Morphological and molecular diagnosis of a fatal form of EBV infectious mononucleosis in a child.
Mortal cases of acute Epstein-Barr virus (EBV) infection in the form of mononucleosis have been seldom described and used to be related to complications of the disease. In this report, the case of a 3-year-old girl is described, with severe form of infectious mononucleosis, deceased in the course of respiratory-circulatory insufficiency with a sudden cessation of heart action. Particular attention was given to histological lesions, phenotype of inflammatory cells and to expression of proteins and EBV RNAs (EBERs) in tissues, examined using immunocytochemical techniques and in situ hybridization. Histological patterns were dominated by massive lymphocyte infiltrates (mostly CD45RO+ and CD3+ cells), mainly in lungs and in liver and, less pronounced, in kidneys and in leptomeninx. Lymphocyte proliferation exhibited polyclonal character: both lambda and kappa chains were present. No myeloblastic differentiation could be demonstrated. The EBV proteins, as well as EBV RNAs (EBERs) were detected both in small lymphocytes B and in enlarged (blast) cells, frequently resembling Reed-Sternberg cells. In our tissue material co-expression of the two proteins (EBNA2+, LMP1+) and EBER has been demonstrated in every organ, in accordance to the latency III pattern described by other authors.
Kasprzak
Aldona
A
Department of Histology and Embryology, Karol Marcinkowski University of Medical Sciences, Poznań. akasprza@amp.edu.pl
Mrówczyńska
Magdalena
M
Wysocki
Jacek
J
Jurczyszyn
Donata
D
Woźniak
Aldona
A
Spachacz
Rafał
R
Biczysko
Wiesława
W
D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D007244:Infectious Mononucleosis / Q000473:pathology* / Q000821:virology*; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology; D008214:Lymphocytes / Q000473:pathology; D025202:Molecular Diagnostic Techniques; D012367:RNA, Viral / Q000032:analysis; D016601:RNA-Binding Proteins / Q000032:analysis; D012269:Ribosomal Proteins / Q000032:analysis
D012367:RNA, Viral; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; C067169:RPL22 protein, human