Myers J L, Peiper S C, Katzenstein A L
Division of Surgical Pathology, University of Alabama, Birmingham.
Mod Pathol. 1989 Sep;2(5):444-8.
Symptomatic pulmonary parenchymal involvement is rare in infectious mononucleosis, and few pathologic descriptions of this lesion exist. We describe an unusual patient who presented with adenopathy and rapidly progressive interstitial lung disease. An open lung biopsy showed a predominantly interstitial infiltrate of mononuclear cells distributed along lymphatic routes. A patchy alveolar exudate was also seen. Biopsy of a paratracheal lymph node showed paracortical hyperplasia typical of infectious mononucleosis. The diagnosis was suspected only after thoracotomy and was established by appropriate serological studies for Epstein-Barr virus. Epstein-Barr virus genomic sequences were also detected within routinely processed lung and lymph node tissues using polymerase chain reaction technology. Infectious mononucleosis should be considered in the differential diagnosis of certain lymphoid lung lesions.
有症状的肺实质受累在传染性单核细胞增多症中较为罕见，且关于此病变的病理学描述很少。我们描述了一位不同寻常的患者，该患者表现为腺病和快速进展的间质性肺病。开胸肺活检显示主要为沿淋巴管分布的单核细胞间质浸润。还可见散在的肺泡渗出物。气管旁淋巴结活检显示具有传染性单核细胞增多症典型的副皮质增生。仅在开胸手术后才怀疑该诊断，并通过针对爱泼斯坦-巴尔病毒的适当血清学研究得以确诊。使用聚合酶链反应技术在常规处理的肺和淋巴结组织中也检测到了爱泼斯坦-巴尔病毒基因组序列。在某些淋巴样肺病变的鉴别诊断中应考虑传染性单核细胞增多症。
