EBV-infected cell lineage by EBER double-staining as a diagnostic and prognostic clue in pediatric EBV-related lymphoproliferative disorders: a Japanese central pathology cohort study
In brief
Children with T/NK-cell EBV-LPD had 59% five-year survival, versus 93% with B-cell disease
In a retrospective cohort of 36 children, double-staining identified EBV mainly in T/NK cells in 17 cases and B cells in 16; five-year overall survival was 59% and 93%, respectively. The findings suggest infected-cell lineage can help classify difficult lesions and assess risk, including in archival samples, but the small cohort limits certainty.
- Journal
- The Journal of infectious diseases (Q1)
- Published
- 23 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Rintaro Ono, Kenichi Sakamoto, Kunihiko Moriya, Akihiro Hoshino, Kentaro Ohki, Nobutaka Kiyokawa, et al.
- PMID
- 42914128
- DOI
- 10.1093/infdis/jiag523
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 25 October 2026): EBER lineage staining informs classification of challenging EBV-related lesions
Abstract
We retrospectively analyzed 36 children with Epstein-Barr virus-related lymphoproliferative disorder (EBV-LPD) from the Japan Children's Cancer Group (2006-2021), focusing on diagnostically challenging lesions not definitively classified as lymphoma. Using EBER in situ hybridization double-staining, we confirmed EBV infection primarily in T/NK cells (EBV-T/NK-LPD, n = 17) or B cells (EBV-B-LPD, n = 16). Lymphoid follicle architecture was effaced in EBV-T/NK-LPD (89%) and EBV-B-LPD (54%). 5-year overall survival was lower for EBV-T/NK-LPD (59%) than EBV-B-LPD (93%). Determining the EBV-infected cell lineage enables clinically relevant classification and risk stratification, and can be applied to archival specimens, including lesions initially interpreted as reactive.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.