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# | This article collects all things '''virus'''. The more general topic of infective things is dealt with in [[microorganisms]]. | ||
Many virus afflict humans. Only a few of them can be diagnosed histologically. | |||
==Viral inclusions - types== | |||
Cowdry types:<ref>URL: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970864-6&figureId=fig3&ecomponentId=mmc3 http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970864-6&figureId=fig3&ecomponentId=mmc3]. Accessed: 12 January 2010.</ref> | |||
*Cowdry type A inclusion:<ref>URL: [http://www.whonamedit.com/synd.cfm/3495.html http://www.whonamedit.com/synd.cfm/3495.html]. Accessed on: 22 January 2010.</ref> | |||
**Round eosinophilic material surrounded by a clear halo. | |||
*Cowdry type B inclusion:<ref>[http://www.whonamedit.com/synd.cfm/3496.html http://www.whonamedit.com/synd.cfm/3496.html]. Accessed on: 22 January 2010.</ref> | |||
**Neuropathology thingy. (???) | |||
Images: | |||
*[http://www.daff.gov.au/animal-plant-health/pests-diseases-weeds/aquatic_animal_diseases_significant_to_australia_identification_field_guide/diseases_of_crustaceans/viral_diseases_of_crustaceans/infectious_hypodermal_and_haematopoietic_necrosis/histological_page_for_infectious_hypodermal_and_haematopoietic_necrosis Cowdry A inclusion (daff.gov.au)]. | |||
*[http://focosi.altervista.org/pathohomoprocess_regressive.html Cowdry type A & type B inclusions (altervista.org)]. | |||
=Viruses= | |||
==Herpes simplex virus== | |||
*Abbreviated ''HSV''. | |||
===General=== | |||
Several subtypes: | |||
*Canker sores - usually HSV-1. | |||
*Genital herpes - usually HSV-2. | |||
===Histology/cytology=== | |||
Features:<ref>SM. 11 January 2010.</ref> | |||
*Clear "ground glass" nuclei. | |||
**Rim of peripheral chromatin. | |||
*Nuclear inclusions. | |||
*Multinucleation with nuclear molding, i.e. multiple nuclei that touch over a large surface area. | |||
Mnemonic - 3 Ms: Margination, Multinucleation, Molding. | |||
Images: | |||
*[http://www.virology.org/sbpgphoto2.html Herpes simplex virus - multinucleation (virology.org)]. | |||
*[http://commons.wikimedia.org/wiki/File:Herpes_simplex_virus_pap_test.jpg HSV on a Pap test - showing multinucleation (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Herpes_esophagitis_-_very_high_mag.jpg HSV esophagitis - very high mag. (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Herpes_esophagitis_-_intermed_mag.jpg HSV esophagitis - intermed. mag. (WC)]. | |||
==Cytomegalovirus== | |||
*Abbreviated ''CMV'' | |||
===General=== | |||
*The name comes from the microscopic appearance. | |||
===Microscopic=== | |||
Features: | |||
*Very large nucleus (as the name implies) with clearing. | |||
*Granular cytoplasmic inclusions (red on H&E sections). | |||
Notes: | |||
*Classically in endothelial cells. | |||
**In the context of [[esophagus|esophageal ulcers]], it is therefore useful to biopsy the base of the ulcer - if this is suspected. | |||
Images: | |||
*[http://commons.wikimedia.org/wiki/File:CMV_placentitis2_mini.jpg CMV placentitis (WC)]. | |||
*[http://www.asm.org/division/c/photo/cmv1.jpg CMV (asm.org)]. | |||
===IHC=== | |||
*IHC for CMV is available - highlights granular cytoplasmic inclusions; increases [[sensitivity]]. | |||
