Internal Medicine

Lymphoma-like syndrome

Localized/disseminated lymphadenopathy and systemic symptoms characteristic of lymphoma


  • 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)

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


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