A 29-year-old female subject underwent US examination 3 days after receiving the second dose of Pfizer-BioNTech vaccine, due to the rapid occurrence of a palpable lump at the level of the left axilla (same site of vaccine injection), along with fatigue. Multiple, round, hypoechoic axillary lymph nodes (maximum diameter 11 × 10 mm) with no fatty hilum and mild hilar vascularization. Shear-wave elastography revealed a soft consistence (mean values between 6 and 19 kPa). Follow-up US examination performed 5 weeks after the second dose only showed a reduction in lymph node size (maximum diameter 9 × 6 mm) (Fig. ). No pathological lymph nodes were found in both ipsilateral and contralateral supra/subclavicular and cervical stations as well as in the contralateral axilla.
A 30-year-old woman with the onset of fever, myalgia and left armpit pain ipsilateral to vaccine injection after the first dose underwent US examination 5 days later. Multiple axillary lymphadenopathies (maximum diameter 15 × 10 mm) with round to oval shape, poor hilar representation, thickened cortex and increased vascularization at color-Doppler were found. No pathological lymph nodes were found in ipsilateral supra and subclavicular lymph node stations as well as in lymph nodes contralateral to the site of vaccine injection.\nUS follow-up performed 4 weeks later showed stable lymph node size with restored fatty hilum as well as reduced cortical thickness and vascularization (Fig. ).