In situ DNA hybridization study of 'primary' cytomegalovirus (CMV) oophoritis

We report the case of a 50 year old woman with metastatic breast carcinoma refractory to chemotherapy who died of candidal septicemia after autologous bone marrow transplantation. Although there was no apparent active cytomegalovirus (CMV) infection (negative cultures and serology for active infection), autopsy revealed histologic evidence of CMV inclusions limited to both ovaries. DNA in situ hybridization was performed on multiple organs, and additional foci of infection in one fallopian tube and the adrenal glands were detected. Previous reports of isolated CMV oophoritis may represent sampling error. An ascending route of infection is suggested. Tubo-ovarian changes due to CMV infection may occur more frequently than suspected; they are difficult to diagnose because even actively CMV infected cells may not be detected by routine histology alone, and because, after the active infection 'heals', no evidence of the virus can be found on histologic examination.