Showing papers in "American Journal of Clinical Pathology in 1975"

Aneurysmal bone cyst secondary to other osseous lesions. Report of 57 cases.

Abstract: Fifty-seven aneurysmal bone cysts which were associated with or secondary to other lesions of bone are reported. The most common associations were with solitary or unicameral bone cyst, and with osteoclastoma. Other associated lesions included osteosarcoma, nonosteogenic fibroma, osteoblastoma, hemangioendothelioma, and hemangioma of bone. Five aneurysmal bone cysts were secondary to fracture or other bone trauma.

Post-jejunoileal-bypass hepatic disease. Its similarity to alcoholic hepatic disease.

Abstract: The authors studied serial hepatic biopsies of five patients who developed hepatic failure following jejunoileal bypass for extreme obesity, with autopsies of two. The hepatic histologic changes included centrilobular or focal alcoholic hyalin, intrasinusoidal collagenosis, fatty hydropic degeneration, and neutrophilic infiltrate. At least two of the patients were abstinent from alcohol, both prior to and after the surgical procedures. The others, after the bypass procedures, had reduced alcohol consumption from previous levels. All patients developed hepatic failure and histologically progressive hepatic disease with alcoholic hyalin and other changes indistinguishable from alcoholic hepatic disease in 21/2 to 5 months, in spite of hyperalimentation and re-establishment of intestinal continuity in four. Nausea, vomiting, abdominal pain and ascites were prominent complaints. Four of the five patients died in hepatic failure. The authors conclude that these cases of progressive hepatic disease with histologic changes simulating those found in livers of alcoholic patients offer evidence that heavy alcohol consumption may affect the liver in an indirect fashion.

The effects of age, sex, and smoking on erythrocytes and leukocytes.

Abstract: Coulter model S blood counts were related to the age, sex, and smoking habits of 1,000 clinic patients. It was found that (1) women have larger erythrocytes than men; (2) erythrocytes enlarge as people age; (3) smokers have larger erythroycytes than nonsmokers; (4) the mean leukocyte count is higher in smokers and increases in proportion to the intensity of smoking. The causes of these alterations are not known. The data indicate that the normal standards for blood cell counts should be adjusted for age, sex, and smoking habits.

Richter's syndrome. A terminal complication of chronic lymphocytic leukemia with distinct clinicopathologic features.

Abstract: Long, John C., AND Aisenberg, Alan C.: Richter's syndrome. A terminal complication of chronic lymphocytic leukemia with distinct clinicopathologic features. Am J Clin Pathol 63: 786-795, 1975. Two patients with chronic lymphocytic leukemia of 8 and 9 years duration had a terminal illness characterized by weight loss, persistent fever, lymphadenopathy, and dysglobulinemia. In both cases autopsy revealed a pleomorphic histiocytic lymphoma which contained multinucleate tumor cells and was associated with persistent chronic lymphocytic leukemia. These two cases are examples of Richter's syndrome, a clinically distinct complication of chronic lymphocytic leukemia that may be confused pathologically with Hodgkin's disease. Review of the medical literature suggests that this syndrome has frequently gone unrecognized. (Key words: Richter's syndrome; Chronic lymphocytic leukemia.)

In-situ and microinvasive adenocarcinoma of the uterine cervix. A clinical, cytologic and histologic study of 14 cases.

