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<p>We report a case of Epstein–Barr virus-associated smooth muscle tumor (EBV-SMT) of the liver that developed two years after umbilical cord blood transplantation (UCBT) for acute myeloid leukemia. A woman in her 50&#xa0;s was found to have a hepatic mass in segment 3 during imaging follow-up for a gallbladder polyp. Histopathological examination of the resected specimen revealed a fascicular proliferation of spindle-shaped tumor cells that were immunohistochemically positive for α-smooth muscle actin (α-SMA) and h-caldesmon, and positive for Epstein–Barr virus–encoded RNA (EBER) by in situ hybridization. The lesion was therefore diagnosed as EBV-SMT. EBV-SMT is a rare neoplasm that typically arises in immunocompromised individuals. Because immune reconstitution after UCBT requires a prolonged period, delayed recovery of T cell-mediated immunity and post-transplant immunosuppression were considered potential contributing factors in this case. When spindle cell tumors develop in immunosuppressed patients, EBV-SMT should be included in the differential diagnosis.</p>

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Epstein–Barr virus-associated smooth muscle tumor of the liver after umbilical cord blood transplantation for acute myeloid leukemia

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Etsuko Hisanaga,
  • Masazumi Koike,
  • Takaaki Sano,
  • Yuka Yoshida,
  • Hideaki Yokoo

摘要

We report a case of Epstein–Barr virus-associated smooth muscle tumor (EBV-SMT) of the liver that developed two years after umbilical cord blood transplantation (UCBT) for acute myeloid leukemia. A woman in her 50 s was found to have a hepatic mass in segment 3 during imaging follow-up for a gallbladder polyp. Histopathological examination of the resected specimen revealed a fascicular proliferation of spindle-shaped tumor cells that were immunohistochemically positive for α-smooth muscle actin (α-SMA) and h-caldesmon, and positive for Epstein–Barr virus–encoded RNA (EBER) by in situ hybridization. The lesion was therefore diagnosed as EBV-SMT. EBV-SMT is a rare neoplasm that typically arises in immunocompromised individuals. Because immune reconstitution after UCBT requires a prolonged period, delayed recovery of T cell-mediated immunity and post-transplant immunosuppression were considered potential contributing factors in this case. When spindle cell tumors develop in immunosuppressed patients, EBV-SMT should be included in the differential diagnosis.