Atypical Lymphoid Cells in Cerebrospinal Fluid in Acute Epstein Barr Virus Infection

Manucha, Varsha; Zhao, Frank; Rodgers, William H.

doi:10.1159/000325517

Cited by 9 publications

(3 citation statements)

References 4 publications

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“… 4 Atypical cells on cytology can also be observed in patients with infections and autoimmune/inflammatory disorders. 5 , 6 Although this patient had CSF cytology with atypical cells and CSF flow cytometry showing an abnormal B-cell population, it was difficult to interpret these results given that an autoimmune/inflammatory process was high on the differential. In this setting, these results alone could not justify a diagnosis of PCNSL and exposure to high-dose methotrexate with its associated side effects including nephrotoxicity, hepatotoxicity, and myelosuppression.…”

Section: Discussionmentioning

confidence: 93%

Use of circulating tumor DNA to guide treatment of primary central nervous system lymphoma: a case report

Bale

Grommes

et al. 2021

Neuro-Oncology Advances

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Section: Discussionmentioning

confidence: 93%

Use of circulating tumor DNA to guide treatment of primary central nervous system lymphoma: a case report

Bale

Grommes

et al. 2021

Neuro-Oncology Advances

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“…In our patient, the CSF cytology also showed atypical cells, which were identified as reactive cells instead of malignant cells by subsequent flow cytometry. The CSF atypical cells in viral infections are relatively uncommon, which reported in Epstein–Barr virus ( 10 ), enteroviruses ( 11 ), West Nile Virus ( 12 ), and VZV ( 8 ). This phenomenon was referred to as a cerebrospinal leukemoid reaction ( 8 , 13 , 14 ), which suggested the atypical cells in CSF are reactive virocytes (cells with different morphologies) and may result from severe infections.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Unusual Varicella-Zoster Virus Meningoencephalitis With Meningomyelitis Mimicking Central Nervous System Leukemia

Liu

Chen

et al. 2022

Front. Med.

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BackgroundVaricella-Zoster Virus (VZV) is a human pathogen from the α-subfamily of herpesviruses. In immunocompromised patients, VZV may produce disease of the central nervous system (CNS). Clinical manifestations of CNS infection with VZV are non-specific and can mimic other infectious and non-infectious diseases. Due to similar symptoms, CNS infection with VZV represents a diagnostic challenge. Here, we report a case of a patient who showed laboratory and imaging manifestations mimicking the neoplastic etiology.CaseA 31-year-old man presented with a 3-day history of headache, 5-h of confusion, generalized tonic-clonic seizures, and transient fever. The patient has a history of acute myelogenous leukemia (AML). His cerebrospinal fluid (CSF) studies revealed markedly elevated protein (10.326 g/L) and atypical cells. Meanwhile, the MRI of brain, cervical, and thoracic spine was reported as extensive (frontal, parieto-occipital and temporal pachymeningeal, and falx cerebri) enhancement and irregular thickening. These examinations suggested a suspicion of CNS involvement of AML. However, based on further investigations with metagenomic next-generation sequencing, a final diagnosis of VZV meningoencephalitis with meningomyelitis was made. With acyclovir and foscarnet sodium therapy, repeated CSF studies revealed normal cell count and protein. No atypical cells were found. The repeated brain MRI also revealed obvious resolution of the previous abnormal pachymeningeal enhancement.ConclusionThis case highlights the importance of recognizing the unusual phenomenon of traditional tests in VZV meningoencephalitis with meningomyelitis, and timely using of further precise examinations to detect viral DNA, which is required to prevent missed diagnosis.

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“…Smears of melanoma composed of a dispersed population of atypical cells may resemble atypical lymphoid cells21 – 23 (such as those seen in Epstein–Barr virus infection),22 23 small or large cell lymphoma,1 6 7 21 24 25 acute myeloid leukaemia, plasmablastic lymphoma26/plasma cell myeloma27 if the cells exhibit plasmacytoid features 13. Smears of plasmablastic lymphoma are composed of dispersed cells with scant to moderate amounts of cytoplasm, eccentrically placed rounded nuclei with vesicular chromatin, one or more prominent nucleoli, along with multinucleate cells and mitotic figures.…”

Section: Discussionmentioning

confidence: 99%

Cytological features of melanoma in exfoliative fluid specimens

et al. 2009

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Atypical Lymphoid Cells in Cerebrospinal Fluid in Acute Epstein Barr Virus Infection

Cited by 9 publications

References 4 publications

Use of circulating tumor DNA to guide treatment of primary central nervous system lymphoma: a case report

Use of circulating tumor DNA to guide treatment of primary central nervous system lymphoma: a case report

Case Report: Unusual Varicella-Zoster Virus Meningoencephalitis With Meningomyelitis Mimicking Central Nervous System Leukemia

Cytological features of melanoma in exfoliative fluid specimens

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