Abstract: In-situ and microinvasive adenocarcinoma of the uterine cervix. A clinical, cytologic and histologic study of 14 cases. Am J Clin Pathol 64: 155-70, 1975. The clinicopathologic features of 14 cases of in-situ and microinvasive adenocarcinoma of the cervix, encountered during the period 1961-1974, form the basis of this report. Seven cases represent examples of in-situ and seven, microinvasive adenocarcinoma. Severe dysplasia and carcinoma in-situ of the squamous epithelium were coincidental finds in 12 patiients. Papanicolaou smears were abnormal in all 14 patients. In nine, malignant glandular cells were identified. Five smears contained both malignant squamous and glandular cells. The mean age of the 14 patients was 38.4 years. Thirteen patients had borne one to six children. Two were pregnant at the time of diagnosis, and four were on birth control medication. Thirteen of the patients underwent conization biopsy. Hysterectomy in one form or another was curative in all. The relatively infrequent occurrence of in-situ adenocarcinoma is probably due to the low incidence of cervical adenocarcinoma and to the fact that the lesion is focal and easily overlooked. Five of the cases in the present series were a chance finding in a review of 200 consecutive cone biopsies of the cervix. The resemblance of the in-situ lesions to carcinoma and the presence of morphologically similar glandular tissue adjacent to foci of microinvasion suggests that the in-situ lesion is the precursor of invasive adenocarcinoma of the cerivs.

Bronchiolo-alveolar carcinoma-cell of origin.

Abstract: Bronchiolo-alveolar carcinoma is the least common of the primary pulmonary carcinomas, and there is controversy as to its cell of origin. In this light- and electron microscopic study of five bronchiolo-alveolar carcinomas, at least two cell types were found, both of bronchiolar origin. One cell type is a metaplastic bronchiolar mucous cell and the other a bronchiolar stem cell that has ultrastructural features of both the respiratory ciliated and the respiratory nonciliated ("Clara") cell. It would not be unusual if tumors of the bronchiolo-alveolar region differentiate into cells of either the bronchiole or the alveolus, for embryologically they have a common origin. However, as information about the ultrastructure of these tumors accumulates, it is becoming apparent that an alveolar-cell carcinoma must be a rare occurrence. Hyperplastic Type II aleveolar epithelial cells may be found about the margins of these tumors and can be mistaken for the neoplastic cells.

Evaluation of ristocetin-Willebrand factor assay and ristocetin-induced platelet aggregation.

Abstract: Normal subjects, patients with various bleeding disorders, and patients with von Willebrand's disease were studied. All patients with von Willebrand's disease had decreased levels of ristocetin-Willebrand factor (range, 0 to 41%) as compared with all other subjects (range, 79 to 202%). Ristocetin-induced platelet aggregation of platelet-rich plasma was abnormal in all patients with von Willebrand's disease tested, and it was possible to correct this abnormal response by addition of normal platelet-poor plasma. Abnormal ristocetin-induced platelet aggregation was seen in patients with intrinsic platelet disorders or, on some occasions, in normal patients who had ingested aspirin. Ristocetin-induced platelet aggregation is not diagnostic, but it may be useful as a simple screening test for patients with possible von Willebrand's disease. In conjunction with other tests, the assay for ristocetin-Willebrand factor will be useful in diagnosis and evaluation of these patients.

Diagnostic reliability of needle biopsy of the parietal pleura. A review of 272 biopsies.

Abstract: The clinical charts and histologic preparations from 245 patients who had pleural biopsies to evaluate pleural effusions of unknown etiology were reviewed. This represents an experience with 272 biopsies, as some patients underwent multiple biopsies. In 57 per cent of the cases of suspected or proven granulomatous disease involving the pleura, the pleural biopsy was positive. Similarly, in 48 per cent of the cases of suspected or proven pleural involvement by carcinoma, tumor was identified in the biopsy specimen. Only two false-positive diagnoses (one of granulomatous pleuritis and one of neoplastic disease) were made. The other 35 histologic diagnoses of granulomatous inflammation and 43 histologic diagnoses of carcinoma were verified. In this study, the authors found that the major limiting factor in establishing a diagnosis is the accuracy in random sampling of the parietal pleural surface. Thus, a negative pleural biopsy should not give the clinician a false sense of security.

