Liver & intrahepatic bile ducts
Viral hepatitis
Epstein-Barr virus hepatitis
Author: Komal Arora, M.D.
Last author update: 1 May 2012
Last staff update: 3 March 2025 (update in progress)
Copyright: 2002-2025, PathologyOutlines.com, Inc.
PubMed Search: Epstein-Barr virus hepatitis
Table of Contents
Definition / general | Laboratory | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosis | Additional referencesCite this page: Arora K. Epstein-Barr virus hepatitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/liverEBV.html. Accessed March 31st, 2025.
Definition / general
- Affects immunocompetent and immunocompromised
- Usually acute self limited disease resembling infectious mononucleosis; rarely causes hepatic failure and death in patients with immunodeficiency syndromes
Laboratory
- Elevated transaminase levels (80%), high EBV serum viral load; elevated bilirubin in only 7%
- In some cases, infiltrating CD8+ T cells but not hepatocytes, are infected with EBV (Hum Pathol 2001;32:757)
- May cause polymorphic B cell hyperplasia or lymphoma in immunocompromised
Microscopic (histologic) description
- Predominantly sinusoidal infiltrate of atypical T lymphocytes with minimal necrosis
- Presence of atypical lymphocytes may coincide with Downey cells in peripheral blood
- Associated with viral associated hemophagocytic syndrome, with prominent erythrophagocytosis by sinusoidal Kupffer cells and portal histiocytes
- Variable mitotic figures and small epithelioid granulomas
- No bile duct injury or venulitis
Microscopic (histologic) images
Images hosted on other servers:
Prominent
inflammation
without hepatocyte
necrosis
Hepatocyte
regeneration with
binucleated figures
and mitotic activity
Differential diagnosis
- CMV
- Diphenylhydantoin drug reaction
- Hepatitis C
- Sinus histiocytosis with massive lymphadenopathy:
- Nodular, portal areas uninvolved
Additional references
