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Acute infectious mononucleosis. CD30 (Ki-1) antigen expression and histologic correlations
S L Abbondanzo1, N Sato, S E Straus
1Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Insights
Acute infectious mononucleosis (AIM) lymph nodes can mimic lymphoma due to immunoblastic proliferation. This case highlights the importance of considering Ki-1-positive lymphoma in the differential diagnosis of AIM.
Area of Science:
- Pathology
- Immunology
- Oncology
Background:
- Lymph nodes in acute infectious mononucleosis (AIM) exhibit paracortical expansion and immunoblastic proliferation.
- These features, along with Reed-Sternberg-like cells, can resemble non-Hodgkin's lymphoma or Hodgkin's disease.
- Ki-1-positive lymphoma (large cell anaplastic lymphoma) shares features with AIM, necessitating its consideration in differential diagnoses.
Abstract:
Lymph nodes from patients with acute infectious mononucleosis (AIM) typically show marked paracortical expansion and a prominent immunoblastic proliferation that can occur in nodules and sheets, as well as within sinuses. The marked immunoblastic proliferation, coupled with Reed-Sternberg-like cells and a polymorphous inflammatory cell background, may simulate either non-Hodgkin's lymphoma or Hodgkin's disease. A recently described entity, Ki-1-positive lymphoma, or large cell anaplastic lymphoma, shares some clinicopathologic and phenotypic features with AIM and must be considered in the differential diagnosis. The present case describes a 20-year-old male who had signs and symptoms consistent with AIM, which he was later proven serologically to have, but whose cervical lymph node showed features suspicious for large cell anaplastic lymphoma. In addition, the Ki-1 (CD30) antigen was expressed by some of the atypical immunoblasts, further raising this possibility.