A woman with mild Covid-19 developed cervical adenopathy, being diagnosed of Epstein−Barr virus infectious mononucleosis. After a FNAP we demonstrate that SARS-CoV-2 is found in lymph nodes (LNs) even in mild disease along with a strong expansion of terminally differentiated effector memory CD4+T-cells , a cell population that is practically absent in LN.
We fully agree with Dr Guerini et al regarding how challenging the differentiation between lung toxicity and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with lung cancer (LC) can be. 1 However, we would like to comment on the management complexity of patients with LC (both for new tumor diagnoses and for known patients with cancer) during the COVID-19 pandemic beyond lung toxicity. There are few publications that address the clinical management of patients with LC in the current SARS-CoV-2 pandemic. [2][3][4][5] The clinical and radiologic manifestations of COVID-19 can mimic pulmonary toxicity or progression of tumor disease in patients with LC. 6 Some extrapulmonary complications of SARS-CoV-2 pneumonia may also simulate progression of cancer disease. 7 On the other hand, some treatment-related complications of patients with LC can radiologically mimic SARS-CoV-2 pneumonia. 8,9 Finally, the management of some diagnostic interventional procedures can be difficult in COVID-19 patients with LC. 10 In this letter, we describe our experience in the management of several patients with LC during the COVID-19 pandemic that affected our region, and which required close multidisciplinary collaboration between different specialists.
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