Cytomegalovirus Studies of Autopsy Tissue. II. Incidence of Inclusion Bodies and Related Pathologic Data

Abstract: Cytomegaloviruses (CMV) were recovered from lung tissue in 34 (6.8%) of 502 unselected autopsy cases. Inclusion bodies were detected in the lung in nine of these cases (26%) and in organs other than the lung in three others. Overall, the incidence of inclusion bodies in this series of 502 cases was 2.4%. Our data strongly indicate that virus isolation is more sensitive than histopathologic study in establishing the presence of CMV infection. However, CMV was not recovered from one kidney and one liver in which inclusion bodies were present, although the virus was isolated from lung. Four of five cases of renal allograft rejection were positive for both CMV and inclusion bodies. The incidence of CMV recovery and inclusion body detection in leukemia and lymphoma cases was more than twice that in cases with other diseases. CMV inclusion bodies with or without associated inflammation were found, in descending order of frequency, in the lung, kidney, liver, pancreas, adrenal gland, esophagus, prostate, testes, thyroid gland, parathyroid gland, stomach, small intestine, large intestine, and heart.

Pre-instrumental variables in coagulation testing.

Abstract: A number of variables thought to affect measurement of prothrombin time (PT) and partial thromboplastin time (PTT) were examined in an effort to determine more precisely their effects on these measurements. On the basis of these studies, it is proposed that blood specimens be anticoagulated with one part 3.8% (w./v.) sodium citrate solution to 19 parts whole blood to avoid excessive anticoagulation of blood samples drawn from patients with polycythemia. Because of the smaller amounts of plasma in such samples, relatively larger amounts of anticoagulant are used, and spuriously prolonged PT and PTT measurements commonly result. No deleterious effect on anemic specimens is evident when the smaller amount of citrate is used. Studies of the stability of these specimens indicate that unopened , vacuum-drawn specimens do not noticeably deteriorate for as long as 6 hours, even when kept at room temperature. Prothrombin time measurements remain constant for as long as 24 hours. However, a 10–15% lengthening of the partial thromboplastin time is evident after 24 hours of storage.

Abnormal forms of bacteria produced by antibiotics.

Abstract: Subinhibitory concentrations of antibiotics can produce in vitro aberrant forms of bacteria that are similar to those observed in specimens and cultures from patients being treated with antibacterial agents. Eight species of bacteria were grown on membranes placed on agar containing subinhibitory concentrations of nine antibiotics. The resulting organisms were examined by Gram stain and electron microscopy. Gram stains showed filamentous and granular forms of enterobacteria with bipolar staining, giant staphylococci, and rodlike pneumococci. Electron micrographs showed changes in the number and distribution of ribosomes in enterobacteria and septum abnormalities in cocci. Such abnormal forms can occasionally simulate the appearance of quite different species, and they may indicate the presence of a subinhibitory antibiotic concentration at the site of infection as a result of prior antibacterial therapy.

Cellular composition of the nipple aspirate specimen of breast fluid. I. The benign cells.

Abstract: A nipple aspirator device was used to obtain breast secretions for cytologic examination, as well as for viral and biochemical analysis. Examination of the first 1,456 specimens from 796 women revealed ductal epithelium in 54%. Ductal epithelial cells were often absent in specimens from normal women; however, 78.5% of women with benign breast disease on tissue biopsy had specimens containing ductal epithelium. Apocrine metaplastic cells were a further indication of the presence of breast disease, and were rarely found in specimens from asymptomatic women. Foam cells were often abundant in specimens from normal breasts, but were found in decreased numbers in specimens from women with benign breast disease. Differences in the occurrence of ductal epithelial cells, apocrine metaplastic cells, and foam cells suggest an alteration in the rate of maturation of ductal epithelium in women with both benign and malignant breast disease. The finding of a relative abundance of cells in nipple aspirate specimens from women wiui breast disease and few or no cells in specimens from women with normal breasts is believed to be of great importance in the cytologic evaluation of nipple aspirate specimens.

Papillary cystadenoma lymphomatosum (Warthin's tumor) in patients in a general hospital over a 24-year period.

