A Transient Inflammatory Reaction with a B-Cell Lymphoid Infiltrate and Dysplastic Bone Marrow Changes Associated with the BNT162b2 COVID-19 Vaccine

  • Daniella Vronsky Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
  • Shimrit Hershkowitz Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
  • Alon Hershko Department of Medicine, Hadassah University Hospital, Jerusalem, Israel; Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
  • Noa Eliakim-Raz Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Keywords

SARS-CoV-2, COVID-19 vaccine, lymphoma-like reaction

Abstract

COVID-19 vaccines were introduced soon after the COVID-19 pandemic emerged in 2020. Various side effects were reported worldwide, including several types of common systemic side effects such as fever and general fatigue. Reports of other rare manifestations also emerged. We report the case of an adult male with a rare systemic syndrome mimicking lymphoma after he had received the first dose of an mRNA-based COVID-19 vaccine. After nearly 6 months of investigation with suspicion for an infection or malignancy, all symptoms resolved, laboratory tests normalized, and imaging showed no sign of active disease.

VIEW THE ENTIRE ARTICLE

References

  • Haidar G, Singh N. Fever of unknown origin. N Engl J Med 2022 Feb 3;386(5):463–477.
  • Baden LR, Sahly HME, 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;384:403–416.
  • Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020;383:2603–2615.
  • Faermann R, Nissan N, Halshtok-Neiman O, Shalmon A, Gotlieb M, Yagil Y, et al. COVID-19 vaccination induced lymphadenopathy in a specialized breast imaging clinic in Israel: analysis of 163 cases. Acad Radiol 2021 Sep;28(9):1191–1197.
  • Placke JM, Reis H, Hadaschik E, Roesch A, Schadendorf D, Stoffels I, et al. Coronavirus disease 2019 vaccine mimics lymph node metastases in patients undergoing skin cancer follow-up: a monocentre study. Eur J Cancer 2021 Sep;154:167–174.
  • Schroeder DG, Jang S, Johnson DR, Takahashi H, Navin PJ, Broski SM, et al. Frequency and characteristics of nodal and deltoid FDG and 11C-choline uptake on PET performed after COVID-19 vaccination. AJR Am J Roentgenol 2021 Nov;217(5):1206–1216.
  • National Comprehensive Cancer Network. COVID-19 resources. Available from: https://www.nccn.org/covid-19 (accessed 26 Feb 2022).
  • Society of Breast Imaging. COVID-19 resources. Available from: https://www.sbi-online.org/RESOURCES/COVID-19Resources.aspx (accessed 26 Feb 2022).
  • Weiss LM, O’Malley D. Benign lymphadenopathies. Mod Pathol 2013 Jan;26(1):S88–96.
  • Tintle S, Chen M. Lymphadenopathy with florid lymphoid and Langerhans cell hyperplasia and hemophagocytosis mimicking lymphoma after COVID-19 mRNA vaccination. EJHaem 2021;2(4):845–847.
  • Baek DW, Hwang S, Kim J, Lee JM, Cho HJ, Moon JH, et al. Patients presenting high fever with lymphadenopathy after COVID-19 vaccination were diagnosed with hemophagocytic lymphohistiocytosis. Infect Dis (Lond) 2022 Apr;54(4):303–307.
  • Cory P, Lawrence H, Abdulrahim H, Mahmood-Rao H, Hussein A, Gane J. Lessons of the month 3: Haemophagocytic lymphohistiocytosis following COVID-19 vaccination (ChAdOx1 nCoV-19). Clin Med 2021 Nov 1;21(6):e677–679.
  • Caocci G, Fanni D, Porru M, Greco M, Nemolato S, Firinu D, et al. Kikuchi-Fujimoto disease associated with hemophagocytic lymphohistiocytosis following the BNT162b2 mRNA COVID-19 vaccination. Haematologica 2022 May 1;107(5):1222–1225.
  • Soub HA, Ibrahim W, Maslamani MA, Ali GA, Ummer W, Abu-Dayeh A. Kikuchi-Fujimoto disease following SARS CoV2 vaccination: case report. IDCases 2021 Aug 10;25:e01253.
  • Tan HM, Hue SSS, Wee A, See KC. Kikuchi–Fujimoto disease post COVID-19 vaccination: case report and review of literature. Vaccines (Basel) 2021 Oct 29;9(11):1251.
  • Podugu A, Kobe M. Kikuchi-Fujimoto disease (KFD): a rare cause of fever and lymphadenopathy following influenza vaccination. CHEST 2013 Oct 1;144(4):230A.
  • Watanabe T, Hashidate H, Hirayama Y, Iinuma Y. Kikuchi-Fujimoto disease following vaccination against human papilloma virus infection and Japanese encephalitis. Eur J Pediatr 2012 Sep;171(9):1409–1411.
  • Published: 2022-06-27

    Issue: 2022: Vol 9 No 6 (view)

    Section: Articles

    How to cite:
    1.
    Vronsky D, Hershkowitz S, Hershko A, Eliakim-Raz N. A Transient Inflammatory Reaction with a B-Cell Lymphoid Infiltrate and Dysplastic Bone Marrow Changes Associated with the BNT162b2 COVID-19 Vaccine. EJCRIM 2022;9 doi:10.12890/2022_003381.

    Most read articles by the same author(s)