Infectious mononucleosis mimicking Epstein-Barr virus positive diffuse large B-cell lymphoma not otherwise specified

Area of Science:

• Virology
• Oncology
• Pathology

Background:

• Epstein-Barr virus (EBV) is the primary cause of infectious mononucleosis (IM).
• Distinguishing IM from lymphomas can be challenging due to overlapping clinical and pathological features.
• Atypical presentations of IM may necessitate biopsies to exclude lymphoma, particularly in older adults.

Observation:

• An 83-year-old male presented with symptoms suggestive of diffuse large B-cell lymphoma.
• Biopsy results ultimately ruled out lymphoma, confirming infectious mononucleosis.
• EBV-positive diffuse large B-cell lymphoma can present similarly to IM due to B-cell proliferation during acute EBV infection.

Findings:

• The study highlights the diagnostic challenge in differentiating IM from lymphoma, especially in atypical presentations.
• EBV infection can lead to significant lymphoproliferation that mimics malignant lymphoma.
• Advanced diagnostic testing is essential for accurate differentiation.

Implications:

• Accurate diagnosis of IM is critical to avoid unnecessary and potentially harmful lymphoma treatments.
• Testing for acute EBV infection should be considered in patients with atypical presentations suggestive of lymphoma.
• This approach can improve patient outcomes by ensuring appropriate management of IM.