Fine needle cytology features of an atypical presentation of infectious mononucleosis

Infectious mononucleosis (IM) is a very common disease, and although in most instances, the patient develops an asymptomatic infection, other patients progress into an array of signs and symptoms that tend to be characteristic of the pathological process, guiding the clinician into choosing the right laboratory examinations under the suspicion of this illness. The most common symptoms are pharyngitis, lymphadenopathies and pyrexia, and the probabilities to develop this mononucleosis triad become greater with age. In other instances, IM can be a challenging disease to diagnose, mainly because the patient debuts with unusual symptoms such as nausea, skin eruptions, diarrhea and epigastric discomfort. The aim of the present article is to report the case of a 21-year-old female with a reactivation of IM, developing only multiple, asymptomatic lymph node enlargements in the head and neck region, showing no other sign or symptom.