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Items 1-8 of 8 |
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Rapid detection of HSV from cytologic specimens collected into ThinPrep fixative.
Fiel-Gan MD, Villamil CF, Mandavilli SR, Ludwig ME, Tsongalis GJ.
Department of Pathology and Laboratory Medicine, Hartford Hospital, Connecticut 06102, USA.
OBJECTIVE: Herpes simplex virus (HSV) infection is associated with substantial morbidity and mortality in neonates. A diagnosis of HSV on cervical cytologic studies could lead to a cesarean section, with an increase in the risk of maternal morbidity. The identification of viral lesions in sexually active women has medical and social implications. There have been reports of false positive diagnoses of HSV in patients with altered endocervical cells and with cervical intraepithelial neoplasia 3. We evaluated a polymerase chain reaction (PCR)-based assay to detect HSV-1 and HSV-2 in routinely collected cervical cytology specimens in ThinPrep fixative (Cytyc Corp., Marlborough, Massachussets, U.S.A.). STUDY DESIGN: DNA was extracted from five cases that demonstrated cytologic changes suggestive of an HSV infection. PCR amplification with subsequent gel electrophoresis was performed to detect the presence of HSV. RESULTS: HSV DNA was detected in three of five cases that were cytologically diagnosed as suspicious or strongly suspicious for HSV infection. CONCLUSION: The combination of the ThinPrep liquid-based method for cervical cytology with PCR allows prompt confirmation of the diagnosis of HSV without sacrificing the diagnostic morphology on the slide.
Publication Types:
- Clinical Trial
- Controlled Clinical Trial
PMID: 10578975 [PubMed - indexed for MEDLINE]
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Role of cytology in the intraoperative diagnosis of HIV-positive patients undergoing stereotactic brain biopsy.
Cajulis RS, Hayden R, Frias-Hidvegi D, Brody BA, Yu GH, Levy R.
Department of Pathology, Northwestern University, Chicago, Illinois, USA.
OBJECTIVE: To determine the accuracy of cytology in the intraoperative diagnosis of central nervous system (CNS) lesions in human immunodeficiency (HIV)-positive patients. STUDY DESIGN: We prospectively studied 75 cases of computed tomography- or magnetic resonance imaging-guided brain biopsies performed with stereotactic instrumentation and a Nashold biopsy cannula over the course of five years. Biopsy samples were sent for both frozen section and immediate cytologic evaluation. Crush preparations (Papanicolaou and Diff-Quik stained) were used for cytologic assessment. There were 23 cases of progressive multifocal leukoencephalopathy (PML), 8 of toxoplasmosis (toxo), 3 of herpes simplex virus, 26 of lymphoma, 3 of HIV encephalitis, 1 of melanoma, 1 of hamartoma and 10 of nonspecific changes (paraffin section). RESULTS: Using permanent hematoxylin and eosin-stained histologic sections as the "gold standard," frozen section had a sensitivity of 78% and a specificity of 90%, while cytology had a sensitivity of 88% and specificity of 90%. Most of the false negative cases in cytology and frozen section were due to the predominance of necrosis and/or gliosis, present in six cases of toxo. Two of the false positive cases in frozen section (diagnosed as lymphoma) showed toxo, while two false positive cases in cytology (diagnosed as PML) showed only gliosis with negative immunoperoxidase staining for PML in the permanent sections. CONCLUSION: First, cytology had higher sensitivity that frozen section. Second, cytology provided faster results in most instances, primarily due to the nature of specimen preparation. Third, most misdiagnoses occurred in infectious diseases, especially toxo; this should therefore be kept in mind when nonspecific changes with an atypical lymphocytic infiltrate are seen. Fourth, cytology can be an alternative to frozen section for the intraoperative diagnosis of CNS lesions in HIV-positive patients. Another advantage of cytology is elimination of the need for cutting potentially infectious fresh tissue.
PMID: 9100784 [PubMed - indexed for MEDLINE]
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Herpesvirus mimics. A potential pitfall in endocervical brush specimens.
Stowell SB, Wiley CM, Powers CN.
Department of Pathology, State University of New York Health Science Center at Syracuse, New York 13210.
The recent media focus on inadequacies in cervical smear collection and interpretation has resulted in improved collection methods, such as endocervical brushes, as well as closer scrutiny of morphologic criteria. However, endocervical cell artifacts may be associated with these endocervical brushes. Recently in our laboratory a case of reactive-atypical endocervical cells that resembled the cytologic changes associated with Herpes simplex virus (HSV) infection resulted in a false-positive diagnosis of HSV infection. Of 14,622 gynecologic specimens accessioned over 14 months, 459 cases with reactive endocervical cells and 117 with atypical endocervical cells were reported. These cases were reviewed by two independent observers with no knowledge of the prior diagnoses and were evaluated for four cytologic criteria considered diagnostic of HSV infection: multinucleation, margination of nuclear chromatin, ground glass chromatin and intranuclear inclusions. Nineteen cases were diagnostic/suggestive of HSV; 19 additional cases were identified as herpesvirus mimics. The original diagnoses, demographics, clinical data and method of collection were reviewed. In all but three cases an endocervical brush was the method of collection. Of the four criteria studied, only ground glass chromatin had both high sensitivity (95%) and specificity (95%). Intranuclear inclusions, while pathognomonic, had low sensitivity (42%). Altered endocervical cells that mimic herpesvirus are a potential pitfall in the diagnosis of HSV infection. Use of strict criteria, knowledge of the collection method and clinical history will avoid misdiagnosis.
