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Pathologische Anatomie der Cytomegalie

Pathologic anatomy of cytomegaly-virus-infection

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Summary

Morphological diagnosis of cytomegaly is based on macroscopic, histopathologic and cytologic criteria. The macropathology of generalized cytomegaly in infants is characterized by cerebral lesions (micro- and polygyria, microencephalia, hydrocephalus, intracranial calcifications), hepato- and splenomegaly, jaundice, hemorrhagic diathesis and anemia. Histopathologically, an interstitial lymphocytic inflammation of organs is found, associated with parenchymal destruction, alterations of organ structure and occurrence of giant cells. Salivary glands, kidneys, lungs, liver, pancreas, thyroid glands, adrenal glands, gastro-intestinal tract and brain are most frequently affected. The cytodiagnosis of cytomegaly is based on three characteristic findings: cell enlargement with an unchanged nucleo cytoplasmic ratio, owl-eye nucleus with nucleus-inclusion body and cytoplasmic inclusions.Intra vitam typical giant cells are observed in saliva, urine, liquor, gastric juice and in biopsy material from liver or parotid gland. These are found rarely in surgical specimens of other organs. Electronmicroscopically the inclusion bodies represent DNS-viruses with polyhedral configuration. The multiplication of infectious viruses takes place in the nucleus.

Zusammenfassung

Die morphologische Diagnose der Cytomegalie beruht auf makroskopischen, histopathologischen und cytologischen Kriterien. Die Makropathologie der generalisierten Cytomegalie im Kindesalter ist durch cerebrale Veränderungen (Mikro- und Polygyrien, Mikroencephalie, Hydrocephalus, intrakranielle Verkalkungen), Hepato- und Splenomegalie, Ikterus, hämorrhagische Diathese und allgemeine Anämie gekennzeichnet. Histopathologisch finden sich interstitielle lymphocytäre Organentzündungen mit Parenchymauflösung, Organumbau und Einschluß von Riesenzellen. Dabei sind am häufigsten Speicheldrüsen, Nieren, Lungen, Leber, Pankreas, Schilddrüse, Nebennieren, Magendarmkanal und Gehirn befallen. Die Cytodiagnostik der Cytomegalie beruht auf drei Hauptmerkmalen: Zellvergrößerung unter Erhaltung der Kern-Cytoplasma-Relation, „Eulenaugenkern“ mit Kern-Einschlußkörper und Cytoplasmaeinschlüssen. Intra vitam sind typische Riesenzellen im Mundspeichel, Urin, Liquor, Magensaft und in Leber- sowie Parotisbiopsien nachgewiesen worden, vereinzelt auch in Operationspräparaten aus anderen Organen. Ultrastrukturell handelt es sich in den Einschlußkörpern um DNS-Virionen mit polyedrischer Konfiguration. Die Neubildung infektiöser Virionen erfolgt im Zellkern.

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  1. Direktor des Pathologischen Institutes der Universität Hamburg, Germany

    G. Seifert

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Seifert, G. Pathologische Anatomie der Cytomegalie. Klin Wochenschr 51, 533–540 (1973). https://doi.org/10.1007/BF01482466

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