Epstein-Barr virus (EBV)-associated lung carcinoma

Epstein-Barr virus (EBV)-associated lung carcinoma (EBVaLC) is a rare group of non-small cell lung cancer (NSCLC). It predominantly affects young, non-smoking Asian patients and is characterized by variable lymphocytic infiltration in the tumor microenvironment. However, due to its rarity, the clinical characteristics of EBVaLC remain incompletely characterized. EBV infection is detected in the vast majority of tumor tissues and is recognized as the principal etiological agent of EBVaLC, which encompasses a small proportion of lung squamous cell carcinomas (LUSC) and rare lung adenocarcinomas (LUAD). Nevertheless, the mechanisms underlying EBV-induced carcinogenesis remain incompletely understood. Definitive diagnosis relies on histopathological examination and EBV-encoded small RNA (EBER) in situ hybridization. However, EBVaLC is frequently misdiagnosed as conventional LUSC in clinical practice. In this review, we use the term “EBV-associated lung carcinoma (EBVaLC)” to encompass the entire spectrum of EBV-positive lung malignancies, summarize the current diagnostic approach for EBVaLC, and integrate clinical and biological insights into EBVaLC, with particular emphasis on how mechanistic insights form other EBV-driven malignancies—especially EBV-mediated reprogramming of latently infected B lymphocytes—may illuminate its pathogenesis.