right supraclavicular lymph node swollen

The patient's pain in the left supraclavicular region resolved. Ultrasonography was performed four days after the second vaccination, which was a one-week follow-up of the first ultrasound. The patient detected newly developed palpable lesions in the right supraclavicular area a day after the vaccination. The patient completed the second dose of COVID-19 vaccination on the right arm.

The patient was advised to take nonsteroidal anti-inflammatory drugs for pain control and to get the second vaccination on the contralateral right arm. She did not have any other adverse reaction including fever, chills, or myalgia following the vaccination. Therefore, we considered that the supraclavicular lymphadenopathy occurred 10 days after the vaccination as an adverse reaction following immunization. (E and F) Another one-week follow-up sonography showed further decreased size (measuring 0.8 × 0.3 cm and 0.5 × 0.3 cm, respectively) of the nodes with normalization of cortical thickness and some identifiable fatty hilum (marked arrow in E).įurther investigation revealed that the patient had received an intramuscular administration of COVID-19 vaccine (Pfizer–BioNTech) on her left arm 17 days before detecting palpable lymph nodes in the left supraclavicular region, where she had been experiencing discomfort for a week. (C and D) One-week follow-up sonography showed decreased size (measuring 0.8 × 0.4 cm and 0.7 × 0.5 cm, respectively) and decreased extent of perinodal fat hyperechogenicity of the lymph nodes. (A and B) Ultrasonography performed on the left supraclavicular region 18 days after the first dose of vaccination demonstrated multiple enlarged (measuring 1.2 × 0.7 cm and 0.9 × 0.7 cm, respectively), cortically thickened lymph nodes with loss of normal fatty hilum and an ill-defined border with perinodal fat hyperechogenicity (marked arrows in B). Left supraclavicular lymphadenopathy that developed 10 days after the first dose of Pfizer–BioNTech COVID-19 vaccine in the left arm. Pathological results showed reactive inflammatory signs with predominant small mature T-lymphoid cells with small mature B-lymphoid cells and a negative Epstein–Barr virus-encoded small RNA result. The lymph nodes were mobile while performing the biopsy. Ultrasonography-guided core needle biopsy of the supraclavicular lymph nodes was performed. Possibility of lymphadenitis and even Kikuchi disease was suggested considering that the patient was an Asian female and there was unilateral nodal involvement at level V. Several (≤five) normal lymph nodes with small size (<0.5 cm in short-axis diameter) and without abnormal morphology were observed in bilateral axillae, more of them on the left side. There were no abnormal lymph nodes in the right supraclavicular area or other lymph node levels of the neck. The lymph nodes were round (short-axis/long-axis ratio greater than 0.5) and showed a thickened cortex with loss of normal fatty hilum and an ill-defined border with perinodal fat hyperechogenicity ( Fig. Ultrasonography revealed multiple (>five) lymph nodes, which had a short-axis diameter of 0.7 cm or less, at level V (posterior triangle) of her left neck, especially in the supraclavicular area. She did not have any prior medical history including cancer. The patient had swelling local inflammatory symptoms and tenderness, but no systemic symptoms such as fever or malaise. She had been complaining of discomfort in the left lateral and posterior neck for a week. A 36-year-old female patient visited our hospital due to palpable lesions in the left supraclavicular area.

Right supraclavicular lymph node swollen