Table 1.
Pooled analysis. CL, clinical lymphadenopathy; SLDI, subclinical lymphadenopathy detected on imaging; SD, standard deviation; N, number of; NET, neuroendocrine tumor; RCC, renal cell carcinoma; US, ultrasound; PET/CT, positron emission tomography/computed tomography; MRI, magnetic resonance imaging; KFD, Kikuchi–Fujimoto Disease; FNA, fine-needle aspiration.
| Total | CL | SLDI | ||||
|---|---|---|---|---|---|---|
| Overall | Reactive Changes or Negative for Malignancy |
Florid Lymphoid Hyperplasia |
Kikuchi–Fujimoto Disease | Overall | ||
| Number of patients | 37 | 18 | 13 | 2 | 3 | 19 |
| Mean age ± SD (years) | 47.8 ± 19.1 | 37.8 ± 15.6 | 44.2 ± 13.1 | 18.0 ± 5.0 * | 23.3 ± 7.5 * | 57.2 ± 17.3 ** |
| Number of females (%) | 23 (62.2) | 9 (50.0) | 7 (53.8) | 1 (50.0) | 1 (33.3) | 14 (73.7) |
| Medical history, n (%) | ||||||
| No history | 9 (24.3) | 9 (50.0) | 7 (53.8) | 1 (50.0) | 1 (33.3) | 0 (0.0) |
| Family history of breast cancer | 2 (5.4) | 2 (11.1) | 2 (11.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Personal history of breast cancer | 7 (18.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 7 (36.8) |
| Personal history of lung cancer | 2 (5.4) | 2 (11.1) | 2 (11.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Personal history of cecum/appendix NET | 2 (5.4) | 1 (5.5) | 1 (5.5) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Personal history of melanoma | 8 (21.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 8 (42.1) |
| Personal history of Merkel cell carcinoma | 2 (5.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (10.5) |
| Personal history of RCC | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Non-neoplastic/malignant history | 3 (8.1) | 3 (16.7) | 0 (0.0) | 1 (50.0) | 2 (66.6) | 0 (0.0) |
| Not reported | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0 | 0 (0.0) | 0 (0.0) |
| Dose and type of last vaccine, n (%) | ||||||
| 1st dose of Pfizer-Bio-Ntech | 13 (35.1) | 7 (38.9) | 6 (46.2) | 0 (0.0) | 1 (33.3) | 6 (31.6) |
| 2nd dose of Pfizer-Bio-Ntech | 7 (18.9) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 6 (31.6) |
| Unspecified dose of Pfizer-Bio-Ntech | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| 1st dose of Moderna | 3 (8.1) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| 2nd dose of Moderna | 3 (8.1) | 2 (11.1) | 1 (7.7) | 1 (50.0) | 0 (0.0) | 1 (5.3) |
| Unspecified dose of Moderna | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| 1st dose of AstraZeneca | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| 2nd dose of AstraZeneca | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| 1st dose of unspecified vaccine | 3 (8.1) | 3 (16.7) | 1 (7.7) | 0 (0.0) | 2 (66.6) | 0 (0.0) |
| 1st dose of Vaxzevria | 2 (5.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (10.5) |
| 2nd dose of CureVac | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Not reported | 1 (2.7) | 1 (5.5) | 0 (0.0) | 1 (50.0) | 0 (0.0) | 0 (0.0) |
| Duration from last vaccination to CL or SLDI, mean ± SD (days) | 14.5 ± 11.0 | 12.5 ± 7.9 | 10.9 ± 6.3 | 10.5 ± 3.5 | 20.7 ± 10.5 * | 16.5 ± 12.9 |
| Laterality of lymphadenopathy compared with site of vaccination, n (%) | ||||||
| Ipsilateral | 23 (62.2) | 10 (55.6) | 9 (69.2) | 1 (50.0) | 0 (0.0) | 13 (68.4) |
| Contralateral | 2 (5.4) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Not reported | 12 (32.4) | 6 (33.3) | 2 (15.4) | 1 (50.0) | 3 (100.0) | 6 (31.6) |
