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Epstein-Barr virus and a unilateral neck mass
Archives of Otolaryngology (Chicago, Ill. : 1960)
|April 1, 1982
Summary
Epstein-Barr infectious mononucleosis (IM) can present as a solitary neck mass, challenging typical diagnoses. Early and specific serologic tests aid in confirming IM in such cases.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Hematology
Background:
- Epstein-Barr virus (EBV) infection, commonly known as infectious mononucleosis (IM), is typically associated with generalized symptoms.
- Neck masses are a common presentation in otolaryngology, with various potential etiologies.
- Solitary neck masses are not classically linked to infectious mononucleosis.
Observation:
- A young adult presented with a single, large neck mass.
- The patient lacked typical signs and symptoms of infectious mononucleosis.
- Despite atypical presentation, heterophil-agglutination testing was positive, and reactive lymphocytes were observed.
Findings:
- A solitary neck mass can be an unusual presentation of Epstein-Barr infectious mononucleosis.
- Positive heterophil-agglutination titers and reactive lymphocytes support the diagnosis even without other IM signs.
- Specific EBV serologic tests, including viral capsid antigen (VCA) IgM and IgG, early antigen (EA), and nuclear antigen (EBNA), are crucial for confirming difficult diagnoses.
Implications:
- Clinicians, particularly surgeons, should consider infectious mononucleosis in the differential diagnosis of solitary neck masses in young adults.
- Awareness of atypical presentations of IM is essential for accurate and timely diagnosis.
- Utilizing a comprehensive panel of EBV serologic tests can resolve diagnostic uncertainty in challenging cases.
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