Interesting Image

Increased ¹⁸F-FDG Uptake in the Axillary Lymph Nodes of the Vaccinated Side Associated with COVID-19 Vaccination

10.4274/mirt.galenos.2021.22590

• Yoichi Otomi
• Saho Irahara
• Hiroaki Inoue
• Takayoshi Shinya
• Hideki Otsuka
• Masafumi Harada

Received Date: 02.04.2021 Accepted Date: 12.05.2021 Mol Imaging Radionucl Ther 2022;31(2):169-171 PMID: 35771098

• Abstract
• Full Text
• Video - Image
• References
• 5
• 789

A 50-year-old female patient underwent (¹⁸fluorine-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) following modified radical mastectomy for cancer of the left breast. Ten days before the PET/CT, the coronavirus disease-2019 (COVID-19) vaccine was injected intramuscularly into the right deltoid muscle. Increased (¹⁸F-FDG uptake of maximum standardized uptake value (11.0) was observed in the lymph nodes of the right axilla, which had not been observed in the previous PET/CT. The size of the oval-shaped lymph nodes was up to approximately 11×9 mm; however, it was larger than that observed on the previous PET/CT. We contemplate that the increased (¹⁸F-FDG uptake was a reactive change in the lymph nodes associated with the COVID-19 vaccine.

Keywords: COVID-19, vaccination, 18F-FDG PET/CT

Ethics

Informed Consent: Written informed consent of the patient was obtained.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Surgical and Medical Practices: Y.O., S.I., H.I., Concept: Y.O., S.I., Design: Y.O., S.I., Data Collection or Processing: Y.O., S.I., H.I., Analysis or Interpretation: Y.O., T.S., H.O., M.H., Literature Search: Y.O., S.I., Writing: Y.O.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.

Images

1. Johnson BJ, Van Abel KM, Ma DJ, Johnson DR. 18F-FDG-avid axillary lymph nodes after COVID-19 vaccination. J Nucl Med 2021;62:1483-1484.
2. Avner M, Orevi M, Caplan N, Popovtzer A, Lotem M, Cohen JE. COVID-19 vaccine as a cause for unilateral lymphadenopathy detected by 18F-FDG PET/CT in a patient affected by melanoma. Eur J Nucl Med Mol Imaging 2021;48:2659-2660.
3. Ahmed N, Muzaffar S, Binns C, Ilyas MW, Usmani S. COVID-19 Vaccination Manifesting as Incidental Lymph Nodal Uptake on 18F-FDG PET/CT. Clin Nucl Med 2021;46:435-436.
4. Nawwar AA, Searle J, Hagan I, Lyburn ID. COVID-19 vaccination induced axillary nodal uptake on [18F]FDG PET/CT. Eur J Nucl Med Mol Imaging 2021;48:2655-2656.
5. Xu G, Lu Y. COVID-19 mRNA vaccination-induced lymphadenopathy mimics lymphoma progression on FDG PET/CT. Clin Nucl Med 2021;46:353-354.
6. Eifer M, Eshet Y. Imaging of COVID-19 vaccination at FDG PET/CT. Radiology 2021;299:E248.
7. Panagiotidis E, Exarhos D, Housianakou I, Bournazos A, Datseris I. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1). Eur Radiol 2010;20:1251-1253.
8. Thomassen A, Lerberg Nielsen A, Gerke O, Johansen A, Petersen H. Duration of 18F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination. Eur J Nucl Med Mol Imaging 2011;38:894-898.