Thymic lesions in fatal infectious mononucleosis

Elizabeth C. Mroczek, Thomas A. Seemayer, Helen L. Grierson, Rodney Smith Markin, James Linder, Beda Brichacek, David T. Purtilo

Research output: Contribution to journalArticle

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Abstract

Thymic lesions were studied in 35 patients with fatal infectious mononucleosis (FIM) including 21 males with the X-linked lymphoproliferative syndrome (XLP) and 14 non-XLP patients. Six patterns based on the lymphocyte content and status of Hassall's bodies were observed: (1) massive lymphoproliferation effaced the architecture and Hassall's bodies (HB) in 6 cases. Epstein-Barr virus (EBV)-laden B cells surrounded by cytotoxic T cells and natural killer cells were found in one of these cases. (2) Only 5 of the 35 thymuses contained normal-appearing HB. (3) Seven showed a moderate reduction in HB. Rarely, multinucleated giant cells and hyaline globules were seen where one might expect HB to reside. Plasma cells and macrophages were generally abundant. (4) Eight displayed a marked depletion of HB. (5) In 7, no HB were recognized. Massive necrosis was seen in one of these cases. (6) Stress involution was encountered in only two patients, both of whom had sporadic fatal IM. Thymic lesions and alterations were similar but less extensive in sporadic FIM. These morphological studies, taken in context with clinical and experimental reports, suggest that destruction of thymic epithelium may contribute to the progression of immune defects seen in XLP following EBV infection. The destruction of HB that we observed was similar in appearance to lesions in several other immune deficiency disorders.

Original languageEnglish (US)
Pages (from-to)243-255
Number of pages13
JournalClinical Immunology and Immunopathology
Volume43
Issue number2
DOIs
StatePublished - May 1987

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Infectious Mononucleosis
Lymphoproliferative Disorders
Epstein-Barr Virus Infections
Hyalin
Immune System Diseases
Giant Cells
Plasma Cells
Human Herpesvirus 4
Natural Killer Cells
Thymus Gland
B-Lymphocytes
Necrosis
Epithelium
Macrophages
Lymphocytes
T-Lymphocytes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Immunology

Cite this

Mroczek, E. C., Seemayer, T. A., Grierson, H. L., Markin, R. S., Linder, J., Brichacek, B., & Purtilo, D. T. (1987). Thymic lesions in fatal infectious mononucleosis. Clinical Immunology and Immunopathology, 43(2), 243-255. https://doi.org/10.1016/0090-1229(87)90132-2

Thymic lesions in fatal infectious mononucleosis. / Mroczek, Elizabeth C.; Seemayer, Thomas A.; Grierson, Helen L.; Markin, Rodney Smith; Linder, James; Brichacek, Beda; Purtilo, David T.

In: Clinical Immunology and Immunopathology, Vol. 43, No. 2, 05.1987, p. 243-255.

Research output: Contribution to journalArticle

Mroczek, EC, Seemayer, TA, Grierson, HL, Markin, RS, Linder, J, Brichacek, B & Purtilo, DT 1987, 'Thymic lesions in fatal infectious mononucleosis', Clinical Immunology and Immunopathology, vol. 43, no. 2, pp. 243-255. https://doi.org/10.1016/0090-1229(87)90132-2
Mroczek, Elizabeth C. ; Seemayer, Thomas A. ; Grierson, Helen L. ; Markin, Rodney Smith ; Linder, James ; Brichacek, Beda ; Purtilo, David T. / Thymic lesions in fatal infectious mononucleosis. In: Clinical Immunology and Immunopathology. 1987 ; Vol. 43, No. 2. pp. 243-255.
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