Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA.
BMJ Case Rep. 2022 Dec 30;15(12):e252030. doi: 10.1136/bcr-2022-252030.
A woman in her mid 40s presented for breast imaging after 1 week of painful and enlarged right axillary lymphadenopathy. She denied history of fever, weight loss, night sweats fatigue, cat scratch or other trauma. She received the second dose of Pfizer COVID-19 vaccine 3 months previously on the contralateral arm. A mammogram demonstrated a single, asymmetric, large and dense right axillary lymph node. Ultrasound confirmed a 2.5 cm lymph node with cortical thickening of 0.6 cm. Ultrasound-guided core biopsy showed necrotising lymphadenitis with associated aggregates of histiocytes and plasmacytoid dendritic cells. Potential causes of necrotising adenitis including , tuberculosis, Epstein-Barr Virus, herpes simplex virus, systemic lupus erythematosus and lymphoma were excluded. In the absence of any identifiable infectious or autoimmune causes, and given the temporal relatedness with vaccine administration, it was determined that the Kikuchi-Fujimoto-like necrotising lymphadenitis was likely secondary to the COVID-19 vaccine. To date, there has been no casual association made between the COVID-19 vaccine and KFD necrotising lymphadenitis.
一位 40 多岁的女性在右腋窝疼痛和淋巴结肿大 1 周后，前来进行乳房影像学检查。她否认有发热、体重减轻、盗汗、猫抓或其他创伤史。她在 3 个月前的对侧手臂上接种了第二剂辉瑞 COVID-19 疫苗。乳房 X 光检查显示右侧单个、不对称、大而致密的腋窝淋巴结。超声检查证实了一个 2.5 厘米的淋巴结，皮质增厚 0.6 厘米。超声引导下的核心活检显示坏死性淋巴结炎，伴有组织细胞和浆细胞样树突状细胞聚集。坏死性淋巴结炎的潜在原因包括结核病、EB 病毒、单纯疱疹病毒、系统性红斑狼疮和淋巴瘤等，但这些原因均被排除。由于没有发现任何可识别的感染或自身免疫原因，并且与疫苗接种时间相关，因此确定 COVID-19 疫苗引起的类似于菊池-藤本病的坏死性淋巴结炎。迄今为止，尚未发现 COVID-19 疫苗与 KFD 坏死性淋巴结炎之间存在因果关系。
