"1. Introduction
Axillary and cervical lymphadenopathy related to recent vaccination is a well-known event following vaccines such as those for smallpox, influenza, human papilloma virus and other vaccines. More recently, COVID-19 vaccination was identified as a cause of inflammatory unilateral axillary and cervical adenopathy. The median duration of adenopathy reported after mRna-1273 (Moderna) and BNT162b2 (Pfizer) vaccine administration ranges from 1–2 days to approximately 10 days in duration; however, in some cases, the lymphadenopathies persisted for more than 1 month after vaccination. The differential diagnosis of lymphadenopathies reactive with other types of lymphadenopathies, such as lymphoma, is very important. Generally, post-vaccine-reactive lymphadenopathy shows a progressive decrease within a number of days after vaccination.
Herein, we discuss a case of right axillary lymphadenopathy developed 10 days following the third dose of BNT162b2 vaccination, which was suspected to be a reactive lymphadenopathy. However, the mass gradually enlarged, and a biopsy of the nodule demonstrated non-Hodgkin lymphoma (NHL). In addition, we performed a review of the literature, and here, we report the results of this review...
4. Results of the Literature Revision
Eight patients who developed NHL after COVID-19 vaccination were identified, including four males and four women. Five patients were vaccinated with the BNT162b2 vaccine (Pfizer), one with the ChAdOx1 nCOV-19 vaccine (AstraZeneca, Cambridge, UK), one with mRNA-1273/Spikevax (ModernaTX) and one patient with the recombinant replication-incompetent adenovirus type 26 (Ad26) viral-vector-based COVID-19 vaccine (Janssen Pharmaceuticals, Beerse, Belgium). Five patients had B-cell lymphoma and three had T-cell lymphoma, while four patients were diagnosed with diffuse large-B-cell lymphoma (DLBCL)...
5. Discussion
The majority of the cases described above and the case of our patient reported here showed similar features, including the short time between vaccination and the development of lymphoma, ranging from 1 to 10 days; the pathologic feature, being B-cell lymphoma in 5/8 cases; and the large dimensions of the lymphadenopathy, ranging from 4 to 6 cm. To the best of our knowledge, this is the first review of malignant lymphoma diagnosed shortly after COVID-19 vaccination. Previous reports showed a progression or pseudo-progression of the disease in patients with a pre-existing lymphoma."
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