Lymphadenopathy following COVID-19 vaccination: a wake-up call from case reports

[摘要] Enlargement of axillary, supraclavicular, or cervical lymph nodes following vaccination with COVID-19 mRNA vaccines is more frequent than initially reported, with a rate reaching up to 16% following the second dose of the Moderna mRNA vaccine. Although vaccine-related lymphadenopathy is most often a benign, self-resolving phenomenon, a few cases or B-cell- or T-cell-derived lymphoma were reported in the literature. There are also reports of clinico-pathological features suggestive of lymphoma but which ultimately proved to be caused by a non- malignant condition such as Epstein–Barr infection, extrapulmonary tuberculosis, or histiocytic necrotising lymphadenitis (Kikuchi‒Fujimoto disease). So far, these isolated observations did not receive much attention in the medical community as the causal relationship with the vaccine administration was not established. On the other hand, they raise concerns in the lay public, especially among patients with similar experiences.Although these individual stories do not allow drawing conclusions about a causal relationship between mRNA vaccination and the course of lymphoid malignancies, we may speculate that in occasional cases transformed lymphocytes are stimulated to expand by the strong immunoinflammatory environment elicited in lymph nodes by the mRNA vaccines. Whether or not such hypothesis is confirmed, treating physicians in charge of patients with post-vaccination lymphadenopathy should be reminded to consider in due course the possibility of an underlying or coincidental malignant disorder, as previously recommended in this journal.1 This is important to prevent detrimental diagnostic delays, unjustified patient’s psychological stress, or inadequate treatments.© British Journal of General Practice 2023REFERENCE 1.↵Garreffa E, York J, Turnbull A, Kendrick D (2021) Regional lymphadenopathy following COVID-19 vaccination: considerations for primary care management. Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp21X716117.

[学科分类] 卫生学