Multifocal lymphadenopathy due to cytomegalovirus and Epstein-Barr virus infection in lymphoma patients receiving chemotherapy: a report of two cases

We describe two cases of multifocal lymphadenopathy due to concurrent cytomegalovirus and EpsteinBarr virus infections after chemotherapy for diffuse large B-cell lymphoma. The patients presented with suspected local recurrence on computed tomography and positron emission tomography-computed tomography at 19 and 8 months after completion of chemotherapy, but neither had any signs of systemic involvement. The enlarged lymph nodes resolved spontaneously without treatment after 2 and 12 weeks, respectively. A compromised cellular immune system after chemotherapy may have allowed the viral infection. This report demonstrates that multifocal lymphadenopathy due to viral infection after chemotherapy in aggressive B-cell lymphoma can mimic tumor recurrence, and that spontaneous resolution without antiviral agents can be achieved.