mRNA COVID-19 aşısı ile ilişkili aksiller ve supraklaviküler lenfadenopatinin B-mod ve Doppler ultrasonografi paternleri

Year 2022, Volume: 47 Issue: 2, 891 - 897, 30.06.2022

Veysel Kaplanoğlu , Hatice Kaplanoğlu , Aynur Turan , Alper Dilli

https://doi.org/10.17826/cumj.1089995

Abstract

Bu çalışmada, Pfizer-BioNTech COVID-19 aşısının birinci veya ikinci dozundan sonra bölgesel lenf düğümü zincirinde ortaya çıkan lenf bezlerinin ultrason görüntüleme özelliklerini sunuyoruz. Aşı enjeksiyon bölgesine komşu ipsilateral lenfadenopati, COVID-19 aşısını takiben son derece nadir ancak beklenen bir advers reaksiyondur. Aksiller lenfadenopati daha yaygın olmasına rağmen, mevcut COVID-19'a karşı yaygın aşılama sonrasında supraklaviküler lenfadenopati vakaları da bildirilmiştir. Pfizer-BioNTech COVID-19 aşısı yapıldıktan sonra radyoloji bölümümüze başvuran, daha önce herhangi bir patolojik durumu olmayan yedi hastaya ultrasonografi incelemesi yapıldı. Bilateral aksiller, supraklaviküler ve subklaviküler lenf nodu istasyonları araştırıldı. Bu hastalar tipik olarak, ipsilateral aksiller ve supraklaviküler bölgelerde büyümüş hipoekoik lenf nodları ile birlikte yağ hilusu kaybı, asimetrik veya yaygın kortikal kalınlaşma ve renkli doppler ultrasonografisinde artmış hiler ve kortikal vaskülarizasyon ile başvururlar. Radyologlar ve klinisyenler bu lenf nodlarının ultrasonografik özelliklerinin farkında olmalı ve bu lenf nodlarının sıklıkla kendi kendini sınırlayan bir süreç olduğu konusunda hastayı iyi bilgilendirilmelidir. Bu nedenle gereksiz aksiller lenf nodu biyopsilerinden kaçınılmalı ve hastalar konservatif olarak tedavi edilmelidir.

Keywords

COVID-19, mRNA aşısı, Supraklaviküler, Lenfadenopati, Ultrasonografi

B-mode and Doppler ultrasonography patterns of axillary and supraclavicular lymphadenopathy associated with mRNA COVID-19 vaccine

Abstract

In this study, we present the ultrasound imaging features of lymph nodes arising in the regional lymph node chain after the first or second dose of the Pfizer-BioNTech COVID-19 vaccine. Ipsilateral lymphadenopathy adjacent to the vaccine injection site is an extremely rare but expected adverse reaction following COVID-19 vaccination. Although axillary lymphadenopathy is more common, cases of supraclavicular lymphadenopathy have also been reported after widespread vaccination against COVID-19. Ultrasonography examinations were performed on seven patients with no previous pathological conditions, who presented to our radiology department after receiving the Pfizer-BioNTech COVID-19 vaccine. Bilateral axillary, supraclavicular and subclavicular lymph node stations were explored. These patients typically present with enlarged hypoechoic lymph nodes with the loss of fatty hilum, asymmetric or diffuse cortical thickening, and increased hilar and cortical vascularization on the color doppler ultrasonography of the ipsilateral axillary and supraclavicular regions. Radiologists and clinicians should be aware of the ultrasonographic features of these lymph nodes and should inform the patient that these lymph nodes are often a self-limiting process. Thus, unnecessary axillary lymph node biopsies should be avoided, and patients should be treated conservatively.

Keywords

COVID-19, mRNA vaccine, Supraclavicular, Lymphadenopathy, Ultrasonography

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