{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:49:17Z","timestamp":1761893357895},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2001,9,28]],"date-time":"2001-09-28T00:00:00Z","timestamp":1001635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2001,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The case of a 22\u2010yr\u2010old male who after a brief febrile episode developed autoimmune hemolytic anemia and right pulmonary infiltrate with pleural effusion is presented. Cytologic examination of the pleural fluid revealed lymphocytosis and hemophagocytosis, primarily of red blood cells (RBCs) by mature histiocytes. There was accompanying splenomegaly, laboratory evidence of hepatic dysfunction, and retroperitoneal lymphadenopathy. Besides profound reduction of red blood cells in the peripheral blood, there was reduction of lymphocytes and platelets. As a neoplastic process was ruled out by bone marrow and pleural biopsies, the disease was considered to be virus\u2010induced and was halted and progressively regressed with early institution of vigorous antiinflammatory therapy with adrenocortical steroids. Upon reviewing the case, examination of the bone marrow biopsy disclosed limited hemophagocytosis of RBCs and lymphocytes by histiocytes and considerable viral cytopathic effect on hematopoietic cells (red and white cell precursors and megakaryocytes), which by appropriate immunolabelling was identified as induced by Epstein\u2010Barr virus. A virus\u2010related acquired hemophagocytic syndrome in its early stages was probably present, yet an undesirable clinical outcome was averted by early institution of vigorous steroid therapy. The need to recognize early hemophagocytic changes in cytologic specimens for early institution of appropriate therapy is emphasized. The possibility of erythrophagocytosis, also manifested during the course of an autoimmune hemolytic process and unrelated to hemophagocytic syndrome, is discussed. Diagn. Cytopathol. 25:248\u2013252, 2001. \u00a9 2001 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/dc.2048","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T20:43:26Z","timestamp":1030308206000},"page":"248-252","source":"Crossref","is-referenced-by-count":7,"title":["Serous fluid cytology as a means of detecting hemophagocytosis in Epstein\u2010Barr virus\u2010induced autoimmune hemolytic anemia"],"prefix":"10.1002","volume":"25","author":[{"given":"Paul","family":"Zaharopoulos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,9,28]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840090407"},{"key":"e_1_2_1_3_2","first-page":"787","article-title":"Hemophagocytic syndrome associated with tuberculosis and mycoplasma infection in two patients","volume":"36","author":"Oyaizu H","year":"1998","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0339(200012)23:6<422::AID-DC13>3.0.CO;2-F"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000328594"},{"key":"e_1_2_1_6_2","first-page":"311","volume-title":"Hematology\u2014basic principles and practice","author":"Hoffman R","year":"1995"},{"key":"e_1_2_1_7_2","first-page":"349","article-title":"Adenovirus\u2010related hemophagocytic syndrome after bone marrow transplantation","volume":"6","author":"Levy J","year":"1990","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/00313029700169644"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(91)70284-9"},{"key":"e_1_2_1_10_2","first-page":"273","article-title":"Tuberculosis associated hemophagocytic syndrome complicated with severe bone marrow failure and disseminated intravascular coagulation","volume":"34","author":"Eliopoulos G","year":"1992","journal-title":"Nouv Rev Fr Hematol"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)90735-L"},{"key":"e_1_2_1_12_2","first-page":"440","article-title":"Hemophagocytosis and undifferentiated carcinoma of the lung","volume":"186","author":"Franco Sorolla JM","year":"1990","journal-title":"Rev Clin Esp"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0925-5710(96)00495-1"},{"key":"e_1_2_1_14_2","first-page":"433","article-title":"Diffuse large cell lymphoma of B\u2010cell type associated with reactive hemophagocytosis","volume":"26","author":"Aung W","year":"1996","journal-title":"Ann Clin Lab Sci"},{"key":"e_1_2_1_15_2","first-page":"637","article-title":"Seven cases of hemophagocytic syndrome complicated with childhood collagen diseases","volume":"36","author":"Wada Y","year":"1996","journal-title":"Ryumachi"},{"key":"e_1_2_1_16_2","first-page":"399","article-title":"Value of hemophagocytosis in the morphological examination of the bone marrow","volume":"73","author":"Brugues BM","year":"1979","journal-title":"Med Clin (Barc)"},{"key":"e_1_2_1_17_2","first-page":"45","article-title":"Syndrome of activation of the mononuclear phagocytic system. 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