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Cytomegalovirus (CMV) infection is one of the most frequently encountered viral infections of the fetus and induces a wide range of histologic and clinical manifestations. Congenital abnormalities are typically restricted to the central nervous system despite evidence of CMV inclusions occurring in most epithelial cells. Although tissue injury and even glomerulonephritis have been observed in congenital CMV infections, renal multicystic dysplasia has not been reported. Herein, we describe a case of unilateral renal dysplasia in a 19-week fetus with concurrent CMV infection. We believe the present case to be the first description of a virus apparently inducing renal multicystic dysplasia.

In cytological examination, human cytomegalovirus (HCMV) infection can not be implied unless typical HCMV-infected cells like owl's-eye cells are present. However, such cells are not always observed in HCMV-infection cases. The aim of our study is to establish the cytopathological features induced by HCMV. In vitro transfection and fluorescence in situ hybridization (FISH) were performed on human embryo lung (HEL) cells. Marked cellular aggregation was observed at 6-hr postinfection (hpi). Multinucleated cells, giant cells, and, particularly, small vacuoles were present in the nuclei or cytoplasm before the appearance of inclusion bodies. However, molding and ground glass in nuclei were absent. Cell clusters displayed round cytoplasm, dispersed later, and showed anisocytosis. All features occurred before 48 hpi when the owl's-eye cell appeared. In FISH, the positive signal highlighted viral particles that became predominant and localized in nuclei. These cytological aspects are dependent on viral replication and contribute to the cytological detection of HCMV infection.

Background: To study the composition and significance of the inclusion bodies of human cytomegalovirus (HCMV)., Methods: Microdissection of inclusion bodies, PCR and Southern blot were adopted to detect DNA, and immunohistochemistry method and catalyzed signal amplification (CSA) were used to detect the different antigens of HCMV., Results: The inclusion bodies of HCMV were separated from the tissue section of human salivary gland. The fragments amplified by PCR from these dissected inclusion bodies were confirmed to be the DNA of HCMV. With the immunohistochemical method CSA, the immediately early and early antigens of HCMV were detected with monoclonal antibodies DDG9/CCH2, while matrix protein AAC10 was negative in the inclusion bodies., Conclusion: The ingredient of inclusion bodies of HCMV included the DNA and the antigens expressed in specific stage of the virus.

We describe 7 histologically proven cases of cytomegalovirus disease in patients without human immunodeficiency virus and without organ transplants, all of whom had associated comorbid conditions. Therapy with ganciclovir generally resulted in a favorable outcome.

We describe 4 patients identified over 5 years with large atypical cells on the feathered edge of routinely prepared peripheral blood films. Films were reviewed either as part of a blood film consultation or a bone marrow examination. The cells were 50 to 60 microns in diameter, with granular eosinophilic cytoplasmic inclusions and eccentric enlarged nuclei. Additional studies including buffy coat preparations and immunohistochemistry revealed that these were circulating cytomegalovirus (CMV)-infected cells, most likely of endothelial origin. All patients were immunocompromised (3 had HIV infection, and 1 was an organ transplant recipient) and had clinical evidence of CMV infection. The unique appearance of these cells at Wright-Giemsa staining, and their possible misidentification as malignant cells or other cells, highlights the need for pathologists to be aware of their morphologic features and possible clinical implication.

A case of parotid juvenile hemangioma associated with cytomegalovirus infection is reported. A growing lobulated mass, measuring 30 x 20 mm, was extirpated from the left parotid gland in a 4-month-old male. Histologically, the tumor consisted of cellular plump endothelial cells, stromal cells and residual ductal and acinar elements of the parotid gland. Numerous intranuclear and cytoplasmic inclusions were observed in the ductal cells of the whole parenchymal part of the parotid gland and the residual part of the tumor. Immunohistochemically, some nuclei of the ductal cells possessing these inclusions were positive for the anti-cytomegalovirus antibody but there were no positive findings in the endothelial or stromal cells. Although the present lesion may suggest that the human cytomegalovirus plays some role in the etiology of juvenile hemangioma, it is unknown whether or not this association is incidental.

Human cytomegalovirus (HCMV) and bone marrow interactions are important in the pathogenesis of HCMV infections. Human bone marrow fibroblastic stromal cells (HBFM-sc) were infected by Towne strain of cytomegalovirus (CMV) in cell culture. Several cytostructural features of control bone marrow stromal cells are described and compared with those of CMV-infected cells. Under these experimental conditions, HBFM-sc are cell types that can be successfully infected by CMV in vitro. The CMV-infected cells displayed typical features characteristic of DNA virus infections, such as cellular swelling, intranuclear inclusions, nucleolar condensation and disappearance (at the end stage), nuclear envelope proliferation as redundant folds. Other characteristics of CVM-infected cells include mitochondrial enlargement and vacuolization, cytoplasmic dense bodies associated or not with viral particles, accumulation and extrusion of viral particles and dense bodies. These preliminary observations shed some light on human bone-marrow stromal-cell morphology and function, one of the latter being that of a potentially harmful reservoir for CMV virus.

Cytomegalovirus (CMV) infection constitutes an important cause of intrauterine death. In the present study CMV infection of placentas resulting from intrauterine deaths was assessed by immunohistochemistry and by the polymerase chain reaction (PCR). Among 32 cases of chronic villitis examined, 7 were found by PCR to be associated with CMV infection, although light microscopic examination revealed only 3 of them, while 4 had shown positive immunohistochemical staining. In conclusion, CMV may be considered to be a relatively common cause of placentitis, and PCR is a helpful tool in confirming the nature of the disease.