Liver & intrahepatic bile ducts

Viral hepatitis

Epstein-Barr virus hepatitis

Topic Completed: 1 May 2012

Minor changes: 17 March 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Epstein-Barr virus hepatitis[TIAB]

Komal Arora, M.D.
Page views in 2020: 1,111
Page views in 2021 to date: 1,222
Cite this page: Arora K. Epstein-Barr virus hepatitis. website. Accessed December 7th, 2021.
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
  • 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:

without hepatocyte

regeneration with
binucleated figures
and mitotic activity

Positive stains
  • EBV antigen, EBV encoded RNA (EBER)
Back to top
Image 01 Image 02