Table 4.

Findings from non-COVID-19 vaccine-associated lymphadenopathy. BCG, bacillus Calmette–Guérin; HPV, human papillomavirus; JEV, Japanese encephalitis virus.

Author (Year and Country of Publication)	Type of Publication	Type of Vaccine	Key Findings
Aelami et al. (2015, Iran)	Retrospective	BCG	A total of 12/13 (92.3%) biopsies or aspirations of distant lymph nodes showed presence of granuloma and/or acid-fast bacilli.
Barouni et al. (2003, Brazil)	Case report	BCG	A 2-year-old male with BCG vaccination at 1 month of age developed lymphadenopathy secondary to atypical tuberculosis. Lymph node aspirates showed presence of atypical tuberculosis.
Biers et al. (2007, UK)	Case report	BCG	A 64-year-old male that received intravesical BCG for urothelial carcinoma developed solitary iliac lymphadenopathy. Biopsy showed granulomatous inflammation.
Gupta et al. (1996, India)	Retrospective	BCG	A total of 112 cases of BCG lymphadenitis with fine-needle aspiration that showed caseating granulomatous inflammation.
Pal et al. (2015, India)	Prospective	BCG	A total of 30 cases of BCG lymphadenitis with needle aspiration smears showing caseating granulomatous inflammation and reactive hyperplasia.
Wang et al. (2019, Taiwan)	Case report	BCG	A 2-year-old female with left axillary lymphadenopathy and caseating granulomatous inflammation seen on excision biopsy.
Dotlic et al. (2012, Croatia)	Case report	BCG and Hepatitis B	A 2-week-old male with inguinal lymphadenopathy after receiving both vaccines at birth. Excision biopsy showed caseating granulomatous inflammation and hyperimmune post-vaccinal reaction involving an atypical T cell proliferation.
Toy et al. (2010, Turkey)	Case report	H1N1	A 23-year-old male with a left supraclavicular painful lymphadenopathy received H1N1 vaccination one week prior to admission. The lymph node was resected and showed post-vaccinal lymphadenitis with CD30-positive immunoblasts, as well as unusually large immunoblasts resembling Hodgkin cells.
Pereira et al. (2019, Portugal)	Case series	HPV 9-valent	An 11-year-old male with inferior cervical and supraclavicular lymphadenopathy that received HPV 9-valent vaccine in the previous week. He subsequently underwent biopsy of the two largest lymph nodes, that showed follicular lymphoid hyperplasia and parafollicular hyperplasia.
Watanabe et al. (2012, Japan)	Case report	HPV and JEV	A 14-year-old female with bilateral tender cervical lymphadenopathy who received HPV and JEV vaccine three days prior. Excision biopsy showed Kikuchi–Fujimoto disease.
Dorfman et al. (1966, USA)	Case report	Measles	An 11-month-old female with left inguinal lymphadenopathy that received a measles vaccine 13 days prior. The resected lymph nodes showed lymphoid hyperplasia.
Sumaya et al. (1976, USA)	Case report	Rubella	A 6-year-old male with painless cervical lymphadenopathy that enlarged after he was vaccinated with HPV-77 DK/5 rubella vaccine. Biopsies showed sinus histiocytosis with massive lymphadenopathy.
White et al. (2012, USA)	Case report	Tetanus	A 50-year-old female with left supraclavicular lymphadenopathy 72 h after she was given the booster dose of tetanus toxoid. Excision biopsy showed sheets of small-to-medium-sized atypical lymphocytes with a flow cytometry analysis interpretation of atypical T cell population co-expressing CD4 and CD8. This was initially reported as a T cell lymphoproliferative disorder. However, after a review, this was reported as ‘pseudolymphomatous’ florid proliferation of CD4 T cells in response to the vaccine.
Hartsock et al. (1967, USA)	Retrospective	Smallpox, cholera, typhus, tetanus, diphtheria, pertussis, Salk (polio), influenza	A total of 20 cases of post-vaccinal lymphadenitis, with 9 cases initially diagnosed as lymphoma. All 20 cases showed a diffuse, follicular, or combined diffuse and follicular hyperplasia, an increased number of reticular lymphoblasts, vascular and sinusoidal changes, and mixed inflammatory response with a variable number of eosinophils, plasma cells, and mast cells.