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Case 199 - Discussion

Hematopathology Case

 

Acute Infectious Mononucleosis

  • Typically in kids or young adults with fever, lymphadenopathy and splenomegaly

  • Tonsil or lymph node with prominent interfollicular expansion by polymorphous cells, including small lymphocyte, immunoblasts, plasmacytoid cells, and plasma cells

  • Atypical cells with immunoblatic or RS cell appearance may be noted. Atypical cells may form large clusters, resembling large cell lymphoma

  • Necrosis

  • Immunoblasts positive for CD30

  • EBER-ISH highlights both large and small cells, whereas in lymphoma, only large cells positive for EBER

  • NEVER diagnose large cell lymphoma in the tonsil or cervical lymph node of kids/young adults without serology studies for viral infection