Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination: A case report and review of literature

Figure 1 Clinical course of the patient. HCC: Hepatocellular carcinoma; HSLR: Hepatic sarcoidosis-like reaction.

Figure 2 Image findings. A: Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) finding, 1 cm defect in S5 at the hepatobiliary phase (white arrow); B: EOB-MRI finding, 1 cm hyperintensity in S5 on diffusion weighted imaging (white arrow); C: EOB-MRI finding, 1 cm hypointensity in S5 on apparent diffusion coefficient map (white arrow); D: Computed tomography (CT) finding, no nodule in S5; E: Contrast-enhanced CT (CECT) finding, 1 cm hypervascular nodule in S5 at the early phase; F: CECT finding, 1 cm delayed contrast enhancement at the late phase; G: Plain ultrasound (US) finding, 1 cm iso-hyperechoic nodule in S5 (reference with EOB-MRI), hepatobiliary phase (white arrow); H: Contrast-enhanced US finding, Incomplete defect in S5 at the late vascular phase (reference with EOB-MRI), hepatobiliary phase (white arrow); I: MRI finding, disappearance of the defect in S5 at the hepatobiliary phase.

Figure 3 Histopathological findings. A: Hematoxylin and eosin (HE) staining, low magnification Noncaseating hepatic sarcoid-like epithelioid granuloma with spindle shaped epithelioid cells (encompassed by yellow line) harboring Langhans-type multinucleated giant cells (circled black) (HE × 40); B: HE staining, high magnification of A (HE × 100).