Evidence map›Paper›PMID 34623624›Full record

ArticleInfectious diseases and therapy2021

A Clinicopathological Study of Cytomegalovirus Lymphadenitis and Tonsillitis and Their Association with Epstein-Barr Virus.

Shan-Chi Yu, Kuan-Yin Ko, Shu-Chun Teng, Tai-Chung Huang, Hsiao-Ting Lo, Chieh-Lung Cheng, Ming Yao, Ruey-Long Hong, Chun-Nan Chen, Tseng-Cheng Chen and 1 more

Open access · goldAbstract read
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Article in Infectious diseases and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Shan-Chi YuGraduate Institute of Microbiology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren-Ai Road, Taipei, 100, Taiwan. b88401002@ntu.edu.tw.ORCID http://orcid.org/0000-0002-3642-2788
Kuan-Yin KoDepartment of Nuclear Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
Shu-Chun TengGraduate Institute of Microbiology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren-Ai Road, Taipei, 100, Taiwan. shuchunteng@ntu.edu.tw.
Tai-Chung HuangDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hsiao-Ting LoDepartment of Pathology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
Chieh-Lung ChengDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ming YaoDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ruey-Long HongDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Chun-Nan ChenDepartment of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Tseng-Cheng ChenDepartment of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Tsung-Lin YangDepartment of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
National Taiwan University Hospital · TWNational Taiwan University · TW

Funding

national taiwan university hospital 110-2
6 · The paper itself

Abstract

introductionHistopathological characteristics of cytomegalovirus (CMV) lymphadenitis have been well described. Rare studies have reported the immune status and clinical features. Clinically, experts believed that CMV lymphadenitis develops in immunocompromised and immunocompetent patients. Infectious mononucleosis (IM)-like syndrome is the most well-known clinical presentation.

methodsWe reviewed archived CMV immunohistochemical stains on lymphoid tissues. The clinicopathological features of CMV-positive cases were studied.

resultsFor lymph nodes, we detected CMV in 29% (5/17) allogeneic peripheral blood hematopoietic stem cell transplantation (PBSCT) recipients, 29% (4/14) post-autologous PBSCT patients, 13% (6/47) patients treated with intravenous chemotherapy, and 9% (9/96) immunocompetent patients. We detected CMV in 7% (2/24) of tonsils but not in the nasopharynx, tongue base, or spleen specimens. The patients with iatrogenic immunodeficiency ranged from 37 to 76 years old. CMV infections developed a few years after lymphoma treatment (median duration after allogeneic PBSCT, 932 days; after autologous PBSCT, 370 days; and after chemotherapy, 626 days). The most common clinical presentation was neck mass (13/25, 42%), followed by asymptomatic image finding (10/25, 40%). Positron emission tomography/computed tomography (PET/CT) scan showed increased uptake compared to the liver in all patients (11/11, 100%). Of 10 lymphoma patients, 8 (80%) had a Deauville score of 4-5; they accounted for 30% (8/27) of lymphoma patients with false-positive PET/CT scan results. All cases were self-limiting. 96% (23/25) cases had Epstein-Barr virus coinfection, and EBER-positive cells were predominantly in a few germinal centers.

conclusionsCytomegalovirus (CMV) lymphadenitis and tonsillitis were subclinical infections, not primary CMV infection with IM-like syndrome. The lymphadenopathy typically developed a few years after lymphoma treatments in the middle-aged and the elderly. The lesions mimicked lymphoma relapse in PET scans. Therefore, recognizing CMV infection in lymphoid tissues is of clinical importance.

Indexed as

CytomegalovirusEpstein–Barr virusLymphadenopathyLymphomaPositron emission tomographyReactive lymphoid hyperplasia

Identifiers

PMID34623624
PMCPMC8572917
OpenAlexW3201753093

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.