Abstract: One hundred thirty-seven Warthin's tumors from 120 patients seen during a 23 1/2 year period were studied as two groups. The first group consisted of 32 tumors removed by the otolaryngology department. Material from these cases was re-examined microscopically for evidence of tumor occurrence within lymph nodes located inside and outside the parotid gland. This group of 32 tumors was also studied as part of the second group, 105 additional lesions removed by the surgery department. Data on patient age, sex, and race, as well as tumor multiplicity, location, and size were incorporated into a single statistical analysis. Seventy-two percent of the tumors in the first group were intranodal in location. Second primary Warthin's tumors occurred in 13 (11%) of the patients. Eight occult tumors were identified, and their importance is discussed. A single Negro, a man, was found among 118 patients. The observed frequency of the tumor was twentyfold less than expected among the Negro population.

Palpation Thyroiditis (Multifocal Granulomatous Folliculitis)

Abstract: Disseminated inflammatory lesions constituting a multifocal granulomatous folliculitis in the thyroid are described. These lesions were present in the majority (greater than 83%) of thyroids removed surgically because of thyroid or nonthyroid (carcinoma of the larynx) disease. They also were found at autopsy in patients who died while hospitalized but not in those who died at home. An identical lesion was produced experimentally in dogs by vigorously squeezing their thyroids. The human folliculitis is believed to result from traumatic injury or rupture of isolated thyroid follicles caused by palpation of the gland (palpation thyroiditis). Palpation thyroiditis may have little, if any, clinical importance. The remote possibility that it might be associated with iatrogenically produced metastasis of thyroid carcinoma is being investigated.

Localized deposition of calcium oxalate around a pulmonary Aspergillus niger fungus ball.

Abstract: A case of pulmonary Aspergillus niger fungus ball is presented. Crystals of calcium oxalate, presumably derived from oxalic acid produced by the fungus, were deposited in tissues around the fungus ball. The crystals were identified by x-ray diffraction analysis. Histochemical technics for the identification of calcium oxalate were applied, and evaluation of those showed Yasue’s silver nitrate–rubeanic acid method to be the most satisfactory. More frequently used methods for identifying calcium salts in tissues may give equivocal reactions. Oxalic acid may cause localized tissue damage, and if this affects blood vessels severe hemorrhage may follow.

Immunologic and Cytochemical Properties of Histiocytic and Mixed Histiocytic–Lymphocytic Lymphomas

Abstract: Lymph nodes were biopsied from seven patients with the presumptive clinical diagnosis of lymphoma and studied for their ability to form spontaneous rosettes with sheep erythrocytes (T cell marker), for surface immunoglobulins (B cell marker), for cytochemical reactivity with peroxidase, alpha-naphthyl acetate and butyrate esterases, naphthol ASD chloroacetate esterase, acid phosphatase, periodic acid–Schiff, Sudan black B, and Wright–Giemsa on touch preparations, as well as in hematoxylin and eosin-stained sections. Lymph nodes from patients without hematologic malignancy served as controls. Diagnoses of diffuse histiocytic lymphoma were made in five cases and diffuse mixed histiocyticlymphocytic lymphoma in 2 cases. The cytochemical staining of the lymphoma cells were typical of lymphoid cells rather than macrophages. In five cases neoplastic cells contained surface immunoglobulins, suggesting a B cell origin, and in one case a paucity of cell surface markers was found. Cells from uninvolved nodes of lymphoma patients could not be differentiated from those of the control group.

The effects of time of venipuncture on variation of serum constituents. Consideration of within-day and day-to-day changes in a group of healthy young men.

Abstract: Within-day and the day-to-day variations of serum constituents were evaluated in 11 healthy young men. Eighteen constituents, including electrolytes, metabolites, proteins, and enzymes, were assayed using the AutoChemist MultiChannel Analytic System. Venipunctures were performed at three hours of the day, 8 A.M., 11 A.M., and 2 P.M., on five separate experimental days. A three-factor analysis of variance model was employed to separate analytic variation from biological sources of variation. Statistically significant (p less than .05) group diurnal patterns (main effect of hour) during the six-hour period were found for serum lipids, iron, urea, albumin, total protein, and chloride. A unique individual diurnal pattern (subject-hour interaction) was statistically significant for serum potassium. Statistically significant main effect of month (main effect of day) for the group of subjects was seen for total lipids and potassium; however, the subject-day interaction term, which is an index of the day-to-day variation for the subjects, was significant (p less than .05) for all of the constituents except for sodium ion. The comparison of the variation expected within-day versus the variation seen day-to-day over four months was made by pooling the sources of within-day variation (main effect of hour + subject-hour interaction + subject-day-hour interaction) and by pooling the day-to-day variation terms (main effect of day + subject-month interaction). For serum cholesterol, potassium, acid phosphatase, and phosphate ion, the within-day variation was greater than the day-to-day variation occurring over four months, while the other constituents showed day-to-day variations of a greater magnitude than that experienced during the six-hour period.

