Subject(s)
Abdominal Pain/etiology , Adrenal Gland Diseases/pathology , Castleman Disease/diagnosis , Edema/pathology , Fever/etiology , Abdominal Pain/diagnosis , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Antineoplastic Agents, Hormonal/administration & dosage , Antineoplastic Agents, Hormonal/therapeutic use , Azetidines/administration & dosage , Azetidines/therapeutic use , Bone Marrow/metabolism , Bone Marrow/pathology , Bortezomib/administration & dosage , Bortezomib/therapeutic use , Castleman Disease/drug therapy , Castleman Disease/pathology , Cyclosporine/administration & dosage , Cyclosporine/therapeutic use , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Drug Therapy, Combination , Fever/diagnosis , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Janus Kinase Inhibitors/administration & dosage , Janus Kinase Inhibitors/therapeutic use , Male , Middle Aged , Purines/administration & dosage , Purines/therapeutic use , Pyrazoles/administration & dosage , Pyrazoles/therapeutic use , Renal Insufficiency/etiology , Reticulin , Sulfonamides/administration & dosage , Sulfonamides/therapeutic use , Thrombocytopenia/etiologyABSTRACT
ABSTRACT: Vaccinations can cause hypermetabolic axillary lymphadenopathy on FDG PET. We present the case of a 71-year-old man who underwent FDG PET/CT for melanoma staging 6 days following a COVID (coronavirus disease) vaccination. Imaging showed a prominent intramuscular mass at the vaccination site, in addition to extensive axillary lymphadenopathy. The mass was compatible with a hematoma at the vaccination site, and the lymphadenopathy was most likely reactive. This case demonstrates unconventional findings in response to a routine vaccination event-findings that, in light of current world events, are likely to be routinely encountered on PET imaging and that should be recognized reactive rather malignant.
Subject(s)
COVID-19 Vaccines/adverse effects , Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography , Vaccination , Aged , Humans , Male , Melanoma/diagnostic imaging , Melanoma/immunologyABSTRACT
PURPOSE OF REVIEW: Summarize recent recommendations on clinical management of adults and youth with elevated lipoprotein(a) [Lp(a)] who are at-risk of or affected by cardiovascular disease (CVD). RECENT FINDINGS: There is ample evidence to support elevated Lp(a) levels, present in approximately 20% of the general population, as a causal, independent risk factor for CVD and its role as a significant risk enhancer. Several guidelines and position statements have been published to assist in the identification, treatment and follow-up of adults with elevated levels of Lp(a). There is growing interest in Lp(a) screening and strategies to improve health behaviors starting in youth, although published recommendations for this population are limited. In addition to the well established increased risk of myocardial infarction, stroke and valvular aortic stenosis, data from the coronavirus pandemic suggest adults with elevated Lp(a) may have a particularly high-risk of cardiovascular complications. Lp(a)-specific-lowering therapies are currently in development. Despite their inability to lower Lp(a), use of statins have been shown to improve outcomes in primary and secondary prevention. SUMMARY: Considerable differences exist amongst published guidelines for adults on the use of Lp(a) in clinical practice, and recommendations for youth are limited. With increasing knowledge of Lp(a)'s role in CVD, including recent observations of COVID-19-related risk of cardiovascular complications, more harmonized and comprehensive guidelines for Lp(a) in clinical practice are required. This will facilitate clinical decision-making and help define best practices for identification and management of elevated Lp(a) in adults and youth.