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Pathology of Infectious Mononucleosis

  • Barbara H. Tindle
Part of the Clinical Topics in Infectious Disease book series (CLIN.TOP.INFECT)

Abstract

The histopathology of infectious mononucleosis was described in 1920 by Sprunt and Evans, whose findings were based on lymph node biopsy sections from three of six individuals who were afflicted with this malady. Several reports subsequently stressed the lymphoid hyperplasia in various tissues and suggested similarities between this reactive lesion and lymphoproliferative neoplasms (Longcope 1922; Baldridge, Rohner, and Hansmann 1926; Downey and Stasney 1936; Gall and Stout 1940; Custer and Smith 1948). In more recent publications, while the problem of distinguishing between reactive and neoplastic processes is cited, specific histopathologic differences between infectious mononucleosis and malignant lymphoma are also discussed and emphasized (Lukes, Tindle, and Parker 1969; McMahon, Gordon, and Rosen 1970; Agliozzzo and Reingold 1971; Salvador, Harrison, and Kyle 1972; Tindle, Parker, and Lukes 1972; Gowing 1975). The identification of the cellular proliferation in infectious mononucleosis as predominantly that of immunoblasts, as cells resulting from antigenic stimulation (Dameshek 1963), has contributed greatly to our interpretation and understanding of this and other immunoblastic processes.

Keywords

Infectious Mononucleosis Atypical Lymphocyte Lymphogranuloma Venereum Sternberg Cell Epithelioid Histiocyte 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Agliozzo, C.M., and Reingold, I.M. (1971). Infectious mononucleosis simulating Hodgkin’s disease: A patient with Reed-Stemberg cells. Am. J. Clin. Pathol. 56:730–737.PubMedGoogle Scholar
  2. Ainley, N.J. (1949). A fatal case of infectious mononucleosis with extensive zonal necrosis of the liver. Ulster Med. J. 18:192–222.Google Scholar
  3. Allen, F.H., and Kellner, A. (1947). Infectious mononucleosis: An autopsy report.Am. J. Pathol. 23: 463–477.PubMedGoogle Scholar
  4. Allen, U.R., and Bass, B.H. (1963). Fatal hepatic necrosis in glandular fever.J. Clin. Pathol. 16: 337–339.PubMedCrossRefGoogle Scholar
  5. Ambler, M., Stoll, J., Tzamaloukas, A., and Albala, M.M. (1971). Focal encephalitis in infectious mononucleosis: A report with pathological description. Ann. Intern. Med. 75:579–582.PubMedGoogle Scholar
  6. Baldridge, C.W., Rohner, F.J., and Hansmann, G.H. (1926). Glandular fever (infectious mononucleosis).Arch. Int. Med. 38:413–448.CrossRefGoogle Scholar
  7. Banks, P.M., Caron, B.L., and Morgan, T.W. (1982, March 17). Application of monoclonal hybridoma antibodies to imprint preparations of lymphoid tissue for the identification of immunologic cell types. Address presented at the American Society of Clinical Pathologists, New Orleans.Google Scholar
  8. Bell, J.S., and Mason, J.M. (1980). Sudden death due to spontaneous rupture of the spleen from infectious mononucleosis. J. Forensic Med. FSCA 25: 20–24.Google Scholar
  9. Boyd, J.F., and Reid, D. (1968). Bone marrow in nine cases of glandular fever and a review of the literature. J. Clin. Pathol. 21:683–694.PubMedCrossRefGoogle Scholar
  10. Campbell, A.C.P. (1948). The bone marrow in glandular. Pathol. Bacteriol. 60:629–634.CrossRefGoogle Scholar
