Medical Oncology

, Volume 13, Issue 4, pp 207–213

Atypical clonal T-cell proliferation in infectious mononucleosis

  • Ummekalsoom R. Malik
  • Leslie Oleksowicz
  • Janice P. Dutcher
  • Peter H. Wiernik
  • Howard Ratech
  • Michael J. Borowitz
Article

DOI: 10.1007/BF02990933

Cite this article as:
Malik, U.R., Oleksowicz, L., Dutcher, J.P. et al. Med Oncol (1996) 13: 207. doi:10.1007/BF02990933

Abstract

An atypical case of infectious mononucleosis characterized by fever, acute tonsillitis, and bilateral cervical adenopathy is reported in a previously healthy young man. Although serology was positive for the Epstein-Barr virus, the patient did not display peripheral blood lyrnphocytosis or atypical, reactive lymphocytes. The patient’s tonsilar tissue revealed an expanded T-zone of diffuse, monomorphous lymphocytes suggestive of lymphoma. Immunophenotypic analysis of the tonsilar tissue demonstrated more than 90% expression of pan-T markers, while pan-B markers were positive in 5-10% of the interfollicular T-zone cells and in 90% of germinal centre cells. In situ hybridization with a probe specific for EBER1 demonstrated positive staining in approximately 1% of the interfollicular tonsilar lymphocytes. Finally, Southern blot analysis of tonsilar tissue demonstrated a clonal rearrangement of the T-cell receptor gene. The patient recovered from his infection and remains in good health years after presenting with his illness. This case illustrates that T-cell clonality must be evaluated with caution in the setting of a viral infection and can occur in association with benign, self-limited infectious mononucleosis.

Keywords

infectious mononucleosis Epstein-Barr virus clonality T-cell lymphoproliferation T-cell receptor rearrangement 

Copyright information

© Humana Press Inc. 1996

Authors and Affiliations

  • Ummekalsoom R. Malik
    • 1
  • Leslie Oleksowicz
    • 1
    • 3
  • Janice P. Dutcher
    • 1
    • 3
  • Peter H. Wiernik
    • 1
    • 3
  • Howard Ratech
    • 2
  • Michael J. Borowitz
    • 4
  1. 1.Department of OncologyMontenore Medical CenterBronxNew York
  2. 2.Department of PathologyMontefiore Medical Center, Albert Einstein College of MedicineBronxNew York
  3. 3.Albert Einstein Cancer CenterJohns Hopkins University Medical CenterBaltimoreUSA
  4. 4.Johns Hopkins University Medical CenterBaltimoreUSA