Limits of applicability of the firefly luminescence ATP assay for the detection of bacteria in clinical specimens.

Abstract: ATP measurement can be used as an indicator of biological mass, and the extreme sensitivity of the firefly ATP assay has led to its use in bacterial detection systems. Clinical specimens present problems not encountered with cultured isolates of known bacterial species. The lower limit of sensitivity for detecting bacteria using the firefly assay is 100,000 bacteria per ml. Non-bacterial ATP, which is probably present in all clinical specimens, produces false-positive results unless it is completely destroyed, and this destruction must be carried out under conditions that do not affect bacterial ATP. A cause of false-negative results is the presence in all urine specimens of unidentified materials that inhibit the luminescent enzymic reaction. These considerations indicate that application of the firefly ATP assay in bacterial detection systems for clinical specimens is feasible only if a preparatory step separates bacteria from interfering materials and from non-bacterial sources of ATP, and concentrates microorganisms to measurable levels. These limitations sharply curtain the applicability in diagnostic microbiology of this exotic chemical reaction.

Cellular composition of the nipple aspirate specimen of breast fluid. II. Abnormal findings.

Abstract: Studies of cellular findings in nipple aspirate specimens from 796 women revealed 50 women with abnormal cells and/or microcalcifications. The clinical correlation of these abnormalities with breast cancer appears to be highly significant: abnormal cells were found in 50% of the satisfactory specimens from women who had breast cancer or who had had a previous mastectomy for breast cancer. Continued observation of the women for evidence of regression, persistence, or progression of the cytologic abnormalities is required to determine the significance of the abnormalities. Microcalcifications were present in nipple aspirates from 27% of the women whose mammograms were interpreted as showing calcification. The absence of mammographic confirmation of the cytologic findings of microcalcifications may be an indication for re-evaluation of the existing mammograms and repeat clinical and mammographic examination at more frequent intervals for early localization of small lesions.

Hepatocellular carcinoma and intermediate alpha1-antitrypsin deficiency (MZ phenotype).

Abstract: A case history of a 16-year-old boy with hepatocellular carcinoma and an intermediate deficiency of alpha1-antitrypsin (MZ phenotype) is presented. Previous reports have suggested that hepatocellular carcinoma may be associated with the Z variant of antitrypsin and either a severe or intermediate antitrypsin deficiency. The present case is unusual because of the rather high level of the serum trypsin inhibitory capacity for an MZ heterozygote (1.633 units), which may be due to involvement of the liver by the tumor or to a recent partial hepatectomy. PAS-positive antitrypsin globules were seen in the primary tumor and in nodules metastatic to the mesentery, as well as in nonneoplastic portions of the liver. Hepatocellular carcinoma is another disease state that may occur preferentially in individuals with either severe or intermediate deficiencies of alpha1-antitrypsin.

Comparative evaluation of the Limulus assay and the direct Gram stain for detection of significant bacteriuria.

Abstract: A double-blind study comparing the Limulus in-vitro endotoxin assay with the direct Gram stain of uncentrifuged urine for detection of significant bacteriuria was performed. One-thousand seventy-seven urine specimens were examined by the two methods and the results compared with results of quantitative urine cultures. Two hundred three samples produced growth of >105 organisms per ml. urine. The Limulus assay detected 86.2% of these specimens, and 98.8% of urines that contained >105 Gram-negative bacilli per ml. The Gram stain procedure detected only 69.5% of urines containing >105 organisms per ml. and 74.5% of specimens with >105 Gram-negative bacteria per ml. urine. The Limulus assay demonstrated both greater sensitivity and greater specificity than the Gram stain procedure. Moreover, the Limulus test is much less susceptible to errors of interpretation than methods involving microscopy.