  11. Carter, R.L., and Penman, H.G. (1969). Histopathol- ogy of infectious mononucleosis. In Infectious Mononucleosis R.L. Carter and H.G. Penman (eds.). Oxford, Blackwell Publications, chap. 9.Google Scholar
  12. Chin, T.D.Y. (1976). Diagnosis of infectious mononucleosis.South. Med. J. 69:654–658.PubMedCrossRefGoogle Scholar
  13. Chittal, S.M., Caveriviere, P., Schwarting, R., Gerdes, J., Al Saati, T., Rigal-Huguet, F., Stein, H., and Delsol, G. (1988). Monoclonal antibodies in the diagnosis of Hodgkin’s disease. The search for a rational panel. Am. J. Surg. Pathol. 12:9–21.PubMedCrossRefGoogle Scholar
  14. Cossman, J., Uppencamp, M., Sundeen, J., Coupland, R., and Raffeld, M. (1988). Molecular genetics and the diagnosis of lymphoma. Arch. Pathol Lab. Med. 112:117–127.PubMedGoogle Scholar
  15. Crawford, D.H., Brickell, P., Tidman, N., and McConnel, I. (1981). Increased numbers of cells with suppressor T cell phenotype in the peripheral blood of patients with infectious mononucleosis. Clin. Exp. Immunol. 43:291–299.PubMedGoogle Scholar
  16. Custer, R.P., and Smith, E.B. (1948). Pathology of infectious mononucleosis.Blood 3:830–857.PubMedGoogle Scholar
  17. Dameshek, W. (1963). “Immunoblasts” and “im- munocytes” an attempt at a functional nomenclature, Blood 21:243–245.PubMedGoogle Scholar
  18. Denman, A.M., and Pelton, B.K. (1974). Control mechanisms in infectious mononucleosis. Clin. Exp. Immunol. 18:13–25.PubMedGoogle Scholar
  19. DeWaele, M., Thielemans, C., and Van Camp, K.G. (1981). Characterization of immunoregulatory T cells in EBV-induced infectious mononucleosis by monoclonal antibodies. N. Engl. J. Med. 304: 460–462.CrossRefGoogle Scholar
  20. Dorfman, R.F., and Remington, J.S. (1973). Value of lymph node biopsy in the diagnosis of acute acquired toxoplasmosis. N. Engl. J. Med. 289: 878–881.PubMedCrossRefGoogle Scholar
  21. Dorfman, R.F., and Wamke, R. (1974). Lymphade- nopathy simulating the malignant lymphomas.Google Scholar
  22. Downey, H., and McKinlay, C.A. (1923). Acute lymphadenosis compared with acute lymphatic leukemia. Arch. Intern. Med. 32:82:113.Google Scholar
  23. Downey, H., and Stasney, J. (1936). The pathology of the lymph nodes in infectious mononucleosis. Folia Haemat 54:417–438.Google Scholar
  24. Doyle, A.P., and Hellstrom, H.R. (1963). Mesantoin lymphadenopathy morphologically simulating Hodgkin’s disease. Ann. Intern. Med 54:363–368.Google Scholar
  25. Fox, H. (1927). Infectious mononucleosis: Histology of a tonsil and a lymph node. Am. J. Med. Sei 173:486–490.CrossRefGoogle Scholar
  26. Gall E.A., and Stout, H.A. (1940). The histological lesion in lymph nodes in infectious mononucleosis. Am. J. Pathol 16:433–448.PubMedGoogle Scholar
  27. Gowing, N.F.C. (1975). Infectious mononucleosis: Histopathologic aspects. Pathol. Ann 10:1–20.Google Scholar
  28. Hammond, W.O., Harlan, J.M., and Steinberg, S.E. (1979). Severe neutropenia in infectious mononucleosis. West. J. Med 131:92–97.PubMedGoogle Scholar
  29. Harrison, C.V. (1966). Lymph nodes in infectious mononucleosis. InRecent Advances in Pathology e.V. Harrison (ed.). London, J. & A. ChurchiU, pp. 210–220.Google Scholar
  30. Hartsock, R.J. (1968). Postvaccinal lymphadenitis: Hyperplasia of lymphoid tissue that stimulates malignant lymphoma. Cancer 21:632–649.PubMedCrossRefGoogle Scholar