==Human papilloma virus== | |||
*Abbreviated ''HPV''. | |||
===General=== | |||
*Causes a lot of pathology: | |||
**Benign: | |||
***[[Verruca vulgaris]]. | |||
***[[Condyloma acuminatum]]. | |||
***[[Esophagus#Human_papilloma_virus_esophagitis|HPV esophagitis]]. | |||
**Malignant: | |||
***[[Uterine cervix|Cervical cancer]] and precursors ([[LSIL]], [[HSIL]]). | |||
***Anal cancer and precurors ([[Anus#Anal_intraepithelial_neoplasia|AIN]]) | |||
***Squamous cell carcinoma in the [[Head & neck pathology|head & neck]]. | |||
Oncocytic types: | |||
*HPV 18 - predominantly adenocarcinoma.<ref name=pmid15551313>{{Cite journal | last1 = De Boer | first1 = MA. | last2 = Peters | first2 = LA. | last3 = Aziz | first3 = MF. | last4 = Siregar | first4 = B. | last5 = Cornain | first5 = S. | last6 = Vrede | first6 = MA. | last7 = Jordanova | first7 = ES. | last8 = Fleuren | first8 = GJ. | title = Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries. | journal = Int J Cancer | volume = 114 | issue = 3 | pages = 422-5 | month = Apr | year = 2005 | doi = 10.1002/ijc.20727 | PMID = 15551313 }}</ref> | |||
*HPV 16 - predominantly squamous cell carcinoma.<ref name=pmid15551313/> | |||
Recombinant vaccine (Gardasil, Silgard) - covers:<ref name=pmid21942919>{{Cite journal | last1 = McCormack | first1 = PL. | last2 = Joura | first2 = EA. | title = Spotlight on Quadrivalent Human Papillomavirus(Types 6, 11, 16, 18) Recombinant Vaccine(Gardasil®) in the Prevention of PremalignantGenital Lesions, Genital Cancer, and Genital Warts in Women†. | journal = BioDrugs | volume = 25 | issue = 5 | pages = 339-43 | month = Oct | year = 2011 | doi = 10.2165/11205060-000000000-00000 | PMID = 21942919 }}</ref> | |||
*HPV 6. | |||
*HPV 11. | |||
*HPV 16. | |||
*HPV 18. | |||
===Microscopic=== | |||
Features: | |||
*Koilocytes: | |||
** Perinuclear clearing. | |||
** Nuclear changes. | |||
*** Size similar (or larger) to those in the basal layer of the epithelium. | |||
*** Nuclear enlargement should be evident on low power, i.e. 25x. | |||
*** Central location - nucleus should be smack in the middle of the cell. | |||
Images: | |||
*[http://commons.wikimedia.org/w/index.php?title=File:Low-grade_squamous_intraepithelial_lesion.jpg LSIL (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Low-grade_sil_and_endocx.jpg LSIL & endocervix (WC)]. | |||
===IHC=== | |||
*p16 +ve -- stains most cells infected by HPV. | |||
==Adenovirus== | |||
===General=== | |||
*Common in kids. | |||
**May be seen in the context of [[adenovirus appendicitis|(adenovirus) appendicitis]]. | |||
===Microscopic=== | |||
Features: | |||
*"Smudge" cells<ref>URL: [http://www.pathguy.com/lectures/infect.htm http://www.pathguy.com/lectures/infect.htm]. Accessed on: 8 July 2010.</ref> - black/blue blob ~ 10-15 micrometers. (???) | |||
Notes: | |||
*May be morphologically similar to ''[[CMV]]'', ''[[HSV]]'', ''[[VZV]]'' inclusions. | |||
Images: | |||
*[http://img.medscape.com/fullsize/migrated/438/534/cc438534.haur.fig1.jpg Adenovirus (medscape.com)].<ref>URL:[http://www.medscape.com/viewarticle/438534_2 http://www.medscape.com/viewarticle/438534_2]. Accessed on: 8 July 2010.</ref> | |||
*[http://wiki.medpedia.com/Image:Ab14.jpg?filetimestamp=20091014175858 Smudge cell (medpedia.com)]. | |||
