Non-Hodgkin Lymphoma Developed Shortly after mRNA COVID-19 Vaccination: Report of a Case and Review of the Literature

Luigi Cavanna; Sergio Ottavio Grassi; Livia Ruffini; Emanuele Michieletti; Egidio Carella; Dante Palli; Adriano Zangrandi; Nicola Inzerilli; Patrizia Bernuzzi; Camilla Di Nunzio; Chiara Citterio

doi:10.3390/medicina59010157

Medicina (Jan 2023)

Non-Hodgkin Lymphoma Developed Shortly after mRNA COVID-19 Vaccination: Report of a Case and Review of the Literature

Luigi Cavanna,
Sergio Ottavio Grassi,
Livia Ruffini,
Emanuele Michieletti,
Egidio Carella,
Dante Palli,
Adriano Zangrandi,
Nicola Inzerilli,
Patrizia Bernuzzi,
Camilla Di Nunzio,
Chiara Citterio

Affiliations

Luigi Cavanna: Department of Oncology and Hematology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Sergio Ottavio Grassi: ASST Lodi, 26900 Lodi, Italy
Livia Ruffini: Nuclear Medicine Division, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy
Emanuele Michieletti: Department of Radiology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Egidio Carella: Department of Radiology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Dante Palli: Surgey and Breast Unit, Guglielmo da Saliceto Hospital, Via Taverna 49, 29121 Piacenza, Italy
Adriano Zangrandi: Pathology Unit, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Nicola Inzerilli: Department of Oncology and Hematology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Patrizia Bernuzzi: Department of Oncology and Hematology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Camilla Di Nunzio: Department of Oncology and Hematology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy
Chiara Citterio: Department of Oncology and Hematology, ASL Piacenza, Via Taverna 49, 29121 Piacenza, Italy

DOI: https://doi.org/10.3390/medicina59010157
Journal volume & issue: Vol. 59, no. 1
p. 157

Abstract

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We report on a 66-year-old man who presented with a right axillary lymphadenopathy approximately 10 days after receiving the third dose of the BNT162b2 vaccine. The lymphadenopathy gradually enlarged, and physical examination and ultrasound (US) revealed one right axillary 6.99 cm and one right supraclavicular 2.36 cm lymphadenopathy. Histologic examination of the right axillary nodule revealed anaplastic large-cell lymphoma that was ALK negative and CD30 positive. A total body computerized tomography (CT) scan, positron emission tomography (PET) and bone-marrow biopsy showed a stage-II non-Hodgkin lymphoma (NHL). The patient was treated with chemotherapy and a scheme of Brentuximab Vedotin, Cyclophosphamide, Doxorubicin and Prednisone (BV-CHP) for six cycles and is now well and in complete remission. The revision of the literature revealed eight additional cases of NHL developed shortly after COVID-vaccination. There were four cases of diffuse large-B-cell lymphoma (DLBCL) (one in a patient who was a heart transplant recipient and developed an Epstein–Bar-virus-positive DLBCL), one case of extranodal NK/T-cell lymphoma, one patient with subcutaneous panniculitis-like T-cell lymphoma, one case of marginal zone B-cell lymphoma and one primary cutaneous anaplastic large-cell lymphoma (PC-ALCL). In five cases, the lymphoma developed after BNT162b2 mRNA vaccination, including one case after ChAdOx1 nCOV-19, one case after the adenovirus type 26 (Ad26) vaccine and one after mRNA-1273/Spikevax (ModernaTX). We are aware that the link between COVID-19 vaccination and lymphoma most likely is a chance phenomenon, and that COVID-19 vaccines represent very efficient products for many people around the world. However, we believe that clinical events, even if only temporally associated with novel treatments or novel vaccines, should be reported for the benefit of the patients and the scientific community.

Published in Medicina

ISSN: 1010-660X (Print); 1648-9144 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: https://www.mdpi.com/journal/medicina

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