  31. Henle, W., Henle, G., and Horwitz, C.A. (1974). Ep- stein-Barr virus specific diagnostic tests in infectious mononucleosis.Human Pathology 5:552–565.CrossRefGoogle Scholar
  32. Hoagland, R.J., and McClusky, R.T. (1955). Hepatitis in infectious mononucleosis. Ann. Intern. Med 43:1019–1930.PubMedGoogle Scholar
  33. Jackson, J., Jr., and Parker, F. (1944). Hodgkin’s disease. II. Pathology N. Engl. J. Med 231:35–44.CrossRefGoogle Scholar
  34. Kaplan, H.S. (1981). Hodgkin’s disease: Biology, treatment prognosis. Blood 57:813–822.PubMedGoogle Scholar
  35. Kung, P.C., Goldstein, G., and Schlossman, S.F. (1979). Monoclonal antibodies defining distinctive human T cell surface antigens. Science 206: 347–349.PubMedCrossRefGoogle Scholar
  36. Lai, P.K. (1977). Infectious mononucleosis: Recognition and management. Hosp. Prac 12:47–52.Google Scholar
  37. Lazarus, K.H., and Baehner, R.L. (1981). Aplastic anemia complicating infectious mononucleosis: A case report and review of the literature. Pediatrics 67:907–910.PubMedGoogle Scholar
  38. Longcope, W.T. (1922). Infectious mononucleosis (glandular fever) with a report of ten cases. Am. J. Med Sei 164:781–808.CrossRefGoogle Scholar
  39. Lukes, R.J. (1970). The pathology of the white pulp of the spleen. In Die Milz/The Spleen K. Lennert and D. Harms (eds.). Beriin and New York, Springer-Verlag, pp. 130–138.CrossRefGoogle Scholar
  40. Lukes, R.J., Butler, J.J., and Hicks, E.B. (1966). Natural history of Hodgkin’s disease related to its pathologic picture. Cancer 19:317–344.CrossRefGoogle Scholar
  41. Lukes, R.J., and Cox, R.H. (1958). Clinical and morphological findings in 30 fatal cases of infectious mononucleosis. Am. J. Pathol 34:586.Google Scholar
  42. Lukes, R.J., Parker, J.W., Taylor, C.R., Tindle, B.H., Cramer, A.D., and Lincoln, T.L. (1978). Immunologic approach to non-Hodgkin’s lymphomas and related leukemias: An analysis of the results of multiparameter studies in 425 cases. Sem. Hemat 15:321–351.Google Scholar
  43. Lukes, R.J., and Tindle, B.H. (1975). Immunoblastic lymphadenopathy: A hyperimmune lesion resembling Hodgkin’s disease. N. Engl. J. Med 292:1–8.PubMedCrossRefGoogle Scholar
  44. Lukes, R.J., Tindle, B.H., and Parker, J.W. (1969). Reed-Stemberg-Hke cells in infectious mononucleosis. 2:1003–1004.Google Scholar
  45. McKenna, R.W., Parkin, J., Gajl-Peczalska, K.J., Kersey, J.H., and Brunning, R.D. (1977). Ultra- structural, cytochemical, and membrane surface marker characteristics of the atypical lymphocytes in infectious mononucleosis. Blood 50:505–515.PubMedGoogle Scholar
  46. McMahon, N.J., Gordon, H.W., and Rosen, R.B. (1970). Reed-Stemberg cells in infectious mononucleosis. Dis. Child 120:148–150.Google Scholar
  47. Niederman, J.C., Miller, G., Pearson, H.A., Pagano, J.S., and Dowaliby, J.M. (1976). Infectious mononucleosis: Epstein-Barr virus shedding in saliva and oropharynx. N. Engl. J. Med 294:1355–1359.PubMedCrossRefGoogle Scholar
  48. Papamichail, M., Sheldon, P.J., and Holborow, E.J. (1974). T- and B-cell subpopulations in infectious mononucleosis. Clin. Exp. Immunol 18:1–11.PubMedGoogle Scholar
  49. Pattengale, P.K., Smith, R.W., and Perlin, E. (1974). Atypical lymphocytes in infectious mononucleosis: Identification by T and B cell markers. N. Engl. J. Med 291:1145–1148.PubMedCrossRefGoogle Scholar
