擦過細胞診で感染細胞がみられたヘルペス食道炎の１例

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  • Herpetic esophagitis with characteristic cytologic findings.

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We report a case of herpetic esophagitis in which direct vision brush cytology showed characteristic findings. A 78-year-old woman was treated for a femur fracture. Since she experienced hematemesis and anemia, an upper gastrointestinal endoscopy was performed. Brush cytology showed many small round epithelial cell singly or in small aggregates. Characteristic “ground-glass” appearance of the nucleus, with deposition of chromatin material beneath the nuclear membrane (full type), and large eosinophilic intranuclear inclusion bodies (Cowdry type A) were observed. These epithelial cells also formed multinucleated giant cells. In addition to these findings, a few bizzare cells with atypical nuclei had orangeophilic cytoplasm.<BR>Paraffin-embedded tissue was stained by the standard immunoperoxidase anti-peroxidase technique with antiherpes simplex type 1 and 2 antisera. Positive staining of intranuclear and paracytic inclusions was observed. Electron microscopy showed that the infected cells contained numerous intranuclear and paracytic viral capsids approximately 100 nm in diameter. The diagnosis of herpetic esophagitis was suggested from light and electron microscopic examination and confirmed by immunoperoxidase staining.

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