A successful ultrastructural observation of herpes virusinfected cells in the specimen of sputum smear cytology.

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A healthy 66-year-old male developed severe leukopenia (300/mm3). After oral medication for high fever and chills. He was treated with G-CSF and steroid pulse therapy and recovered. On hospital day 12 sputum smear cytology revealed characteristic herpes virus (HV)-infected cells, including multinucleated cells. Light microscopically, marked nuclear swelling of mono and multinucleated cells with a ground-glass and/or mold-like appearance was observed with eytoplasm resembling that of squamous epithelia cells.<BR>These HV-infected cells were directly examined in Papanicolaou stained-sputum smear specimens after double fixation in glutaraldehyde and osmium tetroxide solution. Although tissue preservation was poor, both 80-100 nm intranuclear and 150-200 nm intracisternal or intravacuolar virus particles were clearly detected ultrastructurally. The nucleus contained mostly loosely-arranged to partly packed virus particles, which appeared to be coreless, although some contained a doughnut-shaped core. Bundles of intracytoplasmic tonofilaments and desmosomes were also found.<BR>These findings showed that direct sputum smear cytology observation of the specimens ultrastructurally demonstrates the presence of virus particles and is useful in confirming the cytologic diagnosis.
特定非営利活動法人日本臨床細胞学会の論文