Epstein-Barr Virus Hepatitis

EBV Hepatitis: Liver involvement is seen in >90% of patients with infectious mononucleosis. Most cases are subclinical. Symptoms develop in only 5-10% of patients. Microscopically, there are dense lymphocytic infiltrates in portal tracts and sinusoids. Large atypical lymphocytes may be found. In the sinusoids, these cells are arranged in single-file (Indian file) or string-of-beads pattern. Kupffer cells are hypertrophied. Infrequent findings include epithelioid granulomas, focal hepatocellular necrosis, and cholestasis.