Chronic and recurrent benign lymphadenopathy without constitutional symptoms associated with human herpesvirus-6B reactivation

Fabio Forghieri, Mario Luppi, Patrizia Barozzi, Giovanni Riva, Monica Morselli, Sara Bigliardi, Chiara Quadrelli, Daniela Vallerini, Monica Maccaferri, Valeria Coluccio, Ambra Paolini, Elisabetta Colaci, Goretta Bonacorsi, Antonino Maiorana, Sara Tagliazucchi, Fabio Rumpianesi, Francesco Mattioli, Livio Presutti, Roberta Gelmini, Claudio CermelliGiulio Rossi, Patrizia Comoli, Roberto Marasca, Franco Narni, Leonardo Potenza

Research output: Contribution to journalArticle

Abstract

Chronic/recurrent behaviour may be encountered in some distinct atypical or malignant lymphoproliferations, while recurrences are not generally observed in reactive/benign lymphadenopathies. We retrospectively analysed a consecutive series of 486 human immunodeficiency virus-negative adults, who underwent lymphadenectomy. Neoplastic and benign/reactive histopathological pictures were documented in 299 (61·5%) and 187 (38·5%) cases, respectively. Of note, seven of the 111 (6·3%) patients with benign lymphadenopathy without well-defined aetiology, showed chronic/recurrent behaviour, without constitutional symptoms. Enlarged lymph nodes were round in shape and hypoechoic, mimicking lymphoma. Reactive follicular hyperplasia and paracortical expansion were observed. Human herpesvirus (HHV)-6B positive staining in follicular dendritic cells (FDCs) was documented in all seven patients. Serological, molecular and immunological examinations suggested HHV-6B reactivation. Among the remaining 104 cases with reactive lymphoid hyperplasia in the absence of well-known aetiology and without recurrences, positivity for HHV-6B on FDCs was found in three cases, whereas in seven further patients, a scanty positivity was documented in rare, scattered cells in inter-follicular regions. Immunohistochemistry for HHV-6A and HHV-6B was invariably negative on 134 lymph nodes, with either benign pictures with known aetiology or malignant lymphoproliferative disorders, tested as further controls. Future studies are warranted to investigate a potential association between HHV-6B reactivation and chronic/recurrent benign lymphadenopathy.

Original languageEnglish
Pages (from-to)561-572
Number of pages12
JournalBritish Journal of Haematology
Volume172
Issue number4
DOIs
Publication statusPublished - Feb 1 2016

Keywords

  • Benign lymphadenopathy
  • Chronic/recurrent lymphadenopathy
  • Human herpesvirus 6
  • Immunohistochemistry
  • Reactive follicular hyperplasia

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Forghieri, F., Luppi, M., Barozzi, P., Riva, G., Morselli, M., Bigliardi, S., Quadrelli, C., Vallerini, D., Maccaferri, M., Coluccio, V., Paolini, A., Colaci, E., Bonacorsi, G., Maiorana, A., Tagliazucchi, S., Rumpianesi, F., Mattioli, F., Presutti, L., Gelmini, R., ... Potenza, L. (2016). Chronic and recurrent benign lymphadenopathy without constitutional symptoms associated with human herpesvirus-6B reactivation. British Journal of Haematology, 172(4), 561-572. https://doi.org/10.1111/bjh.13871