Nasopharyngeal carcinomas, a common occurrence in Southern Chinese people, shows a strong association with Epstein-Barr virus (EBV); in the same population, sinonasal carcinomas are distinctly rare. Although most nasopharyngeal carcinomas are lymphoepitheliomas, sinonasal carcinomas have a wide morphological spectrum. We studied the clinicopathological features and EBV status of 29 sinonasal carcinomas from Hong Kong Chinese patients. By in situ hybridization using antisense Epstein-Barr virus early RNA (EBER) probe, seven tumors were shown to be strongly positive for the EBV RNA. They displayed a wide morphological spectrum, including one cylindric cell carcinoma, one intestinal type adenocarcinoma, four nonkeratinizing squamous cell carcinomas, and one undifferentiated carcinoma. All were from elderly subjects (mean age, 67), including six men and one woman. Three of these seven patients had complete remission after radiotherapy with a median follow-up period of 29 months. In two cases, EBV latent membrane protein-1 was expressed. Detection of the virus in a number of histological subtypes, including cylindric cell carcinoma and adenocarcinoma, suggests that EBV may play a role in the pathogenesis of a diverse spectrum of carcinomas.