期刊
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
卷 142, 期 6, 页码 788-794出版社
OXFORD UNIV PRESS INC
DOI: 10.1309/AJCP3C3BVARTZZWX
关键词
Epstein-Barr virus; Pleural effusion; Real-time quantitative PCR
类别
Objectives: The etiology of pleural effusions (PEs) varies, and a percentage of PEs remains unexplained despite an intensive workup. One previous study documented a high prevalence of Epstein-Barr virus (EBV)-DNA in unselected and unexplained PEs. Our aim is to characterize the clinical and cytomorphologic features of EBV-associated PEs, which have not been described. Methods: A database search was performed for PEs with EBV-DNA identified in the fluid by real-time quantitative polymerase chain reaction. The corresponding fluid cytology and chemistry were reviewed, and the patients' demographic data and clinical features were recorded. Results: A total of 20 cases of EBV-DNA positive PE were found All patients had a history of lung transplantation. Most of the PE EBV loads were relatively low. Cytologically, polymorphous lymphocytosis was present in more than 70% of PEs. Scattered lymphocytic mitosis and apoptosis were seen in some cases. Mesothelial cells varied in number, and some cases showed reactive atypia. The lymphocytes were predominantly T cells with the CD4/CD8 ratio varying from 10:1 to 3:20. Conclusions: EBV infection/reactivation can account for certain proportions of idiopathic PEs. Polymorphous lymphocytosis is the most common cytologic feature, but atypical features (in both lymphocytes and mesothelial cells) can be seen.
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