  50. Pinkus, G.S., Thomas, P., and Said, J.W. (1985). Leu-Ml-A marker for Reed-Stemberg cells in Hodgkin‘s disease. An immunoperoxidase study of paraffin-embedded tissue. Am. J. Pathol 119:224–252.Google Scholar
  51. Pratt, C.L.G. (1931). The pathology of glandular fever. Lancet 2:19A-195 Google Scholar
  52. Raftery, M., Schumacher, E.E., Grain, G.O., and Quinn, E.I. (1954). Infectious mononucleosis and Guillain-Barre syndrome. Report of three cases. Arch. Intern. Med 93:246–253.CrossRefGoogle Scholar
  53. Rappaport, H. (1966). Tumors of the hematopoietic system. In Atlas of Tumor Pathology. Washington, D.C., Armed Forces Institute of Pathology, sec. 3, fasc. 8, p. 156.Google Scholar
  54. Reed, D.M. (1902). On the pathologic changes in Hodgkin’s disease with special reference to its relation to tuberculosis. Bull. Johns Hopkins Hosp 10:133–196.Google Scholar
  55. Reichman, S., Burke, A.V., and Davis, W.D. (1957). Hepatic involvement in infectious mononucleosis. Am. J. Dig. Dis 2:430–436.PubMedCrossRefGoogle Scholar
  56. Reinherz, E.L., Kung, P.C., Goldstein, G., and Schlossman, S.F. (1979). Separation of subsets of human T cells by a monoclonal antibody. Proc. Natl. Acad Sei (USA) 76:4061–4065.CrossRefGoogle Scholar
  57. Rosdahl, N., Larsen, S.O., and Clemmensen, J. (1974). Hodgkin’s disease in patients with previous infectious mononucleosis: 30 years’ experience. Br. Med J 2:253–256.PubMedCrossRefGoogle Scholar
  58. Salvador, A.H., Harrison, E.G., and Kyle, R.A. (1972). Lymphadenopathy due to infectious mononucleosis: Its confusion with malignant lymphoma. Cancer 21:1029–1040 Google Scholar
  59. Salzstein, S.L., and Ackerman, L.V. (1959). Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically and pathologically malignant lymphomas. Cancer 12:164–182.CrossRefGoogle Scholar
  60. Saxen, E., Saxen, L., and Gronvoos, P. (1958). Glandular toxoplasmosis: A report on 23 histologically diagnosed cases. Acta Pathol. Microbiol. Scand 44:319–328.CrossRefGoogle Scholar
  61. Shebani, K., Fritz, R.M., Winberg, C.D., Burke, J.S., and Rappaport, H. (1984). Monocytoid cells in reactive follicular hyperplasia with and without multifocal histiocytic reactions: An immunohisto- chemical study of 21 cases including suspected cases of toxoplasmic lymphadenitis. Am. J. Clin. Pathol 81:453–458.Google Scholar
  62. Sheldon, P.J., Hemsted, E.H., Papamichail, M., and Holborow, E.J. (1973). Thymic origin of atypical lymphoid cells in infectious mononucleosis. Lancet 1:1153–1155.PubMedCrossRefGoogle Scholar
  63. Smith, C.B., and Custer, R.P. (1946). Rupture of the spleen in infectious mononucleosis. Blood 1:317–333.PubMedGoogle Scholar
  64. Sprunt, T.P., and Evans, F.A. (1920). Mononuclear leukocytosis in reaction to acute infection (“infectious mononucleosis”). Bull. Johns Hopkins Hosp 31:410–417.Google Scholar
  65. Stansfeld, A.G. (1961). The histologic diagnosis of toxoplasmic lymphadenitis. J. Clin. Pathol 14: 565–572.PubMedCrossRefGoogle Scholar
  66. Stein, H., Hansmann, M-L., Lennert, K., Brandtzaeg, P., Gatter, K.C., and Mason, D.Y. (1986). Reed- Stemberg and Hodgkin cells in lymphocyte predominant Hodgkin’s disease of nodular subtype contain J-chain. Am. J. Clin. Pathol 86:292- 297.Google Scholar
