title: Infectious mononucleosis in an adult progressing to fatal immunoblastic lymphoma.
abstract: We report a case of infectious mononucleosis progressing to fatal immunoblastic lymphoma. The patient, a 44-year-old man who may have had an immunoregulatory defect, failed to have an appropriate T-cell response to his Epstein-Barr (EB) viral infection. His active EB viral infection was manifest by seroconversion of IgM-viral capsid antibody and a greater than four fold rise in IgG-viral capsid antibody. Also, he transmitted his EB viral infection to his wife who became ill 1 month after his death. Clinically the patient's illness was characterized by waxing and waning lymphadenopathy, persistent fever, diarrhea (similar to that associated with cholera), a coagulopathy, and gastrointestinal bleeding. The patient had pathologic findings of a diffuse immunoblastic lymphoma involving lymph nodes, small bowel, liver, pancreas, kidneys, lungs, and bone marrow. Immunologic cell markers showed the tumor to be polyclonal.
mesh_terms: D000328:Adult; D000956:Antigens, Viral / Q000032:analysis; D002648:Child; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000276:immunology; D007244:Infectious Mononucleosis / Q000150:complications* / Q000276:immunology / Q000635:transmission; D007421:Intestine, Small / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000209:etiology* / Q000473:pathology; D008297:Male; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000956:Antigens, Viral