Identification of cytomegalovirus in a liquid-based gynecologic sample using morphology, immunohistochemistry, and DNA real-time PCR detection.
The viral cytopathic effects of cytomegalovirus (CMV) are rarely encountered in conventional cervical vaginal smears and have never been reported in a liquid-based gynecologic sample (SurePath). We present results of a liquid-based gynecologic sample (SurePath) from an asymptomatic patient with classic CMV-associated granular or dense cyanophilic intracytoplasmic and intranuclear inclusion bodies with a clear surrounding zone. These inclusions were immunohistochemically positive for CMV. The patient also had human papilloma virus (HPV)-associated koilocytes that showed a unique perinuclear immunostaining pattern suggesting coinfection with both CMV and HPV. CMV amplification using real-time polymerase chain reaction (PCR) of DNA extracted from the liquid-based sample confirmed the morphologic and immunohistochemical findings of CMV infection. These observations suggest that a liquid-based preparation can be used to assess CMV infection morphologically, immunohistochemically, and by real-time PCR.
Sekhon
Harmanjatinder S
HS
Division of Cytopathology and Division of Molecular Diagnostics, Department of Pathology, Oregon Health and Sciences University, Portland, Oregon 97201, USA. sekhonh@ohsu.edu
Press
Richard D
RD
Schmidt
Waldemar A
WA
Hawley
Mary
M
Rader
Anne
A
D000328:Adult; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007120:Immunochemistry; D007150:Immunohistochemistry; D007181:Inclusion Bodies, Viral / Q000473:pathology / Q000648:ultrastructure / Q000821:virology; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D016133:Polymerase Chain Reaction; D014626:Vaginal Smears
D004279:DNA, Viral