Transient localized hemophagocytosis in pleural effusion

Epstein-Barr virus [EBV] is one of the most important causes of hemophagocytic syndrome. We report a 76-year-old man who presented with pneumonia like symptoms and pleural effusion following upper respiratory tract infection. He underwent thoracentesis and pleural fluid cytology revealed large number of histiocytic macrophages that had phagocytosed RBCs and other inflammatory cells like lymphocytes and neutrophils. Pleural fluid analysis showed Epstein-Barr virus Antigen [EBNA] as the causing agent and corticosteroid therapy was initiated. A few days later, pleural effusion subsided and further cytologic examinations revealed no trace of hemophagocytosis