Spontaneous resolution of post-transplant localized cytomegalovirus lymphadenitis mimicking tumor recurrence

Transpl Infect Dis. 2014 Aug;16(4):676-80. doi: 10.1111/tid.12254. Epub 2014 Jun 26.

Abstract

Compromised T-cell immunity persists for up to 1 year after autologous stem cell transplantation (ASCT), and patients treated with ASCT are more likely to develop atypical lymphoid hyperplasia that mimics tumor recurrence. Here, we present a case of cervical lymphadenitis due to cytomegalovirus (CMV) reactivation in a patient who had undergone ASCT for Burkitt lymphoma, which mimicked tumor recurrence on computed tomography and positron emission tomography-computed tomography 6 months after ASCT. This lesion was confined to the regional lymph nodes and was not accompanied by signs of systemic involvement, such as fever, splenomegaly, an elevated C-reactive protein level, or viremia. The localized CMV lymphadenitis resolved spontaneously without treatment after 6 months (12 months after ASCT) and the elevated CMV immunoglobulin-M titer normalized 6 months after resolution. Our experience with this case suggests that cautious follow-up without anti-CMV treatment should be considered in cases of post-ASCT localized CMV lymphadenitis without systemic involvement in patients with complete engraftment.

Keywords: CMV; atypical lymphoid hyperplasia; autologous stem cell transplantation; cytomegalovirus lymphadenitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burkitt Lymphoma
  • Cytomegalovirus Infections / pathology*
  • Humans
  • Lymphadenitis / pathology
  • Lymphadenitis / virology*
  • Male
  • Neoplasm Recurrence, Local
  • Stem Cell Transplantation / adverse effects*