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

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Abstract
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. Diagn. Cytopathol. 2004;30:411–417.