Elgert Paul A, Yee-Chang Melissa, Simsir Aylin
NYU School of Medicine Affiliation with NYC Health + Hospitals Bellevue, Cytopathology Supervisor, Pathology, 462 First Avenue, New York, 10016, New York.
Cytopathology NYC Health + Hospitals Bellevue, Clinical Assistant Professor, NYU School of Medicine, Director, Cytopathology NYC Health + Hospitals Bellevue, 462 First Avenue, New York, 10016, New York.
Diagn Cytopathol. 2018 Jul;46(7):593-599. doi: 10.1002/dc.23951. Epub 2018 Apr 26.
Cytomegalovirus (CMV) is a ubiquitous infection typically affecting over 50% of the US population by age 40. We report 8 cases of CMV infections detected in cervical cancer screening tests, the largest series of cases thus far reported in gynecologic cytology specimens.
A retrospective review of our pathology archival computer database was performed from January 1, 1994 through December 31, 2016 for CMV infections reported in cervical cytology specimens. The slides were retrieved for review if available.
The eight patients ranged in age from 21-46 years, with a median age of 27 years and average age of 29.5 years. Two patients were significantly immunocompromised with one patient having AIDS and one patient diagnosed with autoimmune disease. The remaining six patients are considered immunocompetent. Cases were identified most often in the fall and winter months (6 of 8 cases). Seven cases were found using Surepath Pap (SP) liquid-based processing and one case was reported in a classic Papanicolaou smear (CPS).
There was no correlation of cytologic presentation of CMV with a distinct cytohormonal pattern or inflammatory constituents. Rare diagnostic cells with changes of CMV infection were seen in 75% of the cases. The presence of CMV did not usually result in adverse patient outcome, except where CMV was one of the multiple opportunistic infections detected in the patient with AIDS.
巨细胞病毒（CMV）感染普遍存在，到40岁时，通常影响超过50%的美国人群。我们报告了在宫颈癌筛查试验中检测到的8例CMV感染病例，这是迄今为止在妇科细胞学标本中报告的最大病例系列。
对我们病理档案计算机数据库进行回顾性分析，时间跨度为1994年1月1日至2016年12月31日，以查找宫颈细胞学标本中报告的CMV感染情况。如有可用的玻片，则取出进行复查。
8例患者年龄在21至46岁之间，中位年龄为27岁，平均年龄为29.5岁。2例患者存在明显免疫功能低下，1例患有艾滋病，1例被诊断为自身免疫性疾病。其余6例患者被认为免疫功能正常。病例最常出现在秋季和冬季（8例中的6例）。7例是通过Surepath Pap（SP）液基处理发现的，1例是在经典巴氏涂片（CPS）中报告的。
CMV的细胞学表现与独特的细胞激素模式或炎症成分之间没有相关性。75%的病例中可见具有CMV感染变化的罕见诊断细胞。CMV的存在通常不会导致患者出现不良后果，除非CMV是艾滋病患者检测到的多种机会性感染之一。
