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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 3 min.
1 topic, 7 min.
6 topics, 21 min.
9 topics, 19 min.
Circumscribed Mass – Intramammary Lymph Node
2 m.Circumscribed Mass – Fibroadenoma
2 m.Increasing Oval Circumscribed Mass on Ultrasound
2 m.Breast Clustered Microcyst
2 m.Complicated Breast Cyst
2 m.Complicated Cyst that Resolved on Ultrasound
2 m.Axillary Adenopathy Post Covid Vaccine
3 m.Evolving Fat Necrosis (Post Breast Reduction)
2 m.BI-RADS 3 Indications on Ultrasound – Summary
7 m.7 topics, 19 min.
Circumscribed Breast Fibroadenoma on MRI
6 m.Dominant Focus on Breast MRI without T2 Hyperintensity
3 m.Enhancing Dominant/Unique Focus on Breast MRI - Companion Case
2 m.Focal NME (Non-Mass Enhancement) on Breast MRI
3 m.Fat Necrosis on Breast MRI
2 m.BI-RADS 3 Indications on MRI – Summary
5 m.BI-RADS 3 – Conclusion
2 m.0:00
This was a screening mammogram that was performed on a patient who had
0:05
a COVID 19 vaccine one week previously. The vaccine was done in the
0:10
right arm and on her MLO view, we noticed that there was what looked
0:16
like an enlarged lymph node that's partially visualized up here in the right
0:20
axilla. So the patient was given a BI RADS 0 and recommended to
0:25
come back for a diagnostic ultrasound exam. These are the images from the
0:30
ultrasound. So we do see this lymph node,
0:34
which has some cortical thickening measuring up to four millimeters. Three
0:40
millimeters is typically our cutoff for a lymph node.
0:45
Because this was so soon after her COVID 19 vaccine, we followed the
0:50
SBI recommendation and recommended for her to come back for
0:54
a short term follow up to see if this resolved.
0:59
When she came back, this was right at 12 weeks after her second
1:03
vaccine. So we would expect the vaccine related adenopathy to resolve.
1:10
We actually saw that the lymph node had gotten a little bit bigger.
1:20
So now that, again, we see some of the cortical thickening
1:26
measuring up to five or six millimeters and it looks like there's actually
1:30
some eccentric cortical thickening here. This was then recommended for a
1:35
biopsy and patient was diagnosed with CLL. This is unusual to have unilateral
1:43
adenopathy with CLL, but it can happen. And this is a reason that
1:47
we want to make sure we're following these patients to resolution of adenopathy,
1:51
even when we think it's possibly related to the timing of a COVID
1:55
vaccine. So this was a patient who was recalled from screening mammogram
2:00
for axillary adenopathy. We did see some cortical thickening on her follow
2:05
up. We thought because of the timing, so close to her COVID vaccine,
2:10
it was likely reactive. Did not resolve at the 12 week follow up appointment
2:15
and biopsy did show CLL. So this is just a good reminder and
2:21
this is a new topic and may be evolving, but this is what
2:25
the current guidelines are recommending that we do.
Interactive Transcript
0:00
This was a screening mammogram that was performed on a patient who had
0:05
a COVID 19 vaccine one week previously. The vaccine was done in the
0:10
right arm and on her MLO view, we noticed that there was what looked
0:16
like an enlarged lymph node that's partially visualized up here in the right
0:20
axilla. So the patient was given a BI RADS 0 and recommended to
0:25
come back for a diagnostic ultrasound exam. These are the images from the
0:30
ultrasound. So we do see this lymph node,
0:34
which has some cortical thickening measuring up to four millimeters. Three
0:40
millimeters is typically our cutoff for a lymph node.
0:45
Because this was so soon after her COVID 19 vaccine, we followed the
0:50
SBI recommendation and recommended for her to come back for
0:54
a short term follow up to see if this resolved.
0:59
When she came back, this was right at 12 weeks after her second
1:03
vaccine. So we would expect the vaccine related adenopathy to resolve.
1:10
We actually saw that the lymph node had gotten a little bit bigger.
1:20
So now that, again, we see some of the cortical thickening
1:26
measuring up to five or six millimeters and it looks like there's actually
1:30
some eccentric cortical thickening here. This was then recommended for a
1:35
biopsy and patient was diagnosed with CLL. This is unusual to have unilateral
1:43
adenopathy with CLL, but it can happen. And this is a reason that
1:47
we want to make sure we're following these patients to resolution of adenopathy,
1:51
even when we think it's possibly related to the timing of a COVID
1:55
vaccine. So this was a patient who was recalled from screening mammogram
2:00
for axillary adenopathy. We did see some cortical thickening on her follow
2:05
up. We thought because of the timing, so close to her COVID vaccine,
2:10
it was likely reactive. Did not resolve at the 12 week follow up appointment
2:15
and biopsy did show CLL. So this is just a good reminder and
2:21
this is a new topic and may be evolving, but this is what
2:25
the current guidelines are recommending that we do.
Report
Description
Faculty
Emily B. Ambinder, MD
Assistant Professor - Breast Imaging Division
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine
Tags
Women's Health
Ultrasound
Non-infectious Inflammatory
Neoplastic
Mammography
Breast
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