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EBV-associated gastritis

Tuesday 25 September 2007

Gastrointestinal symptoms of EBV infection are nonspecific and occur rarely. EBV inducing acute gastrointestinal pathology is poorly recognized without suspicion.


- EBV-related gastritis


- severe gastritis associated with primary Epstein-Barr virus (EBV) infection in immunocompetent
- intermittent fever of unknown origin
- epigastric pain
- diffuse thickening of the gastric wall
- numerous ulcers in the stomach
- dense and diffuse atypical lymphoid infiltrate in the lamina propria
- erosions
- focal lymphoepithelial lesions
- no lymphoid follicles
- no Helicobacter pylori

Immunohistochemical studies

- lymphoid infiltrate to consist of mixed T and B cells.

Immunoglobulin heavy chain gene arrangement analysis

- polyclonal pattern.

NP The plasma cells present no light chain restriction by in situ hybridization.


- peripheral lymphocytosis
- atypical lymphocytes
- positive serum IgM antibody to EBV capsid antigen in the absence of IgG antibody.

In situ hybridization by Eber probe

- numerous EBV-positive lymphocytes in the gastric mucosa.

Differential diagnosis

- gastric lymphomas


- Chen ZM, Shah R, Zuckerman GR, Wang HL. Epstein-Barr virus gastritis: an underrecognized form of severe gastritis simulating gastric lymphoma. Am J Surg Pathol. 2007 Sep;31(9):1446-51. PMID: 17721202