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Case 41. EBV hepatitis (infectious mononucleosis) (24 y-o M)
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| Liver biopsy from a young adult showing fever, skin rash and moderate liver dysfunction |
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Key words : infectious mononucleosis, EB virus, hepatitis
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| Histologic features of acute EBV hepatitis are nonspecific. Mild portal and lobular inflammation is observed (HE). | EBER-1 (EBV-related small nuclear RNA) is demonstrated in the nucleus of a few hepatocytes (in situ hybridization). | |
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| Reference case 41A Autopsied liver in case of EBV-related fulminant hepatitis in a 27 y-o man (HE). Massive hepatocellular necrosis is seen in the lethal EBV activation. |
Reference case 41B Infectious mononucleosis, showing epipharyngeal swelling in a 10 year-old boy (biopsy, HE). Atypical lymphoid cells are observed in the necrotic background. The large-sized lymphcytes express T-cell phenotypes. |
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| Reference case 41B Infectious mononucleosis, showing epipharyngeal swelling in a 10 year-old boy (biopsy, HE). In the non-necrotic part of the epipharynx, activated atypical lymphocytes are intermingled with small lymphocytes. |
Reference case 41B Infectious mononucleosis, showing epipharyngeal swelling in a 10 year-old boy (biopsy, HE). EBER-1 is demonstrated in the nuclei of small-sized B-cells, while the activated T-cells are negative. The lesion diminished in size in one week. |
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| Reference case 41C Acute CMV hepatitis. Liver biopsy after liver transplantation from a live mother (HE). The appearance of clustered neutrophils within the liver lobule strongly suggests cytomegalovirus infection in this situation. |
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