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Guidelines Provided for Unilateral Lymphadenopathy After COVID-19 Vaccination

FRIDAY, March 12, 2021 -- In a report published online March 4 in the Journal of the American College of Radiology, guidelines are provided for the management of unilateral axillary lymphadenopathy (UAL) identified on imaging tests in the context of COVID-19 vaccination.

Helen Anne D'Alessandro, M.D., from Massachusetts General Hospital in Boston, and colleagues present guidance for the management of UAL in individuals undergoing imaging tests for diverse medical reasons.

The authors note that providers and radiologists should be aware that UAL may be identified on diverse imaging examinations in patients recently vaccinated for COVID-19. On all intake forms, vaccination information should be documented (date, vaccination site, type of vaccine); this information should be accessible for radiologists at the time of exam interpretation. Ipsilateral UAL after recent (within the last six weeks) COVID-19 vaccination is a benign imaging finding in most clinical settings, and clinical follow-up is recommended rather than additional imaging or biopsy. A coordinated management plan is recommended in settings with a heightened pretest probability of malignancy, including additional imaging, short-interval follow-up, and biopsy; providers should be aware of a patient's vaccination history and risk for metastatic lymphadenopathy. To avoid delays to vaccination and recommended imaging for optimal health care, clear guidelines should be communicated to patients and providers.

"Advanced planning can support our patients to feel confident and safe to receive their vaccinations as well as undergo recommended imaging in their usual care," a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical, medical device, and medical technology industries.

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