Bone Marrow Findings in Infectious Mononucleosis and Mononucleosis‐Like Diseases in the Older Adult

Abstract

The bone marrow findings in 5 older adults with infectious mononucleosis or mononucleosis‐like illnesses are presented. These individuals were initially considered to have lymphoproliferative disorders which often have similar constitutional signs and symptoms. All had atypical lymphocytosis of the peripheral blood. In addition, there were also abnormalities in the bone marrow. The most common findings included focal collections of lymphocytes and the presence of granulomas. The granulomas were small without caseous necrosis and giant cells were infrequent. This is in contrast to the idea that the bone marrow is normal in infectious monoculeosis and gives support to performing core biopsies as the aspirate smears in these individuals did not demonstrate the focal lymphocytosis or granulomas. Whereas, infectious mononucleosis and mononucleosis‐like illness may be uncommon in the older individual, they certainly are not rare and it is important to differentiate these benign disorders from the more serious lymphoproliferative diseases. Heterophil test and/or Epstein Barr titers are important confirmatory tests.

Bone marrow involvement in patients with posttransplant lymphoproliferative disorders: incidence and prognostic factors

“…M-PTLDs generally show morphologic evidence of neoplastic cells in the BM; even when subtle, these can be highlighted by the appropriate immunohistochemical markers [24][25][26]. Since BM findings such as small lymphoid aggregates, mild plasmacytosis, and evidence of rare EBV-infected small lymphocytes by EBERish can be seen after transplant in individuals without PTLD [27][28][29][30][31][32], we chose to consider these features insufficient evidence for BM involvement. As previously stated, in our study, diagnosis of BM involvement by either m-PTLD or p-PTLD was made based on strict morphologic and phenotypic criteria.…”

Leukemia cutis – epidemiology, clinical presentation, and differential diagnoses

“…The frequency is reported at 2.1-30 % depending on the underlying form of leukemia and can precede apparent leukemia by several months or even years. Thus knowledge of these diseases is of particular importance [20]. In addition to acute forms of leukemia, myeloid sarcoma or LC can also occur in conjunction with chronic leukemia, i.e., CLL and myeloproliferative syndromes, especially chronic myeloid leukemia (CML).…”

Lymph Node Lesion of Acute Infectious Mononucleosis in the Elderly : A Case Report

“…2,3 However, when IM occurs in elderly individuals, it frequently presents diagnostic problems. 4,5 Only a few reports detailed clinical, histological and immunohistological findings of IM ineldery have been published in the literature. [6][7][8] The histomorphological findings IM in elderly patients appear similar to those of typical IM in younger patients.…”