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CASE SNIPPET
Year : 2021  |  Volume : 67  |  Issue : 3  |  Page : 180-181

Supraclavicular lymphadenopathy secondary to COVID-19 BNT162b2 vaccine


1 Department of Medicine, Hospital General de Castellon, Castellon, Spain
2 Department of Ophthalmology, Hospital of Vinaros, Castellon, Spain

Date of Submission17-Mar-2021
Date of Decision24-Mar-2021
Date of Acceptance02-Jun-2021
Date of Web Publication13-Aug-2021

Correspondence Address:
M Manuel Roca
Department of Ophthalmology, Hospital of Vinaros, Castellon
Spain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpgm.JPGM_254_21

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How to cite this article:
Roca B, Rambla M, Roca M M. Supraclavicular lymphadenopathy secondary to COVID-19 BNT162b2 vaccine. J Postgrad Med 2021;67:180-1

How to cite this URL:
Roca B, Rambla M, Roca M M. Supraclavicular lymphadenopathy secondary to COVID-19 BNT162b2 vaccine. J Postgrad Med [serial online] 2021 [cited 2021 Nov 28];67:180-1. Available from: https://www.jpgmonline.com/text.asp?2021/67/3/180/323980




As COVID-19 vaccines are being authorized and recommended for use worldwide, it is important to understand what is known about them, particularly in terms of effectiveness and safety.[1] Common side-effects from these vaccines include mild grade fever, fatigue, headache, myalgia, and pain at the injection site,[2] but information available about them is still limited. Herein we report a patient who presented with supraclavicular reactive lymphadenopathies after receiving the COVID-19 BNT162b2 vaccine (Pfizer-BioNTech).

A previously healthy 29-year-old woman presented with a two-day history of mild discomfort and a lump in her left supraclavicular region. Seven days earlier she had received the first dose of above mentioned COVID-19 vaccine in ipsilateral deltoid muscle. On examination she was in good health. Two lymphadenopathies, 1.5 cm and 1 cm in diameter respectively, were noted in her left supraclavicular region [Figure 1]. Mild pain on pressure was also present in the vaccine injection site.
Figure 1: Lymphadenopathies in the left supraclavicular region

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Her routine investigations, including blood cell counts, biochemistry and serologies, was normal. Chest radiograph was normal. Ultrasound examination disclosed two left supraclavicular lymphadenopathies [Figure 2] with no other abnormalities found in the neck or axillary regions. As the patient was otherwise asymptomatic, she uneventfully received the second dose of the same COVID-19 vaccine, 21 days after the first dose. She required no specific treatment. The lymphadenopathies progressively diminished in size and finally disappeared over the next few weeks.
Figure 2: Lymphadenopathies in the left supraclavicular region

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Lymphatic vessels from the deltoid region drain in the axillary and supraclavicular lymph nodes, and both axillary and supraclavicular lymphadenopathies have been previously described as side effect of different vaccines.[3],[4] Recently two other cases of reactive lymphadenopathies following COVID-19 vaccinations, presenting as a lump in the neck, have been reported.[5] But this a barely known side effect of COVID-19 vaccines.[2] Since a diagnosis of malignancy is considered in patients presenting with left supraclavicular lymphadenopathies, awareness of this side effect of COVID-19 vaccines is particularly important to avoid unnecessary evaluation and reduce anxiety of affected patients.[6]

Declaration of patient consent

The authors certify that appropriate patient consent was obtained.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
 :: References Top

1.
Wu CP, Adhi F, Culver D. Vaccination for COVID-19: Is it important and what should you know about it? Clevel Clin J Med 2021 (in press).  Back to cited text no. 1
    
2.
Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403-16.  Back to cited text no. 2
    
3.
Pereira MP, Flores P, Neto AS. Neck and supraclavicular lymphadenopathy secondary to 9-valent human papillomavirus vaccination. BMJ Case Rep 2019;12:e231582.  Back to cited text no. 3
    
4.
Toy H, Karasoy D, Keser M. Lymphadenitis caused by H1N1 vaccination: Case report. Vaccine 2010;28:2158-60.  Back to cited text no. 4
    
5.
Mitchell OR, Dave R, Bekker J, Brennan PA. Supraclavicular lymphadenopathy following COVID-19 vaccination: An increasing presentation to the two-week wait neck lump clinic? Br J Oral Maxillofac Surg 2021;59:384-5.  Back to cited text no. 5
    
6.
Lehman CD, D'Alessandro HA, Mendoza DP, Succi MD, Kambadakone A, Lamb LR. Unilateral lymphadenopathy after COVID-19 vaccination: A practical management plan for radiologists across specialties. J Am Coll Radiol 2021;18:843-52.  Back to cited text no. 6
    


    Figures

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