Angioimmunoblastic lymphadenopathy after infectious mononucleosis

Area of Science:

• Immunology
• Virology
• Oncology

Background:

• Infectious mononucleosis, often caused by Epstein-Barr virus (EBV), can have prolonged and severe presentations.
• Angioimmunoblastic lymphadenopathy (AILD) is a rare T-cell lymphoma with a complex etiology.
• The interplay between viral infections and immune dysregulation is crucial in lymphomagenesis.

Observation:

• A 46-year-old man experienced severe infectious mononucleosis due to EBV, complicated by an asymptomatic measles virus infection.
• Sixteen months post-mononucleosis, he developed massive lymphadenopathy, diagnosed as angioimmunoblastic lymphadenopathy via biopsy.
• Clinical presentation included fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, and specific EBV antibodies.

Findings:

• Biopsy revealed diffuse lymphoid infiltration and characteristic arborizing small vessel proliferation of AILD.
• The patient's condition was refractory to multiple treatments including corticosteroids, levamisole, chlorambucil, and radiotherapy.
• Death occurred 18 months after disease onset due to secondary infections.

Implications:

• This case highlights a potential association between prior EBV and measles virus infections and the subsequent development of AILD.
• It underscores the complex immunological changes that may precipitate lymphoproliferative disorders.
• Further research into viral triggers and immune responses in AILD pathogenesis is warranted.