PMID: 8291354 [PubMed - indexed for MEDLINE]
Comment on:
- Acta Cytol. 1988 May-Jun;32(3):314-7
Herpesvirus infection of the male urethra identified by cytology.
Gomousa-Michael M, Rammou-Kinia R.
Publication Types:
PMID: 1311891 [PubMed - indexed for MEDLINE]
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Herpes simplex virus in postradiation cervical smears. A morphologic and immunocytochemical study.
Longatto Filho A, Maeda MY, Oyafuso MS, Kanamura CT, Alves VA.
Division of Pathology, Adolfo Lutz Institute, Sao Paulo State Public Health Service, Brazil.
From January 1987 to August 1988, cytomorphologic criteria of both herpes simplex virus (HSV) and radiation effects were observed in Papanicolaou smears from 3 of 1,340 patients who had received radiotherapy for squamous cell carcinoma of the cervix. Avidin-biotin immunoperoxidase staining, using a rabbit IgG polyclonal HSV antibody, confirmed the presence of HSV antigen in those three postradiation smears. Both multinucleated molded cells and epithelial cells that lacked cytopathic effects were positive for HSV. Three other postradiation smears from these cases were similarly positive for HSV antigen; the one preradiation smear was negative. In situ hybridization and immunoperoxidase studies on sections from the preradiation biopsies were negative: severely altered neoplastic cells showed no reactivity. The absence of HSV markers in the preradiation specimens suggests that the HSV infections were secondary to the radiotherapy; further studies are needed to prove this association and to assess the possible mechanisms. These cases clearly indicate that the overlapping features of radiation and viral effects (such as multinucleation) may be present simultaneously.
PMID: 1699373 [PubMed - indexed for MEDLINE]
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Cytologic evaluation of experimental type 2 herpes simplex infection in mice.
Williams DR, Whitney JE, Harding M, Bodfish K, Skinner GR.
The nature and frequency of cytopathologic changes in female mice genitally infected with type 2 herpes simplex virus have been investigated. The extent of virus infection in an individual mouse was assessed by a system of "plus scoring". Exfoliative cytology clearly provided a reliable evaluation of the extent of virus infection and a reliable prognostic index of mouse mortality. A composite index combining both cytologic and virologic information ('vircyt' value) was derived and shown to provide a convenient and precise prognostic index of mouse mortality.
PMID: 214984 [PubMed - indexed for MEDLINE]
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Clinical and virological findings in patients with cytologically diagnosed gynecologic herpes simplex infections.
Vesterinen E, Purola E, Saksela E, Leinikki P.
Amoung 57,117 routinely collected Papanicolaou smears from the female genital tract there were 90 slides (0.16%) from 85 patients on which a cytologic diagnosis of herpes simplex virus (HSV) infection was made. The characteristic cytologic changes occurred predominantly on the ectocervical part of the smears. The changes were transient but occasionally remained detectable on the corresponding histologic specimens up to 2.5 months. Viral isolation was successful in a majority of cases when performed simultaneously with or less than a week after the cytologic diagnosis. The rate of success rapidly decreased thereafter. Positive fluorescent antibody assays of viral antigens on cytologic smears behaved similarly. Cases with apparent primary infection as well as with secondary infection (recurrences) were included in the material but no differences in the morphology of virally altered cells and be found, indicating that primary and secondary infections could not be distinguished on this basis. There were significantly more cytologic dysplastic changes as well as assorted micro-organism infections in the HSV group as compared to the controls.
PMID: 193333 [PubMed - indexed for MEDLINE]
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Exfoliative cytopathologic studies in organ transplantation IV. The cytologic diagnosis of herpesvirus in the urine of renal allograft recipients.
Bossen EH, Johnston WW.
Cellular changes of herpesvirus infection were found in 12 urine specimens from 4 renal allograft recipients. The cytologic diagnosis of herpes infection in the urine of renal allograft recipients has not been reported previously and is significant because of recent suggestions that viral infection contribute to allograft rejections. We were unable to find a consistent correlation between the cytologic diagnosis of herpesvirus and transplant rejection in the patients we studied.
PMID: 170768 [PubMed - indexed for MEDLINE]
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Items 1-8 of 8 |
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One page. |
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