  67. Stein, H., Mason, D.Y., Gerdes, J., O’Connor, N., Wainscoat, J., Pallesen, G., Gatter, K., Falini, B., Delsol, G., Lemke, H., Schwarting, R., and Lennert, K. (1985). The expression of Hodgkin’s disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: Evidence that Reed- Stemberg cells and histiocytic malignancies are derived from activated lymphoid cells. Blood 66:848–858.PubMedGoogle Scholar
  68. Stemberg, C. (1898). Uber eine Eigennartige unter dem Bilde der preudoleukam Verlaufende: Tuberkulose des lymphatischen Apparates. Z Hulk 19:21.Google Scholar
  69. Strivastava, K.P., Quinlan, E.C., and Casey, T.V. (1972). Spontaneous mpture of the spleen secondary to infectious mononucleosis. Int. Surg 57:171–173.Google Scholar
  70. Stmm, S.B., Park, J.K., and Rappaport, H. (1970). Observations of cells resembling Stemberg-Reed cells in conditions other than Hodgkin’s disease. Cancer 26:116–190 Google Scholar
  71. Swom, M.J., and Urich, H. (1970). Acute encephalitis in infectious mononucleosis. J. Pathol 100: 201–205.CrossRefGoogle Scholar
  72. Symmers, W.S. (1968). Survey of the eventual diagnosis of 600 cases referred for a second histological opinion after an initial biopsy diagnosis of Hodgkin’s disease. J Clin. Pathol 21:650–653.PubMedCrossRefGoogle Scholar
  73. Taylor, C.R. (1976). An immunohistological study of follicular lymphoma, reticulum cell sarcoma and Hodgkin’s disease. Eur. J. Cancer 12:61–75.PubMedCrossRefGoogle Scholar
  74. Tindle, B.H. (1978). The hematopoietic system. In Surgical Pathology W.F. Coulson (ed.). Philadelphia, J.B. Lippincott, chap. 22.Google Scholar
  75. Tindle, B.H. (1981). Pathology of lymphomas including Hodgkin’s disease. In Lymphomas J.M. Bennett (ed.). The Hague, Boston, and London, Mar- tinus Nihoff Publisher, vol. I, pp. 38–40.Google Scholar
  76. Tindle, B.H., Parker, J.W., and Lukes, R.J. (1972). "Reed-Stemberg cells" in infectious mononucleosis? J Clin. Pathol. 58:607–717.Google Scholar
  77. Tubbs, R., Fishleder, A., Weiss, R., Savage, R., Sebek, B., and Weick, J. (1982). Immunohistochemistry of lymphoproliferative disorders, (abstract) Lab. Invest 46:84A.Google Scholar
  78. Turner, R.R., Martin, J., Dorfman, R.F. (1983). Necrotizing lymphadenitis. A study of 30 cases. Am. J. Surg. Pathol 115–123.Google Scholar
  79. Vaughn, S.L., Regan, J.S., and Terplan, K. (1946). Infectious mononucleosis complicated by spontaneous rupture of the spleen and central nervous system involvement. Blood 1:334–338.Google Scholar
  80. Virolainen, M., Andersson, L.C., Lalba, M., and Von Essen, R. (1973). T-lymphocyte proliferation in mononucleosis. Clin. Immunol. Immunopathol. 2:114–120 PubMedCrossRefGoogle Scholar
  81. Wadsworth, R.C., and Keil, P.G. (1952). Biopsy of the liver in infectious mononucleosis. Am. J. Pathol 28:1003–1025.PubMedGoogle Scholar
  82. Yata, J., Desgranges, C., de The, G., and de Tachi- bana, T. (1973). Lymphocytes in infectious mononucleosis: Properties of atypical cells and origin of the lymphoblastoid lines. Biomedicine 19:479–483.PubMedGoogle Scholar
  83. Zeigler, E.E. (1944). Infectious mononucleosis: A report of a fatal case with autopsy. Arch. Pathol 37:196–201Google Scholar

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  • Barbara H. Tindle

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