Infectious Mononucleosis Simulating Hodgkin’s Disease: A Patient with Reed-Sternberg Cells

Abstract

A 22-year-old woman experienced fever, malaise, cervical lymphadenopathy and severe tonsillitis. In order to prevent bilateral peritonsillar abscess formation, a tonsillectomy was performed. Routine histologic examination revealed a polymorphous, atypical, lymphohistiocytic proliferation, vascular endothelial proliferation, and cells indistinguishable from Reed-Sternberg cells. These cells included the spectrum of mononuclear and multinucleated cells described as variants of Reed-Sternberg cells and were a conspicuous feature of the histologic appearance. Subsequent laboratory data were consistent with infectious mononucleosis. The diagnosis of Hodgkin’s disease was deferred. A 2-year follow-up reveals that the patient is asymptomatic. This case is presented to reinforce the opinion that Reed-Sternberg cells in atypical lymphoid proliferations may present a pitfall in diagnosis with serious subsequent prognosis.