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Axillary Lymph Node Anatomy – After Covid 19 Vaccine

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Our next case is a 41-year-old woman with a

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recent diagnosis of right breast cancer, and her

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MRI was for evaluation of the extent of disease, and

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another important fact was that she had a recent

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COVID-19 vaccine administered to her left arm.

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So, taking a look at this patient,

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this is the T1 non-fat-saturated

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image, which I like for the evaluation of

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lymph nodes, and this patient was scanned

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with her just incidentally scanned with

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her arms down, so you can see her pectoralis

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muscle kind of goes out here laterally.

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When the arms are up, this forms more of

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a triangle, and you don't see this lateral

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extent, so she was scanned with her arms down.

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And we can see, starting from the lower axilla,

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there are a few lymph nodes like this one.

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So there's a little C-shaped

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lymph node with central fat.

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So, level one lymph node,

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and then going up, now we're

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getting posterior to the pectoralis.

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We have a couple of lymph nodes here that

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are high up, and there's even one, it's

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hard to see because it's right at the top

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of our scan, but there's one that's clearly

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medial to the pectoralis minor, and that

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would be considered a level three lymph node.

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So, I just wanted to show you those.

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And this is a patient who did receive her COVID

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vaccine on the left side, which is probably

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why her lymph nodes are a little bit more

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prominent when you compare it to the right side.

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35 00:01:48,320 --> 00:01:51,450 She really doesn't have prominent

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lymph nodes on the right side.

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We can also look at these lymph nodes on post.

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Well, you can look at them

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a number of different ways.

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We can see them on STIR images, all these

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little bright dots here are lymph nodes.

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There's that larger C-shaped one, and

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these kind of larger ones behind the

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pect minor and medial to the pect minor.

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And you can look at them on source

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or post-contrast images. There's post-

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contrast image showing a level one

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lymph node, and then kind of going up,

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there's that row that's posterior

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to the pectoralis minor.

Report

Description

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

MRI

Breast

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