*[http://www.flickr.com/photos/ckrishnan/3746778145/in/photostream/ Necrosis in germinal centre - low mag. (flickr.com)]. | |||
*[http://www.flickr.com/photos/ckrishnan/3746778007/in/photostream/ Viral inclusions - high mag. (flickr.com)]. | |||
*[http://www.flickr.com/photos/ckrishnan/3747567554/in/photostream/ IHC for adenovirus (flickr.com)] | |||
==Parvovirus== | |||
*[[AKA]] ''Parvovirus B19''. | |||
===General=== | |||
*Most significant in pregnant women. | |||
**Parvovirus attacks the nucleated RBCs of the fetus - causes an ''aplastic [[anemia]]''. | |||
Trivia: | |||
*First described in 1975.<ref name=pmid46024>{{Cite journal | last1 = Cossart | first1 = YE. | last2 = Field | first2 = AM. | last3 = Cant | first3 = B. | last4 = Widdows | first4 = D. | title = Parvovirus-like particles in human sera. | journal = Lancet | volume = 1 | issue = 7898 | pages = 72-3 | month = Jan | year = 1975 | doi = | PMID = 46024 }}</ref> | |||
**The "B19" part comes from the label for the specimen.<ref name="pmid17304869">{{cite journal |author=Servey JT, Reamy BV, Hodge J |title=Clinical presentations of parvovirus B19 infection |journal=Am Fam Physician |volume=75 |issue=3 |pages=373–6 |year=2007 |month=February |pmid=17304869 |doi= |url=http://www.aafp.org/afp/991001ap/1455.html}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Glassy (red) nuclear inclusions.<ref>URL: [http://www.pathguy.com/lectures/infect.htm http://www.pathguy.com/lectures/infect.htm]. Accessed on: 8 July 2010.</ref> | |||
*Nuclear enlargement. | |||
Images: | |||
*[[WC]]: | |||
**[http://commons.wikimedia.org/wiki/File:Parvovirus_infection_-_cropped_2_-_very_high_mag.jpg Parvovirus - version 1 - very high mag. (WC)]. | |||
**[http://commons.wikimedia.org/wiki/File:Parvovirus_infection_-_cropped_1_-_very_high_mag.jpg Parvovirus - version 2 - very high mag. (WC)]. | |||
*www: | |||
**[http://info.fujita-hu.ac.jp/~tsutsumi/photo/photo210-1.htm Parvovirus (fujita-hu.ac.jp)].<ref>URL:[http://info.fujita-hu.ac.jp/~tsutsumi/case/case210.htm http://info.fujita-hu.ac.jp/~tsutsumi/case/case210.htm]. Accessed on: 8 February 2011.</ref> | |||
**[http://www.scielo.br/img/revistas/rimtsp/v49n2/07f1a.jpg Parvovirus - placenta - (scielo.br)].<ref>URL: [http://www.scielo.br/scielo.php?pid=S0036-46652007000200007&script=sci_arttext http://www.scielo.br/scielo.php?pid=S0036-46652007000200007&script=sci_arttext]. Accessed on: 18 August 2011.</ref> | |||
**[http://www.fujita-hu.ac.jp/~tsutsumi/case/case219.htm Parvovirus - several images (fujita-hu.ac.jp)]. | |||
==Epstein-Barr virus== | |||
*Abbreviated ''EBV'' | |||
===General=== | |||
*Cases [[mononucleosis]]. | |||
*Part of the herpes group of viruses.<ref>URL: [http://www.meddean.luc.edu/lumen/MedEd/orfpath/herpes.htm http://www.meddean.luc.edu/lumen/MedEd/orfpath/herpes.htm]. Accessed on: 14 April 2011.</ref> | |||
====Associations==== | |||
Cancer:<ref name=Ref_PCPBoD8_169>{{Ref PCPBoD8|169}}</ref> | |||
*Classical [[Hodgkin lymphoma]]. | |||
*[[Burkitt lymphoma]]. | |||
*[[Nasopharyngeal carcinoma]]. | |||
*B cell lymphomas -- in immunosuppressed individuals. | |||
