免疫功能低下患者水痘-带状疱疹病毒播散性感染所致胸腔积液的细胞学检查。病例报告。

Cytology of pleural effusion associated with disseminated infection caused by varicella-zoster virus in an immunocompromised patient. A case report.

作者信息

Mori Masaki, Imamura Yoshiaki, Maegawa Hideki, Yoshida Haruyoshi, Naiki Hironobu, Fukuda Masaru

机构信息

Department of Surgical Pathology, Fukui Medical University Hospital, Departments of Pathology and Clinical Laboratory Medicine, Fukui Medical University, Matsuoka, Fukui, Japan.

出版信息

Acta Cytol. 2003 May-Jun;47(3):480-4. doi: 10.1159/000326555.

DOI:10.1159/000326555

PMID:12789936

Abstract

BACKGROUND

Pleural effusion caused by varicella-zoster virus (VZV) is rare. We report a case of a woman with acute lymphocytic leukemia (ALL) who developed a pleural effusion caused by VZV infection.

CASE

A 55-year-old woman with ALL treated with consolidation therapy developed skin vesicles and a pleural effusion. Pleural fluid smears contained numerous mesothelial cells, which had ground-glass nuclei or eosinophilic nuclear inclusions. Some multinucleated giant cells were also seen. Electron microscopic examination revealed intranuclear virus particles, about 150 nm in diameter, in some mesothelial cells. Tissue samples from the skin, lungs, pleura, liver, pancreas, kidneys and gastrointestinal tract, obtained at autopsy, contained many virus-infected cells. They were positive for VZV glyco-protein 1 by immunohistochemistry.

CONCLUSION

VZV infection should be considered in the differential diagnosis of an unexplained exudative pleural effusion, especially in immunocompromised hosts.

摘要

背景

水痘-带状疱疹病毒（VZV）引起的胸腔积液较为罕见。我们报告一例患急性淋巴细胞白血病（ALL）的女性发生VZV感染所致胸腔积液的病例。

病例

一名接受巩固治疗的55岁ALL女性出现皮肤水疱和胸腔积液。胸腔积液涂片含有大量间皮细胞，这些细胞具有毛玻璃样核或嗜酸性核内包涵体。还可见一些多核巨细胞。电子显微镜检查显示部分间皮细胞内有直径约150 nm的核内病毒颗粒。尸检时获取的皮肤、肺、胸膜、肝、胰腺、肾和胃肠道组织样本含有许多病毒感染细胞。免疫组织化学检测显示它们VZV糖蛋白1呈阳性。