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Noor Ahmed Mirwani: Infectious Mononucleosis Through the Lens of Atypical Lymphocytes
Noor Ahmed Mirwani/LinkedIn
Apr 20, 2026, 14:42

Noor Ahmed Mirwani: Infectious Mononucleosis Through the Lens of Atypical Lymphocytes

Noor Ahmed Mirwani, Master Trainer in Blood Transfusion at The Indus Hospital, shared a post on LinkedIn:

“Atypical Lymphocytes in Infectious Mononucleosis

Infectious Mononucleosis (IM) is commonly caused by Epstein-Barr Virus (EBV) infection. The immune response leads to an increased number of Atypical Lymphocytes, which have distinct morphological features.

Atypical Lymphocytes:

  • Larger than normal Lymphocytes
  • Irregular or indented cytoplasm
  • Abundant, pale blue to grayish cytoplasm with scalloped edges that may surround red blood cells
  • Round to oval nucleus with fine chromatin and sometimes visible nucleoli

Common Causes of Atypical Lymphocytes:

  • Epstein-Barr Virus (EBV) – the primary cause of IM
  • Cytomegalovirus (CMV)
  • Viral hepatitis
  • Toxoplasmosis
  • Rubella and other viral infections

CBC Findings in Infectious Mononucleosis:

  • Absolute lymphocytosis (usually >4,500/μL)
  • Marked increase in reactive (Atypical) Lymphocytes)
  • Leukocytosis (elevated WBC count)
  • Possible mild thrombocytopenia and neutropenia”

Noor Ahmed Mirwani

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