| Site of lymphadenopathy, n (%) | out of 32 | out of 13 | out of 8 | |||
| Cervical | 4 (12.5) | 3 (23.1) | 2 (25.0) | 0 (0.0) | 1 (33.3) | 1 (5.3) |
| Axilla | 18 (56.3) | 4 (30.8) | 1 (12.5) | 1 (50.0) | 2 (66.6) | 14 (73.7) ** |
| Supraclavicular | 7 (21.9) | 6 (46.2) | 5 (62.5) | 1 (50.0) | 0 (0.0) | 1 (5.3) ** |
| Others | 2 (6.3) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Not reported | 5 (15.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 5 (26.3) |
| Additional clinical symptoms aside from lymphadenopathy, n (%) | ||||||
| No other symptoms | 2 (5.4) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Pain | 4 (10.8) | 4 (30.8) | 3 (23.1) | 1 (50.0) | 0 (0.0) | 0 (0.0) |
| Fever | 6 (16.2) | 6 (46.2) | 2 (15.4) | 1 (50.0) | 3 (100.0) | 0 (0.0) |
| Fatigue/malaise | 2 (5.4) | 2 (11.1) | 1 (7.7) | 1 (50.0) | 0 (0.0) | 0 (0.0) |
| Myalgia | 2 (5.4) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Dysphagia | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Chills | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Others | 2 (5.4) | 2 (11.1) | 1 (7.7) | 1 (50.0) | 0 (0.0) | 0 (0.0) |
| Not reported | 24 (64.9) | 5 (27.8) | 5 (38.5) | 0 (0.0) | 0 (0.0) | 19 (100.0) |
| Largest dimension of lymph node, mean ± SD (mm) | 20.8 ± 13.3 | 21.1 ± 14.7 | 22.1 ± 18.2 | 15.5 ± 5.5 | 22.3 ± 7.1 | 19.7 ± 2.9 |
| Imaging modality with abnormal findings, n (%) | ||||||
| US | 11 (29.7) | 7 (38.9) | 7 (53.8) | 0 (0.0) | 0 (0.0) | 4 (21.1) |
| PET/CT | 8 (21.6) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 6 (31.6) |
| CT/MRI | 11 (29.7) | 8 (44.4) | 4 (30.8) | 1 (50.0) | 3 (100.0) | 3 (15.8) |
| Not reported | 10 (27.0) | 2 (11.1) | 1 (7.7) | 1 (50.0) | 0 (0.0) | 8 (42.1) |
| Indication for aspiration or biopsy, n (%) | ||||||
| Suspicion of malignancy | 15 (40.5) | 8 (44.4) | 7 (53.8) | 1 (50.0) | 0 (0.0) | 7 (36.8) |
| Family history of malignancy | 1 (2.7) | 1 (5.5) | 1 (7.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Palpable mass | 2 (5.4) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Suspicion of lymphadenitis and/or KFD | 2 (5.4) | 2 (11.1) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Patient’s preference | 2 (5.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (10.5) |
| Oncologic management | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Not reported | 15 (40.5) | 6 (46.2) | 2 (15.4) | 1 (50.0) | 3 (100.0) | 9 (47.4) |
| Type of procedure, n (%) | ||||||
| FNA | 9 (24.3) | 7 (38.9) | 7 (53.8) | 0 (0.0) | 0 (0.0) | 2 (10.5) |
| Core needle biopsy | 12 (32.4) | 7 (38.9) | 5 (38.5) | 0 (0.0) | 2 (66.6) | 5 (26.3) |
| Excision biopsy | 12 (32.4) | 5 (27.8) | 2 (15.4) | 2 (100.0) | 1 (33.3) | 7 (36.8) |
| Others | 4 (10.8) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 4 (21.1) |
| Not reported | 1 (2.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (5.3) |
| Pathological diagnosis, n (%) | ||||||
| Reactive/negative for malignancy | 28 (75.7) | 13 (72.2) | - | - | - | 15 (78.9) |
| Florid lymphoid hyperplasia | 2 (5.4) | 2 (11.1) | - | - | - | 0 (0.0) |
| Kikuchi–Fujimoto Disease | 3 (8.1) | 3 (16.7) | - | - | - | 0 (0.0) |
| Granulomatous inflammation | 2 (5.4) | 0 (0.0) | - | - | - | 2 (10.5) |
| Metastatic malignancy | 2 (5.4) | 0 (0.0) | - | - | - | 2 (10.5) |
* Statistically significant compared with reactive changes or negative for malignancy; ** statistically significant compared with overall clinical lymphadenopathy.