J Pathol Transl Med.  2016 Mar;50(2):147-154. 10.4132/jptm.2015.12.25.

Morphologic Analysis of Cytomegalovirus Infected Cells in Bronchial Washing Cytology: Comparison of Liquid-Based Preparation and Conventional Smear

• Seok JY
• An J
• Ha SY
• Chung DH
• Lee S
• Kim H

• KMID: 2211382
• DOI: http://doi.org/10.4132/jptm.2015.12.25

Abstract

BACKGROUND
The cytopathic effects of cytomegalovirus (CMV) infection have been well described since the virus was first reported; however, the morphology of CMV infection has not been clearly studied. We examined the difference in detailed cytologic findings in bronchial washing cytology between liquid-based and conventionally prepared smears.
METHODS
Bronchial washing cytology was processed using either the conventional preparation (CP) or liquid-based preparation (LBP). Sixty-nine cells with typical cytopathic effects of CMV infection were detected on CP slides and 18 cells on LBP slides. Using the image analyzer, area, circumference, major axis, and minor axis of the cytoplasm, nucleus, and intranuclear inclusion were measured in singly scattered CMV-infected cells, and histiocytes were used as a control.
RESULTS
The mean cytoplasmic area of CMV-infected cells was 1.47 times larger than that of histiocytes in CP and 2.92 times larger in LBP (p<.05). The mean nuclear area of CMV-infected cells was 2.61 times larger than that of histiocytes in CP and 4.25 times larger in LBP (p<.05). The nucleus to cytoplasm ratio and intranuclear inclusion to cytoplasm ratio of the mean area, circumference, major axis, and minor axis in CP were larger than those in LBP (p<.05).
CONCLUSIONS
The sizes of cytoplasm, nucleus, and intranuclear inclusion were larger in LBP than in CP, indicating that CMV-infected cells are easily detectable in LBP. However, the nucleus-to-cytoplasm ratio was larger in CP, suggesting that differentiation from malignancy or regenerative atypia requires caution in CP.

Keyword

Cytomegalovirus; Bronchial washing; Cytology; Lung

MeSH Terms

Axis, Cervical Vertebra
Cytomegalovirus*
Cytoplasm
Histiocytes
Intranuclear Inclusion Bodies
Lung

Figure

• 

  Fig. 1. (A, B) Well-prepared microscopic photographs from the image analyzer program. Specific shape and color are detected by the program. The researcher selects an area of interest, and the area, circumference, major axis, and minor axis are automatically calculated by the image analyzer. The major axis is the longest diameter, and the minor axis is the dimension perpendicular to the major axis. (C) A singly scattered cytomegalovirus infected cell and a histiocyte in a cytology specimen processed by liquid-based preparation are noted with a clean background. The cytoplasm and nucleus are enlarged and show dense cytoplasm with a well-demarcated cytoplasmic border. (D) In a conventionally-prepared cytology smear, a cytomegalovirus infected cell shows a prominent intranuclear inclusion.

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