Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Hodgkin's Lymphoma: Diagnostic Challenge during COVID Vaccination

Benign metabolic uptake on fluorine-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) is not uncommonly seen after immunization. We report a case of 30-year-old man with Hodgkin's lymphoma who underwent two cycles of chemotherapy. Interim (18)F-FDG PET/computed tomography demonstrated complete metabolic response of prior hypermetabolic bilateral supraclavicular and mediastinal lymph nodes. Although multiple new normal-sized hypermetabolic left axillary and subpectoral lymph nodes are noted, relevant history revealed COVID vaccine 7 days prior scan with mild FDG uptake at the left deltoid muscle. These new findings at the left axilla are likely related to recent vaccination. (18)F-FDG PET uptake in the lymph nodes is not so uncommon after immunization; relevant history is very important especially in the phase of massive immunization to avoid false interpretation.