Lymphadenopathy Morphologically Consistent with Hodgkin’s Disease Associated with Epstein-Barr Virus Infection

Poppema, Sibrand; Vanimhoff, Gw; Torensma, Ruurd; Smit, Jw

doi:10.1093/ajcp/84.3.385

Cited by 63 publications

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“…The Reed-Sternberg cell of classical Hodgkin lymphoma and the ReedSternberg-like cell of infectious mononucleosis are not only similar cytologically, but are also similar in their expression of the activation antigen CD30, EBV-encoded RNA transcripts (although not common in young adults with nodular sclerosing classical Hodgkin lymphoma) and their lack of CD45/LCA expression. 5,10,11,20,21 One helpful differentiating feature is the expression of CD15 in ReedSternberg cells of classical Hodgkin lymphoma and lack of expression of CD15 in Reed-Sternberg-like cells of infectious mononucleosis. 21 However, classical Hodgkin lymphoma can infrequently be negative for CD15, 27,[42][43][44] making this distinction more difficult.…”

Section: A Louissaint Jr Et Almentioning

confidence: 99%

“…Unfortunately, these biopsies can lead to a misdiagnosis of lymphoma, as involvement of lymphoid tissue by acute EBV infection can resemble both Hodgkin lymphoma and non-Hodgkin lymphoma. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] This relatively common pitfall can result in inappropriate treatment. Morphological features mimicking non-Hodgkin lymphoma include extensive proliferation of immunoblasts, often in sheets, with marked cytological atypia.…”

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confidence: 99%

“…13,14,17,20 Similarly, Hodgkin lymphoma can be simulated, in part, by the presence of atypical Reed-Sternberg-like cells. [9][10][11]20,21 Although the morphological features associated with acute EBV infection of lymphoid tissue have been described, the immunophenotypic features have not been fully characterized. In this report, we review 18 cases of acute EBV infection in which the involved lymph node or Waldeyer's ring tissue was biopsied or sampled.…”

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confidence: 99%

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Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features

et al. 2012

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The diagnosis of infectious mononucleosis (acute Epstein-Barr virus (EBV) infection) is usually made on the basis of clinical and laboratory findings. However, an atypical clinical presentation occasionally results in a lymph node or tonsillar biopsy. The morphological features of EBV-infected lymphoid tissue can easily mimic lymphoma. Furthermore, the immunophenotype of the immunoblasts has not been well characterized. To assess the morphological spectrum of acute EBV infection and the utility of immunohistochemistry in diagnosing difficult cases that resemble lymphoma, we reviewed 18 cases of acute EBV infection submitted in consultation to our institution with an initial diagnosis of/or suspicion for lymphoma. Patients included nine male and nine female individuals with a median age of 18 years (range 9-69). Biopsies were obtained from lymph nodes (3/18) or Waldeyer's ring (15/18). Infectious mononucleosis was confirmed by monospot or serological assays in 72% of cases (13/18). All cases featured architectural distortion by a polymorphous infiltrate with an immunoblastic proliferation, sometimes forming sheets. Reed-Sternberg-like cells were present in 8/18 (44%) of the cases. Infiltrates were often accompanied by necrosis (10/18) and mucosal ulceration (6/15). The majority of immunoblasts in all cases were CD20 þ B cells with a post-germinal center immunophenotype (strongly positive for MUM1/IRF4 (18/18), CD10À (18/18 negative) and BCL-6À (16/18 negative; 2/18 faint BCL-6 expression in o10% of immunoblasts)). Immunoblasts showed variable weak expression of BCL-2 and polyclonal expression of j and k immunoglobulin light chains in 81% cases. ReedSternberg-like cells in 8/8 cases were CD30 þ , CD15À, BOB.1 þ and OCT-2 þ . In conclusion, an atypical lymphoid infiltrate with numerous MUM1 þ , CD10À, BCL-6À immunoblasts should raise the suspicion of a reactive process, such as infectious mononucleosis, and warrants additional consideration before a diagnosis of lymphoma is made.

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Section: A Louissaint Jr Et Almentioning

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Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features

et al. 2012

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“…On the other hand, it is a pleasant surprise to realize how fast our understanding of this 'enigmatic disease' has grown in recent years. It took roughly 10 years from the first epidemiological evidence of a link between Epstein-Barr virus and HL [1,2] to prove the presence of viral proteins and DNA in the Hodgkin and Reed-Sternberg (HRS) cell [3,4] . It was again a long way to finally defining the very nature of the Reed-Sternberg cell.…”

Section: Hodgkin's Lymphoma: An Appraisal Of Its Biology and Clinicalmentioning

confidence: 99%

Hodgkin’s Lymphoma: An Appraisal of Its Biology and Clinical Manifestation

Borisch¹

2006

Pathobiology

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“…Accepted for publication 2 March 1989 Material and methods The 33 cases of Burkitt's lymphoma were identified according to routine procedures." The 26 nonendemic cases have been described in detail elsewhere.'…”

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Quantity of nuclear DNA in malignancies and benign lymphadenopathies associated with Epstein-Barr virus.

Lehtinen

Aine

et al. 1989

J Clin Pathol

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suMMAy The quantity ofnuclear DNA in 90 tumours with a strong probability ofbeing associated with Epstein-Barr virus (EBV) (11 cases with nasopharyngeal carcinomas, seven cases ofendemic and 26 of non-endemic Burkitt's lymphoma, and 46 cases of Hodgkin's disease) were analysed by flow cytometry. Twenty three cases with benign lymphadenopathies were analysed in a similar way. Except for endemic Burkitt's lymphoma most of the tumours were diploid. Near-diploid aneuploidy (with a DNA index ranging from 1-06 to 1-26) was also found in endemic Burkitt's lymphoma as well as in six non-endemic Burkitt's lymphomas and in eight cases of Hodgkin's disease but was absent in nasopharyngeal carcinomas. Tetraploid aneuploidy was seen in three cases of nasopharyngeal carcinoma. Five of the 23 cases of lymphadenopathy also showed near-diploid DNA, one of which subsequently developed into a non-Hodgkin's lymphoma. It is concluded that near-diploid DNA content seems to be associated with the lymphatic origins of the tumours rather than with EBV.

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Lymphadenopathy Morphologically Consistent with Hodgkin’s Disease Associated with Epstein-Barr Virus Infection

Cited by 63 publications

References 4 publications

Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features

Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features

Hodgkin’s Lymphoma: An Appraisal of Its Biology and Clinical Manifestation

Quantity of nuclear DNA in malignancies and benign lymphadenopathies associated with Epstein-Barr virus.

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