Kanderi Tejaswi, Khoory Maged S
Department of Internal Medicine, UPMC Pinnacle Harrisburg Ringgold Standard Institution, 111 South Front Street, Harrisburg, PA 17011, USA.
Department of Hematology and Oncology, Carlisle Regional Cancer Center, Carlisle, PA 17015, USA.
Int J Hematol Oncol. 2020 Jul 17;9(2):IJH25. doi: 10.2217/ijh-2020-0002.
The Epstein-Barr virus (EBV) causes infectious mononucleosis (IM). In the case of atypical presentation, lymph node and tonsillar biopsies are required to rule out lymphoma. Here, we discuss an 83-year-old male who presented with findings suggestive of diffuse large B-cell lymphoma, which was later ruled out in favor of IM. The distinction between IM and lymphomas is quite challenging due to the extensive overlap between the two diseases. Various studies have demonstrated that EBV-positive diffuse large B-cell lymphoma mimics IM due to large B-cell proliferation in acute EBV infection. We suggest testing for acute EBV infection in addition to utilizing advanced testing to confirm IM in patients with atypical infection, to avoid misdiagnosis leading to inappropriate treatment.
爱泼斯坦-巴尔病毒（EBV）可引起传染性单核细胞增多症（IM）。在非典型表现的情况下，需要进行淋巴结和扁桃体活检以排除淋巴瘤。在此，我们讨论一名83岁男性，其表现提示弥漫性大B细胞淋巴瘤，后来排除该诊断，确诊为IM。由于这两种疾病存在广泛重叠，IM与淋巴瘤的鉴别颇具挑战性。多项研究表明，EBV阳性的弥漫性大B细胞淋巴瘤在急性EBV感染时因大B细胞增殖而酷似IM。我们建议，对于非典型感染的患者，除了采用先进检测手段确诊IM外，还应检测急性EBV感染，以避免误诊导致不恰当治疗。
