Parham D M, Bozeman P, Killian C, Murti G, Brenner M, Hanif I
Department of Pathology and Laboratory Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee 38101.
Am J Clin Pathol. 1993 May;99(5):588-92. doi: 10.1093/ajcp/99.5.588.
Cytologic examination of a bronchoalveolar lavage specimen from a 6-year-old bone marrow transplant recipient revealed pulmonary infiltrates and occasional cells containing discrete pink cytoplasmic inclusions on a May-Grunwald-Giemsa stain. Direct immunofluorescence stains of cytospins prepared from the same specimen were positive for respiratory syncytial virus (RSV). Electron microscopy revealed occasional epithelial cells with cytoplasmic inclusions composed of filamentous virions. The patient died 6 months after the specimen was taken. An autopsy showed ongoing bronchiolitis with diffuse alveolar damage. Occasional bronchiolar epithelial cells contained discrete eosinophilic cytoplasmic inclusions, which on ultrastructural examination proved to be compatible with RSV. Examination of bronchoalveolar lavage fluid from bone marrow transplant recipients should include a search for cytopathic changes compatible with RSV infection. Electron microscopy can be helpful in confirming this diagnosis.
对一名6岁骨髓移植受者的支气管肺泡灌洗标本进行的细胞学检查显示，在美-格-吉姆萨染色下可见肺部浸润以及偶尔出现的含有离散粉红色细胞质包涵体的细胞。对同一标本制备的细胞涂片进行直接免疫荧光染色，结果显示呼吸道合胞病毒（RSV）呈阳性。电子显微镜检查发现偶尔有上皮细胞含有由丝状病毒粒子组成的细胞质包涵体。该患者在标本采集6个月后死亡。尸检显示存在进行性细支气管炎并伴有弥漫性肺泡损伤。偶尔的细支气管上皮细胞含有离散的嗜酸性细胞质包涵体，超微结构检查证明与RSV相符。对骨髓移植受者的支气管肺泡灌洗液检查应包括寻找与RSV感染相符的细胞病变变化。电子显微镜检查有助于确诊。
