title: [Clinico-pathologic Characteristics of Adult Patients with Atypical Infectious Mononucleosis].
abstract: OBJECTIVE
  To investigate the clinicopathologic characteristics of adult patients with atypical infectious mononucleosis(IM).
  
  
  METHODS
  From January 2003 to December 2013, a total of 5 cases of atypical IM misdiagnosed as lymphoma were selected, and the clinico-pathological characteristics and efficacy of treatment were analyzed. Biopsy of lymph node or tonsil was performed to evaluate the possibility of lymphoma. Peripheral blood EBV antibody and EBV-DNA were examined by ELISA and real-time fluorescence quantitative PCR, respectively.
  
  
  RESULTS
  All the cases were considered as lymphoma on the basis of morphological features in initial evaluation before relapse. These features included a florid immunoblastic proliferation, distortion of the underlying nodal or tonsillar architecture and the presence of necrosis. The immunophenotypic features, EBV encoded RNA (EBER) in situ hybridization and the gene rearrangement of immunoglobulin or T cell receptor may be helpful for the distinction of atypical IM from lymphoma.
  
  
  CONCLUSIONS
  IM as EBV-related lymphoproliferative process shows marked clinical and histological diversity. Atypical case of IM may mimic many different type of lymphoma in clinical and pathologic features, and the misdiagnosis should be avoided by using molecular and pathological examination.
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China. E-mail:yuyapingnj@sina.com.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Yu
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Song
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: An
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Xiao-Gang
authors.initials: XG
authors.lastname: Zhou
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Wang
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Jian-Gang
authors.initials: JG
authors.lastname: Mei
authors.affiliation: Department of Hematology, Nanjing General Hospital of Nanjing Military Command of Chinese PLA, Nanjing 210002, Jiangsu Province, China.
authors.forename: Yong-Ping
authors.initials: YP
authors.lastname: Zhai
mesh_terms: D000328:Adult; D001706:Biopsy; D006801:Humans; D016130:Immunophenotyping; D017403:In Situ Hybridization; D007244:Infectious Mononucleosis; D008198:Lymph Nodes; D008214:Lymphocytes; D008223:Lymphoma; D009364:Neoplasm Recurrence, Local