Abstract
This report describes the case of a previously healthy young man who presented with fever, pharyngitis, cervical lymphadenopathy, lymphocytosis, and severe thrombocytopenia. Serological tests for Epstein–Barr virus were diagnostic of a primary Epstein–Barr virus infectious mononucleosis but severe thrombocytopenia aroused the suspicion of a lymphoproliferative disease. T-cell receptor gene analysis performed on peripheral and bone marrow blood revealed a T-cell receptor γ-chain rearrangement without the evidence of malignancy using standard histologic and immunophenotipe studies. Signs and symptoms of the infectious disease, blood count, and T-cell receptor gene rearrangement resolved with observation without the evidence of emergence of a lymphoproliferative disease. In the contest of a suspected lymphoproliferative disease, molecular results should be integrated with all available data for an appropriate diagnosis.
References
Groenen PJTA, Langerak AW, van Dongen JJM, van Krieken JHJM. Pitfalls in TCR gene clonality testing: teaching cases. J Hematopathol. 2008;1:97–109.
Mathew P, Hudnall SD, Elghetany MT, Payne DA. T-gamma gene rearrangement and CMV mononucleosis. Am J Hematol. 2001;66:64–6.
Han YH, Lin P, Amin HM, Ferrajoli A. Postsplenectomy citomegaloviral mononucleosis. Marked lymphocytosis, TCRγ gene rearrangement, and impaired IgM response. Am J Clin Pathol. 2005;123:612–7.
Imashuku S, Hibi S, Tabata Y, Itoh E, Hashida T, Tsunamoto K, Ishimoto K, Kawano F. Outcome of clonal hemophagocytic lymphohistiocytosis: analysis of 32 cases. Leuk Lymphoma. 2000;37:577–84.
Gaillard F, Mechinaud-Lacroix F, Papin S, Moreau A, Mollat C, Fiche M, Peltier S, De Faucal PJ, Rousselet MC, Praloran V, Harousseau JL. Primary Epstein-Barr virus infection with clonal T-cell lymphoproliferation. Am J Clin Pathol. 1992;98:324–33.
Wick MJ, Woronzoff-Dashkoff KP, McGlennen RC. The molecular characterization of fatal infectious mononucleosis. Am J Clin Phatol. 2002;117:582–8.
Malik UR, Oleksowicz L, Dutcher JP, Ratech H, Borowitz MJ, Wiernik PH. Atypical clonal T-cell proliferation in infectious mononucleosis. Med Oncol. 1996;13:207–13.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Marbello, L., Riva, M., Veronese, S. et al. T-cell receptor gene rearrangement in Epstein–Barr virus infectious mononucleosis. Med Oncol 29, 2300–2302 (2012). https://doi.org/10.1007/s12032-011-9987-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12032-011-9987-8