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Lymphadenopathy due to infectious mononucleosis: Its confusion with malignant lymphoma
Author(s) -
Salvador Antonio H.,
Harrison Edgar G.,
Kyle Robert A.
Publication year - 1971
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197105)27:5<1029::aid-cncr2820270505>3.0.co;2-w
Subject(s) - mononucleosis , lymph node biopsy , medicine , lymphoma , pathology , histopathology , lymphoblast , lymph node , atypical lymphocyte , reticular connective tissue , biopsy , lymph , immunology , virus , biology , genetics , cell culture
Infectious mononucleosis (IM) may be diagnosed clinically, or, since lymphadenopathy is a major feature, lymph node biopsy may be performed to establish the diagnosis. However, in 5 of 11 cases in which lymph node biopsies were obtained, the initial histopathologic examination suggested lymphoma or Hodgkin's disease. The histopathologic or clinical features eventually led to consideration of IM in all cases, and the diagnosis was confirmed by the usual laboratory findings and by follow‐up information. Histopathologic findings of IM include, 1. variable incomplete effacement of lymph node architecture, 2. “mixed” lymphoid proliferation, often with a prominent component of reticular lymphoblasts, producing a “mottled” appearance, 3. cellular filling of sinuses, and 4. moderate trabecular, capsular, and perinodal infiltration. Recognition of the reticular lymphoblast, which may simulate a Sternberg‐Reed cell, is important to prevent an erroneous diagnosis of Hodgkin's disease in these cases. The histopathology resembles that of postvaccinial and related lymphad‐enopathies which may reflect its probable viral pathogenesis.