Abstract
An atypical case of infectious mononucleosis characterized by fever, acute tonsillitis, and bilateral cervical adenopathy is reported in a previously healthy young man. Although serology was positive for the Epstein-Barr virus, the patient did not display peripheral blood lyrnphocytosis or atypical, reactive lymphocytes. The patient's tonsilar tissue revealed an expanded T-zone of diffuse, monomorphous lymphocytes suggestive of lymphoma. Immunophenotypic analysis of the tonsilar tissue demonstrated more than 90% expression of pan-T markers, while pan-B markers were positive in 5-10% of the interfollicular T-zone cells and in 90% of germinal centre cells. In situ hybridization with a probe specific for EBER1 demonstrated positive staining in approximately 1% of the interfollicular tonsilar lymphocytes. Finally, Southern blot analysis of tonsilar tissue demonstrated a clonal rearrangement of the T-cell receptor gene. The patient recovered from his infection and remains in good health years after presenting with his illness. This case illustrates that T-cell clonality must be evaluated with caution in the setting of a viral infection and can occur in association with benign, self-limited infectious mononucleosis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 207-213 |
| Number of pages | 7 |
| Journal | Medical Oncology |
| Volume | 13 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 1996 |
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Keywords
- clonality
- Epstein-Barr virus
- infectious mononucleosis
- T-cell lymphoproliferation
- T-cell receptor rearrangement
ASJC Scopus subject areas
- Oncology
- Cancer Research
- Hematology
Cite this
Atypical clonal T-cell proliferation in infectious mononucleosis. / Malik, Ummekalsoom R.; Oleksowicz, Leslie; Dutcher, Janice P.; Wiernik, Peter H.; Ratech, Howard; Borowitz, Michael J.
In: Medical Oncology, Vol. 13, No. 4, 12.1996, p. 207-213.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Atypical clonal T-cell proliferation in infectious mononucleosis
AU - Malik, Ummekalsoom R.
AU - Oleksowicz, Leslie
AU - Dutcher, Janice P.
AU - Wiernik, Peter H.
AU - Ratech, Howard
AU - Borowitz, Michael J.
PY - 1996/12
Y1 - 1996/12
N2 - An atypical case of infectious mononucleosis characterized by fever, acute tonsillitis, and bilateral cervical adenopathy is reported in a previously healthy young man. Although serology was positive for the Epstein-Barr virus, the patient did not display peripheral blood lyrnphocytosis or atypical, reactive lymphocytes. The patient's tonsilar tissue revealed an expanded T-zone of diffuse, monomorphous lymphocytes suggestive of lymphoma. Immunophenotypic analysis of the tonsilar tissue demonstrated more than 90% expression of pan-T markers, while pan-B markers were positive in 5-10% of the interfollicular T-zone cells and in 90% of germinal centre cells. In situ hybridization with a probe specific for EBER1 demonstrated positive staining in approximately 1% of the interfollicular tonsilar lymphocytes. Finally, Southern blot analysis of tonsilar tissue demonstrated a clonal rearrangement of the T-cell receptor gene. The patient recovered from his infection and remains in good health years after presenting with his illness. This case illustrates that T-cell clonality must be evaluated with caution in the setting of a viral infection and can occur in association with benign, self-limited infectious mononucleosis.
AB - An atypical case of infectious mononucleosis characterized by fever, acute tonsillitis, and bilateral cervical adenopathy is reported in a previously healthy young man. Although serology was positive for the Epstein-Barr virus, the patient did not display peripheral blood lyrnphocytosis or atypical, reactive lymphocytes. The patient's tonsilar tissue revealed an expanded T-zone of diffuse, monomorphous lymphocytes suggestive of lymphoma. Immunophenotypic analysis of the tonsilar tissue demonstrated more than 90% expression of pan-T markers, while pan-B markers were positive in 5-10% of the interfollicular T-zone cells and in 90% of germinal centre cells. In situ hybridization with a probe specific for EBER1 demonstrated positive staining in approximately 1% of the interfollicular tonsilar lymphocytes. Finally, Southern blot analysis of tonsilar tissue demonstrated a clonal rearrangement of the T-cell receptor gene. The patient recovered from his infection and remains in good health years after presenting with his illness. This case illustrates that T-cell clonality must be evaluated with caution in the setting of a viral infection and can occur in association with benign, self-limited infectious mononucleosis.
KW - clonality
KW - Epstein-Barr virus
KW - infectious mononucleosis
KW - T-cell lymphoproliferation
KW - T-cell receptor rearrangement
UR - http://www.scopus.com/inward/record.url?scp=0030441268&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030441268&partnerID=8YFLogxK
U2 - 10.1007/BF02990933
DO - 10.1007/BF02990933
M3 - Article
VL - 13
SP - 207
EP - 213
JO - Medical Oncology and Tumor Pharmacotherapy
JF - Medical Oncology and Tumor Pharmacotherapy
SN - 0340-7004
IS - 4
ER -