Bone marrow - nonneoplastic
Infectious / inflammatory
CMV

Author: Dragos Luca, M.D. (see Authors page)

Revised: 12 July 2017, last major update December 2014

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: CMV [title] bone marrow [title]

Cite this page: CMV. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonemarrowcmv.html. Accessed October 20th, 2017.
Definition / general
Clinical presentation and diagnosis
  • Clinical and hematologic features show considerable overlap with EBV infection
  • Intrauterine infection is associated with thrombocytopenia and hemolytic anemia in neonates
  • CMV pp65 antigenemia assay is more specific in immunocompromised patients than antibody titers
Case reports
Microscopic (histologic) description
  • Generally nonspecific findings in bone marrow including myeloid and megakaryocytic suppression
  • Infected cells with intranuclear inclusions (not identifiable in many cases); may be highlighted via IHC or ISH
  • Nuclear inclusions: single, round or oval, deep blue or amphophilic, surrounding halo, margination of nuclear chromatin
  • Cytoplasmic inclusions: multiple, irregular in shape, basophilic
  • Occasional hemophagocytosis (Hum Pathol 1998;29:1074), granulomas (Postgrad Med J 1987;63:277), lymphoid aggregates or hematogones (Leuk Res 2003;27:193)
  • Atypical lymphocytosis in peripheral blood (mostly increased transformed large granular lymphocytes and NK cells, infrequent infectious mononucleosis-like classic Downey type 2 cells)
  • May have circulating CMV infected endothelial cells at feathered edge of peripheral blood smear in immunosuppressed individuals
Microscopic (histologic) images

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Site unknown (not bone marrow)

Electron microscopy description
  • Virus particles with electron dense icosahedral core containing capsomeres with a large pleomorphic lipid envelope
  • Particles composed of filamentous or amorphous material detached from nuclear membrane
Differential diagnosis