**[[Post-transplant lymphoproliferative disorder]]. | |||
*[[Hemophagocytic syndrome]].<ref name=pmid20819601>{{cite journal |author=Jin YK, Xie ZD, Yang S, Lu G, Shen KL |title=Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: a retrospective study of 78 pediatric cases in mainland of China |journal=Chin. Med. J. |volume=123 |issue=11 |pages=1426–30 |year=2010 |month=June |pmid=20819601 |doi= |url=}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Variable - see specific pathologies in ''Associations'' section. | |||
**+/-Atypical lymphocytes. | |||
**+/-Hemophagocytosis (uncommon). | |||
==Polyomavirus== | |||
May refer to: | |||
#BK virus. | |||
#*See: ''[[Renal_transplant_pathology#Polyomavirus]]'' and ''[[Urine_cytopathology#Human_polyoma_infection]]. | |||
#Merkel cell polyomavirus. | |||
#*See: ''[[Merkel cell carcinoma]]''. | |||
=See also= | |||
*[[Microorganisms]]. | |||
*[[Basics]]. | |||
*[[HIV]]. | |||
=References= | |||
{{Reflist|2}} | |||
[[Category:Microorganisms]] |
Revision as of 05:16, 15 November 2011
This article collects all things virus. The more general topic of infective things is dealt with in microorganisms.
Many virus afflict humans. Only a few of them can be diagnosed histologically.
Viral inclusions - types
Cowdry types:[1]
- Cowdry type A inclusion:[2]
- Round eosinophilic material surrounded by a clear halo.
- Cowdry type B inclusion:[3]
- Neuropathology thingy. (???)
Images:
Viruses
Herpes simplex virus
- Abbreviated HSV.
General
Several subtypes:
- Canker sores - usually HSV-1.
- Genital herpes - usually HSV-2.
Histology/cytology
Features:[4]
- Clear "ground glass" nuclei.
- Rim of peripheral chromatin.
- Nuclear inclusions.
- Multinucleation with nuclear molding, i.e. multiple nuclei that touch over a large surface area.
Mnemonic - 3 Ms: Margination, Multinucleation, Molding.
Images:
- Herpes simplex virus - multinucleation (virology.org).
- HSV on a Pap test - showing multinucleation (WC).
- HSV esophagitis - very high mag. (WC).
- HSV esophagitis - intermed. mag. (WC).
Cytomegalovirus
- Abbreviated CMV
General
- The name comes from the microscopic appearance.
Microscopic
Features:
- Very large nucleus (as the name implies) with clearing.
- Granular cytoplasmic inclusions (red on H&E sections).
Notes:
- Classically in endothelial cells.
- In the context of esophageal ulcers, it is therefore useful to biopsy the base of the ulcer - if this is suspected.
Images:
IHC
- IHC for CMV is available - highlights granular cytoplasmic inclusions; increases sensitivity.
Human papilloma virus
- Abbreviated HPV.
General
- Causes a lot of pathology:
- Benign:
- Malignant:
- Cervical cancer and precursors (LSIL, HSIL).
- Anal cancer and precurors (AIN)
- Squamous cell carcinoma in the head & neck.
Oncocytic types:
Recombinant vaccine (Gardasil, Silgard) - covers:[6]
- HPV 6.
- HPV 11.
- HPV 16.
- HPV 18.
Microscopic
Features:
- Koilocytes:
- Perinuclear clearing.
- Nuclear changes.
- Size similar (or larger) to those in the basal layer of the epithelium.
- Nuclear enlargement should be evident on low power, i.e. 25x.
- Central location - nucleus should be smack in the middle of the cell.
Images:
IHC
- p16 +ve -- stains most cells infected by HPV.
Adenovirus
General
- Common in kids.
- May be seen in the context of (adenovirus) appendicitis.
Microscopic
Features:
- "Smudge" cells[7] - black/blue blob ~ 10-15 micrometers. (???)
