Vaccine associated hypermetabolic axillary lymphadenopathy after COVID-19 vaccination: a systematic review

Abstract

Vaccinations against COVID-19 are frequently given intramuscularly to the arm. After receiving the COVID-19 vaccine, axillary lymphadenopathy has been documented as an adverse reaction. The occurrence of ipsilateral (or contralateral) lymphadenopathy in individuals with breast cancer who got the COVID-19 immunization creates a diagnostic conundrum. This systematic study aims to assess the prevalence and clinical features of vaccine associated hypermetabolic axillary lymphadenopathy (VAHL) after COVID-19 vaccination. The PRISMA protocol was followed in conducting the systematic review. "Vaccine" or "vaccination" and "lymphadenopathy" or "lymph node" and "COVID-19" were the search phrases used. Using the predefined keywords from the systematic review procedure, 33 papers or reports were found. After irrelevant materials (such as regulations, reviews, opinions, and critiques) were eliminated, ten articles or reports were included in the evaluation. After receiving the COVID-19 vaccine, 91/22,532 cases (0.4% of cases overall) of clinically detectable lymphadenopathy were found. The axillary lymphadenopathy linked with the vaccination had a mean size of 18.2 mm (range 16–21 mm). The median time between receiving a vaccine and developing axillary lymphadenopathy was 6.9 days (range 2–18 days). 119-patient research found that enlarged axillary lymphadenopathy clears up in 4 to 5 weeks. Axillary lymphadenopathy linked to vaccines is relatively prevalent. Its management is based on a multidisciplinary assessment considering the patient's demographics, immunization history, and radiological findings. Additional imaging and biopsies can increase the demand for healthcare services. Proper timing and lateral arrangement of immunization and imaging should be encouraged to prevent ambiguity and patient concern.