Table 3 A recommended checklist to help guide the pathologic workup of a lymph node biopsy in children and young adults

1- Remember to include EBV infection in the differential diagnosis when dealing with typical and atypical changes of lymph nodes, especially in children and young adults.

2- Be familiar with morphologic changes and IHC staining patterns expected in EBV infection, especially in lymph node and bone marrow.

3- Always review and correlate with a concurrent peripheral blood smear whenever EBV infection is suspected.

4- Correlate with EBV serology and/or EBV viral load whenever EBV infection is suspected upon review of a lymph node biopsy or bone marrow.

5- Know lymphoproliferative disorders where EBER positivity is expected (and those where EBER positivity excludes the diagnosis, e.g., ALCL).

6- Learn all clinical syndromes, common and rare, associated with acute, subacute, and chronic EBV infection.

7- Compare and correlate with radiologic and clinical findings but be aware of the effect of patient triage and bias of specialization (e.g., a very sick patient with lymphadenopathy and fever may get a different work up if admitted to the infectious disease ward versus the hematology/oncology ward).