Notes:
Images:
- Adenovirus (medscape.com).[8]
- Smudge cell (medpedia.com).
- Necrosis in germinal centre - low mag. (flickr.com).
- Viral inclusions - high mag. (flickr.com).
- IHC for adenovirus (flickr.com)
Parvovirus
- AKA Parvovirus B19.
General
- Most significant in pregnant women.
- Parvovirus attacks the nucleated RBCs of the fetus - causes an aplastic anemia.
Trivia:
Microscopic
Features:
- Glassy (red) nuclear inclusions.[11]
- Nuclear enlargement.
Images:
- WC:
- www:
Epstein-Barr virus
- Abbreviated EBV
General
- Cases mononucleosis.
- Part of the herpes group of viruses.[14]
Associations
Cancer:[15]
- Classical Hodgkin lymphoma.
- Burkitt lymphoma.
- Nasopharyngeal carcinoma.
- B cell lymphomas -- in immunosuppressed individuals.
Microscopic
Features:
- Variable - see specific pathologies in Associations section.
- +/-Atypical lymphocytes.
- +/-Hemophagocytosis (uncommon).
Polyomavirus
May refer to:
- BK virus.
- Merkel cell polyomavirus.
- See: Merkel cell carcinoma.
See also
References
- ↑ URL: http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970864-6&figureId=fig3&ecomponentId=mmc3. Accessed: 12 January 2010.
- ↑ URL: http://www.whonamedit.com/synd.cfm/3495.html. Accessed on: 22 January 2010.
- ↑ http://www.whonamedit.com/synd.cfm/3496.html. Accessed on: 22 January 2010.
- ↑ SM. 11 January 2010.
- ↑ 5.0 5.1 De Boer, MA.; Peters, LA.; Aziz, MF.; Siregar, B.; Cornain, S.; Vrede, MA.; Jordanova, ES.; Fleuren, GJ. (Apr 2005). "Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries.". Int J Cancer 114 (3): 422-5. doi:10.1002/ijc.20727. PMID 15551313.
- ↑ McCormack, PL.; Joura, EA. (Oct 2011). "Spotlight on Quadrivalent Human Papillomavirus(Types 6, 11, 16, 18) Recombinant Vaccine(Gardasil®) in the Prevention of PremalignantGenital Lesions, Genital Cancer, and Genital Warts in Women†.". BioDrugs 25 (5): 339-43. doi:10.2165/11205060-000000000-00000. PMID 21942919.
- ↑ URL: http://www.pathguy.com/lectures/infect.htm. Accessed on: 8 July 2010.
- ↑ URL:http://www.medscape.com/viewarticle/438534_2. Accessed on: 8 July 2010.
- ↑ Cossart, YE.; Field, AM.; Cant, B.; Widdows, D. (Jan 1975). "Parvovirus-like particles in human sera.". Lancet 1 (7898): 72-3. PMID 46024.
- ↑ Servey JT, Reamy BV, Hodge J (February 2007). "Clinical presentations of parvovirus B19 infection". Am Fam Physician 75 (3): 373–6. PMID 17304869. http://www.aafp.org/afp/991001ap/1455.html.
- ↑ URL: http://www.pathguy.com/lectures/infect.htm. Accessed on: 8 July 2010.
- ↑ URL:http://info.fujita-hu.ac.jp/~tsutsumi/case/case210.htm. Accessed on: 8 February 2011.
- ↑ URL: http://www.scielo.br/scielo.php?pid=S0036-46652007000200007&script=sci_arttext. Accessed on: 18 August 2011.
- ↑ URL: http://www.meddean.luc.edu/lumen/MedEd/orfpath/herpes.htm. Accessed on: 14 April 2011.
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 169. ISBN 978-1416054542.
- ↑ Jin YK, Xie ZD, Yang S, Lu G, Shen KL (June 2010). "Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis: a retrospective study of 78 pediatric cases in mainland of China". Chin. Med. J. 123 (11): 1426–30. PMID 20819601.