Incidental finding of cytomegalovirus inclusions in cervical glands

Ross, Livia

doi:10.1016/0002-9378(66)90544-8

Cited by 14 publications

(10 citation statements)

References 4 publications

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“…7 However, histologically diagnosed CMV cervicitis is rare, with reports limited to individual cases or small numbers of cases. [1][2][3][4][5] In addition, CMV inclusions have been detected rarely in cervical smears, 1 11 although in our cases of histologically confirmed CMV infection, inclusion bodies were not seen in the corresponding cervical smears. The finding of CMV inclusion bodies in five cervical biopsies over a short time period suggests that CMV infection of the cervix may be more common than is generally appreciated, and that a high index of suspicion is required to diagnose this.…”

Section: Discussionmentioning

confidence: 91%

“…H istologically diagnosed cytomegalovirus (CMV) infection of the cervix is rare and the published literature is limited to a few reports, mainly of individual cases or small numbers of cases. [1][2][3][4][5] In this report, we describe the histological features in five biopsies from four patients with CMV infection of the cervix diagnosed in a single institution over an eight month period. By documenting the associated histological appearances we hope to identify features that should alert the pathologist to search for CMV inclusion bodies.…”

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confidence: 99%

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Cytomegalovirus infection of the cervix: morphological observations in five cases of a possibly under-recognised condition

McGalie

McBride²,

McCluggage³

2004

J Clin Pathol

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Aims: Histologically diagnosed cytomegalovirus (CMV) infection of the cervix is rare and the associated morphological features are not well described. This study describes histopathological findings in five biopsies from four patients with CMV cervicitis. Methods: CMV inclusions were identified in five cervical biopsies from four patients in a single institution over eight months. The clinical notes were reviewed, the morphological features documented, and immunohistochemical staining for CMV performed. CMV immunohistochemical staining was also performed on 30 consecutive cervical biopsies in which inclusions were not seen histologically. Results: None of the patients was immunocompromised but one was postnatal. Numbers of CMV inclusions ranged from occasional to abundant and they were located mainly in endocervical glandular epithelial cells but also in endothelial and mesenchymal cells. Inclusions were not seen in squamous cells. Inclusions were eosinophilic and were intracytoplasmic rather than intranuclear. They were positive immunohistochemically for CMV. Associated morphological features included fibrin thrombi within small blood vessels (three cases), dense active inflammatory infiltrates (five cases), lymphoid follicles (two cases), vacuolation of glandular epithelial cells (two cases), and reactive changes in glandular epithelial cells (two cases). CMV inclusions were not identified in the 30 additional cases that underwent immunohistochemical staining. Conclusions: CMV infection of the cervix may be more common than is thought. Patients are usually immunocompetent and require no treatment. Morphological features such as a dense inflammatory cell infiltrate with lymphoid follicles, and especially fibrin thrombi within small vessels, should alert the pathologist to look closely for the pathognomonic CMV inclusion bodies.H istologically diagnosed cytomegalovirus (CMV) infection of the cervix is rare and the published literature is limited to a few reports, mainly of individual cases or small numbers of cases. [1][2][3][4][5] In this report, we describe the histological features in five biopsies from four patients with CMV infection of the cervix diagnosed in a single institution over an eight month period. By documenting the associated histological appearances we hope to identify features that should alert the pathologist to search for CMV inclusion bodies. We also reviewed the clinical notes to ascertain whether factors predisposing to CMV infection were present and performed CMV immunohistochemical staining on 30 consecutive cervical biopsies where inclusions were not seen to determine whether this might identify additional cases that were not diagnosed on morphological examination. MATERIALS AND METHODSCases were reported by a gynaecological pathologist (WGM) in a single institution over an eight month period. The five cases of CMV cervicitis were from a total of 957 cervical biopsies reported during that period. The associated morphological features were documented.

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Section: Discussionmentioning

confidence: 91%

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confidence: 99%

Cytomegalovirus infection of the cervix: morphological observations in five cases of a possibly under-recognised condition

McGalie

McBride²,

McCluggage³

2004

J Clin Pathol

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“…Commonly, CMV cytopathic changes have been shown in endocervical glandular cells in biopsy specimens or cervical/endocervical smears in asymptomatic females. 4,5,7,14,15 CMV-associated inclusions are rarely observed in squamous cells of cervical/endocervical smears or biopsies. 8 Although one cannot discount sampling, we found only rare endocervical glandular cells with CMV-associated cytopathic changes.…”

Section: Discussionmentioning

confidence: 99%

“…2 Depending on age, geographical, and socioeconomic distribution, 4 -12% of sexually transmitted disease clinic patients are CMV culturepositive using cervical swabs, 3 but histological evidence of CMV-associated cellular features in a cervical wedge biopsy from a young female were not identified until 1966. 4 Despite widely instituted cervical-vaginal smears, only recently have a handful of studies reported CMV-associated cytopathic changes in cervical smears by morphological examination and/or confirmed by immunohistochemistry. [5][6][7][8][9] Although serial blood samples are routinely used to detect CMV infection in high-risk patients, asymptomatic low-risk patients who harbor CMV often remain unidentified.…”

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confidence: 99%

Identification of cytomegalovirus in a liquid‐based gynecologic sample using morphology, immunohistochemistry, and DNA real‐time PCR detection

Sekhon

Press

Schmidt

et al. 2004

Diagnostic Cytopathology

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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.

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“…(1 967) described the appearance of cytomegalic inclusion-bearing cells in a cervical smear, and Jindrak (1964), Ross (1966) and Goldman et al (1969) reported cytomegalic inclusions as incidental findings in endocervical glands. It was therefore decided that a comparison of cytology with virus isolation should be carried out for CMV infections at the same time as that for HSV.…”

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confidence: 99%

An Evaluation of Cytology in the Diagnosis of Herpes Simplex Virus Infection and Cytomegalovirus Infection of the Cervix Uteri

Morse

Coleman

Gardner

1974

BJOG

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A cytological and virological study was made to determine the incidence of herpes simplex virus (HSV) infection and cytomegalovirus (CMV) infection of the cervix uteri in 197 women attending a venereal diseases clinic. Cervical cytology was compared with virus isolation as a means of detecting these infections. Herpes simplex virus was isolated from 11 out of 186 women appropriately tested (5 -9 per cent) and an additional 5 patients (2.7 per cent) showed only cytological evidence of the infection, giving a combined diagnostic rate of 8.6 per cent. Cytomegalovirus was isolated from 12 out of 145 patients suitably tested (8.3 per cent) and an inclusion-bearing cell was identified in one of these patients. An association between CMV and multiple genital warts was noticed.

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Incidental finding of cytomegalovirus inclusions in cervical glands

Cited by 14 publications

References 4 publications

Cytomegalovirus infection of the cervix: morphological observations in five cases of a possibly under-recognised condition

Cytomegalovirus infection of the cervix: morphological observations in five cases of a possibly under-recognised condition

Identification of cytomegalovirus in a liquid‐based gynecologic sample using morphology, immunohistochemistry, and DNA real‐time PCR detection

An Evaluation of Cytology in the Diagnosis of Herpes Simplex Virus Infection and Cytomegalovirus Infection of the Cervix Uteri

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