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Vaccine-induced axillary lymphadenopathy (breast MRI)

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

BRCA 1 carrier, yearly MRI breast screening. Yellow fever vaccination 10 days prior to scan via injection in the right arm.

Patient Data

Age: 35 years
Gender: Female

Dynamic scans with IV gadolinium show gross level 1, 2 and 3 right axillary lymphadenopathy with smaller left sided axillary lymphadenopathy. Breasts are normal.

Case Discussion

Yellow fever vaccine is a weakened live virus and is associated with systemic flu-like symptoms. Lymphadenopathy can occur. Follow-up ultrasound and biopsy of these lesions after 2 weeks showed reduced size of the nodes and "reactive" change on cytology. It is important to obtain a complete history or even talk with the patient when interpreting any radiological examination in order to avoid false positive results.

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