Localized/disseminated lymphadenopathy and systemic symptoms characteristic of lymphoma

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Aetiology

• Drug reaction: Phenytoin, Carbamazepine
• Immune disorders: Rheumatoid arthritis, systemic lupus erythematosus (SLE)
• Viral infections: Cytomegalovirus (CMV), Epstein-Barr virus (EBV)
• Bacterial infections: Cat-scratch disease
• Others:
  • Castleman’s disease (HHV-8)
  • Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease)
  • Lymphomatoid papulosis (Cutaneous lymphoproliferative disorder)

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Clinical features

• Protracted fever (≥15 days)
• Alteration of the general status (asthenia, anorexia, and weight loss)
• Clinical lymphoproliferative syndrome:
  • Lymphadenopathies with malignancy criteria (firm, fixed, or supracentimetric)
  • Hepatomegaly
  • Splenomegaly