Soft tissue
Smooth muscle
Epstein-Barr virus associated smooth muscle tumors (EBV-SMT)

Author: Vijay Shankar, M.D.

Revised: 7 September 2018, last major update November 2012

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Epstein-Barr virus AND smooth muscle tumors

Cite this page: Shankar, V. Epstein-Barr virus associated smooth muscle tumors (EBV-SMT). website. Accessed November 20th, 2018.
Definition / general
  • Not a WHO diagnosis
Clinical features
  • EBV-SMT are histologically distinct from classic soft tissue smooth muscle tumors, are not readily evaluated by conventional histologic criteria; multifocal tumors are due to multiple infection events, not metastasis (Am J Surg Pathol 2006;30:75)
  • AIDS patients have multifocal tumors in liver, brain, spinal cord and adrenal gland, with slow disease progression (Oncology 2008;74:167)
  • Note: EBV is also associated with leiomyosarcoma in immunocompromised (Am J Surg Pathol 2000;24:614)
  • EBV-SMTs have variable aggressiveness with tumor-related death occurring in 4 of 51 patients (Patholog Res Int 2011;2011:561548)
Case reports
  • Excision, possibly chemotherapy; also improving host immune status (Sarcoma 2008;2008:859407)
  • Occasionally causes death
Microscopic (histologic) description
  • Well differentiated smooth muscle tumors with primitive round cell areas and prominent intratumoral T cells
  • No / mild atypia, no / rare mitotic figures, no pleomorphism
  • May occasionally have features of high grade sarcoma
Microscopic (histologic) images

Images hosted on other servers:

Liver tumor

Tumors post-liver transplant

Liver tumors in AIDS patient

EBV-SMTs with variable aggressiveness

Positive stains
Negative stains
Molecular / cytogenetics description
  • Multiple tumors in same patient are clonally distinct