Hypermetabolic lymphadenopathy following the administration of COVID-19 vaccine and immunotherapy in a lung cancer patient: a case report

Shreya Tripathy, Nathaniel Alvarez, Shubham Jaiswal, Ryan Williams, Munaf Al-Khadimi, Sarah Hackman, William Phillips, Supreet Kaur, Sherri Cervantez, William Kelly, Josephine Taverna

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Given the current climate of the pandemic, lung cancer patients are especially vulnerable to complications from severe acute respiratory syndrome coronavirus 2 infection. As a high-risk population group, these patients are strongly advised to receive coronavirus disease 2019 vaccination in accordance with Center for Disease Control and Prevention guidelines to minimize morbidity and mortality. In recent years, immunotherapy has taken a preeminent role in the treatment of non-small cell lung cancer with dramatic improvement in overall survival. Reactive lymphadenopathy following the administration of a coronavirus disease 2019 vaccination can confound the radiographic interpretation of positron emission tomography–computed tomography or computed tomography scans from lung cancer patients receiving immunotherapy. Case presentation: Here, we present a case of a 61-year-old Caucasian female and former smoker who developed cervical, hilar, supraclavicular, mediastinal, and left retroauricular lymphadenopathy following her coronavirus disease 2019 booster vaccination. At the time, she had been receiving long-term immunotherapy for the treatment of advanced lung adenocarcinoma. Biopsy was pursued owing to concerns of treatment failure and confirmed recurrent malignancy. Conclusion: This case report highlights the importance of lymph node biopsies in lung cancer patients who present with contralateral lymphadenopathy following coronavirus disease 2019 vaccination to rule out tumor recurrence in this deserving patient population.

Original languageEnglish (US)
Article number445
JournalJournal of Medical Case Reports
Issue number1
StatePublished - Dec 2022


  • COVID-19
  • COVID-19 vaccine
  • Case report
  • Lung cancer
  • Lymphadenopathy

ASJC Scopus subject areas

  • General Medicine


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