Chih-Yi Liu ^1 2, Yen-Chuan Hsieh ³, Sheng-Tsung Chang ^4 5, Hung-Chang Wu ⁶, Shang-Wen Chen ⁷, Shih-Sung Chuang ⁸

Affiliations

1. Department of Pathology, Zhongli District, Ten Chan Hospital, Taoyuan City, Taiwan.
2. School of Medicine, National Tsing Hua University, Hsinchu City, Taiwan.
3. Department of Clinical Pathology, Chi Mei Medical Center, Tainan City, Taiwan.
4. Department of Pathology, Chi Mei Medical Center, Tainan City, Taiwan.
5. Department of Nursing, National Tainan Institute of Nursing, Tainan City, Taiwan.
6. Department of Internal Medicine, Chi Mei Medical Center, Tainan City, Taiwan.
7. Division of Hemato-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
8. Department of Pathology, Chi Mei Medical Center, Tainan City, Taiwan. cmh5301@mail.chimei.org.tw.

ABSTRACT

Epstein-Barr virus (EBV)-associated lymphomas can, on rare occasions, involve body cavities, making effusion cytology an important diagnostic tool. This mini-review explores the spectrum of EBV-related lymphomas that may be detected in serous fluids, including EBV-positive nodal T/NK-cell lymphoma (EBV + nT/NKCL), extranodal NK/T-cell lymphoma, primary effusion lymphoma, EBV-positive diffuse large B-cell lymphoma, and classic Hodgkin lymphoma. We present an index case of EBV + nT/NKCL with lymphomatous pleural effusion and discuss the cytologic features, differential diagnoses, and role of ancillary studies such as immunocytochemistry, EBER in situ hybridization, and molecular assays. Accurate diagnosis requires the integration of cytomorphologic, immunophenotypic, and molecular findings with clinical information to establish a definitive diagnosis and distinguish these aggressive lymphomas from reactive and non-hematologic mimics.

Keywords: Azurophilic granules; Cytotoxic phenotype; EBER; EBV; Effusion cytology; Immunophenotyping; T/NK-cell lymphoma.

【Review 】Blood Res. 2025 Jul 2;60(1):37. doi: 10.1007/s44313-025-00088-0.