Immunohistochemistry improves the detection of adenovirus in gastrointestinal biopsy specimens from hematopoietic stem cell transplant recipients

Anna Sophie Weidner, Nicole C. Panarelli, Hanna Rennert, Jose Jessurun, Rhonda K. Yantiss

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: Gastrointestinal infections by cytomegalovirus (CMV) and adenovirus may complicate hematopoietic stem cell transplantation (HSCT). Although CMV and adenovirus produce recognizable cytopathic changes, these changes may be subtle or focal. The value of viral immunohistochemistry in detecting infection in HSCT recipients when cytopathic changes are not identified has not been demonstrated. Methods: H&E-stained sections from gastrointestinal biopsy specimens were reviewed by three pathologists. Cases were classified as negative, suspicious, or positive for CMV and/or adenovirus infection based on the presence or absence of viral inclusions. Viral immunohistochemistry was performed, and the results were compared with the interpretations of H&E-stained sections. Results: Four of 104 cases contained viral inclusions confirmed by immunohistochemistry: two were infected with CMV, and two were positive for adenovirus. All three reviewers correctly classified both immunopositive CMV cases on H&E evaluation. However, all reviewers missed the diagnosis of adenovirus on H&E assessment in one case. Conclusions: In HSCT recipients, cytopathic changes of adenovirus may be easily missed in H&E-stained sections of gastrointestinal biopsy specimens. Thus, the routine use of adenovirus immunohistochemistry in all cases is recommended. Both cases of CMV infection were apparent on H&E evaluation, so the judicious use of immunohistochemical stains for CMV in selected cases may be considered.

Original languageEnglish (US)
Pages (from-to)627-631
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume146
Issue number5
DOIs
StatePublished - 2016

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Hematopoietic Stem Cells
Adenoviridae
Cytomegalovirus
Immunohistochemistry
Hematopoietic Stem Cell Transplantation
Transplants
Biopsy
Cytomegalovirus Infections
Adenoviridae Infections
Coloring Agents
Transplant Recipients
Infection

Keywords

  • Adenovirus
  • CMV
  • Gastrointestinal tract
  • Transplant

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Immunohistochemistry improves the detection of adenovirus in gastrointestinal biopsy specimens from hematopoietic stem cell transplant recipients. / Weidner, Anna Sophie; Panarelli, Nicole C.; Rennert, Hanna; Jessurun, Jose; Yantiss, Rhonda K.

In: American Journal of Clinical Pathology, Vol. 146, No. 5, 2016, p. 627-631.

Research output: Contribution to journalArticle

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abstract = "Objectives: Gastrointestinal infections by cytomegalovirus (CMV) and adenovirus may complicate hematopoietic stem cell transplantation (HSCT). Although CMV and adenovirus produce recognizable cytopathic changes, these changes may be subtle or focal. The value of viral immunohistochemistry in detecting infection in HSCT recipients when cytopathic changes are not identified has not been demonstrated. Methods: H&E-stained sections from gastrointestinal biopsy specimens were reviewed by three pathologists. Cases were classified as negative, suspicious, or positive for CMV and/or adenovirus infection based on the presence or absence of viral inclusions. Viral immunohistochemistry was performed, and the results were compared with the interpretations of H&E-stained sections. Results: Four of 104 cases contained viral inclusions confirmed by immunohistochemistry: two were infected with CMV, and two were positive for adenovirus. All three reviewers correctly classified both immunopositive CMV cases on H&E evaluation. However, all reviewers missed the diagnosis of adenovirus on H&E assessment in one case. Conclusions: In HSCT recipients, cytopathic changes of adenovirus may be easily missed in H&E-stained sections of gastrointestinal biopsy specimens. Thus, the routine use of adenovirus immunohistochemistry in all cases is recommended. Both cases of CMV infection were apparent on H&E evaluation, so the judicious use of immunohistochemical stains for CMV in selected cases may be considered.",
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