• Classic CMV intranuclear inclusions are deep purple, occupy
>50% of the nuclear diameter, have a clear perinuclear zone
and a rim of condensed nuclear chromatin
• In this case the perinuclear clear zone is obliterated by
the large size of the CMV inclusion
• Intracytoplasmic CMV inclusions can be present as small punctate dots(nicely seen in this case)
• Cytomegalovirus, beta-group herpesvirus
• Viral infection of endothelium and epithelial cells as well as stromal cells
• Productive infection results in viral cytopathic changes described below
• Endothelial cell damage can lead to vascular injury
• Widely distributed in normal population where it is acquired sexually, perinatally, in breast milk, intrauterine or by respiratory droplets
• Causes asymptomatic or mononucleosis like infection; latent in leukocytes
• In immunocompromised patient^s becomes disseminated
• May result in perforation
• Bloody diarrhea
|General Gross Description|
• Discrete ulcers when endothelial cell involvement pronounced.
• May perforate.
|General Micro Description|
• Cytopathic changes associated with viral infection and replication include marked cellular enlargement.
• Large intranuclear and/or intracytoplasmic eosinophilic inclusions
• Intranuclear inclusions occupying >50% of nuclear diameter are diagnostic
• Necrosis with endothelial cell involvement
• Diagnostic Surgical Pathology, 2d edition, Sternberg SS (ed). Philadelphia: Lippincott-Raven,1996, pp. 1335.