-19 vaccination 3 days prior to presenting to the emergency department complaining of 2 weeks of abdominal pain and 20-pound unintentional weight loss. Unilateral axillary lymphadenopathy, ipsilateral to the vaccination site, was found on a contrast-enhanced computed tomography examination of the chest, abdomen, and pelvis. Subsequent diagnostic mammograms did not demonstrate evidence of malignancy; however, axillary ultrasound again revealed nonspecific lymphadenopathy. A short-term follow-up axillary ultrasound was recommended, rather than a lymph node biopsy, given the history of recent vaccination. At clinical follow-up, the patient's abdominal pain resolved and no further weight loss was noted. This case report discusses the key components and workup recommendation of unilateral axillary lymphadenopathy in the setting of COVID-19 vaccination.
随着越来越多的人接种2019冠状病毒病（COVID-19）疫苗，疫苗的副作用将变得更加明显。已发现的一种报告副作用是接种部位同侧的单侧腋窝淋巴结病。一般来说，单侧腋窝淋巴结病的鉴别诊断范围广泛，包括恶性肿瘤、感染、自身免疫性疾病和医源性病因。我们报告一例病例，一名38岁既往健康的女性，在前往急诊科就诊前3天接种了第一剂辉瑞COVID-19疫苗，她主诉腹痛2周，体重意外减轻20磅。在胸部、腹部和骨盆的增强计算机断层扫描检查中发现了接种部位同侧的单侧腋窝淋巴结病。随后的诊断性乳房X线摄影未显示恶性肿瘤的证据；然而，腋窝超声再次显示非特异性淋巴结病。鉴于近期接种疫苗的病史，建议进行短期随访腋窝超声检查，而不是淋巴结活检。在临床随访中，患者的腹痛缓解，未再出现体重减轻。本病例报告讨论了COVID-19疫苗接种背景下单侧腋窝淋巴结病的关键组成部分和检查建议。