Transportation Delay and the Microbiological Quality of Clinical Specimens

Abstract: An in-use study was done to determine the effect of transportation delay on the microflora of clinical specimens collected for microbiological analysis in a 1,000-bed university hospital. Portions of wound, respiratory, and urine specimens were planted for bacterial isolation on the wards immediately after collection. The remainder of each specimen was kept at room temperature with or without holding medium until it was picked up by messengers and taken to the bacteriology laboratory. The results of immediate planting on the ward were compared with those obtained by planting in the laboratory. Alterations in microflora were observed in all three types of specimens after averages of 2 to 4 hours of delay in planting.

Vaginal adenosis. Analysis of 325 biopsy specimens from 100 patients.

Abstract: Biopsy-proven vaginal adenosis was found in 88% of a group of 100 asymptomatic young women with known or suspected to have histories of intrautering diethylstilbestrol (DES) exposure. Histologic features were roughly quantitated and were found to vary markedly from patient to patient, but the following proved to be the most consistent features: (1) variation in glandular configuration (simple, complex, cystic); (2) the presence of epithelium recapitulating all parts of the mullerian duct system (endocervical, endometrial and tubal); (3) limited involvement of the vaginal mucosa (no surface involvemtn in 23.8% of the patients); (4) extensive squamous metaplasia; (5) submucosal inflammation. There was no glandular dysplasia or coexistent adenocarcinoma. The squamous epithelium in many specimens contained little or no glycogen, and in some manifested cellular activity consistent with a regenerative response to inflammation. Sufficient atypicality to implicate vaginal adenosis as a premalignant lesion was not found in any biopsy specimen.

The Effects of Anesthetics on an In-vivo Oxygen Electrode

Abstract: The IBC in-vivo oxygen electrode may be used during anesthesia. The possibility that three common inhalation anesthetics--halothane, enflurane, and methoxyflurane--might be reduced at the electrode, thereby changing the PO2 value, was tested. Enflurane and methoxyflurane do not affect the current produced at the electrode; halothane significantly increases PO2 readings at oxygen tensions below 105 torr. It is suggested that PaO2 readings below 105 torr be confirmed by the standard bench method.

A pulmonary fungus ball produced by Cladosporium cladosporioides.

Abstract: A case of pulmonary fungus ball produced by Cladosporium cladosporioides is reported. The fungus occupied a cavity in the upper lobe of right lung. Invasion of the cavitary wall or adjacent pulmonary tissue by the fungus was not observed.

Mucormycosis in a transplant recipient.

Abstract: Mucormycosis classically occurs in patients who have uncontrolled diabetes who develop rhinocerebral disease. A fatal case of rhinocerebral infection caused by Rhizopus arrhizus in a 53-year-old man who had received a renal homograft three years previously is reported. Only five similar cases have been documented, all since 1970. Although direct smears of the purulent nasal exudate revealed the presence of numerous Gram-negative bacilli, later identified as Haemophilus influenzae, the diagnosis of mucormycosis was made by demonstrating the typical broad, nonseptate branched hyphae in the necrotic tissue obtained by surgical debridement of the paranasal sinuses. Culture of this material revealed growth of mold-like fungus which, upon direct microscopic examination, showed sporangiophores bearing spherical sporangia arising directly from a cluster of root-like structures of rhizoids. Despite the immediate institution of therapy with amphotericin B postoperatively, the patient died 48 hours later. Subsequently, the Rhizopus isolated was shown to be resistant to both amphotericin B and 5-fluorocytosine. The present case and two others stress the importance of an aggressive diagnostic approach to patients suspected of having mucormycosis, because the usual microbiologic technics are frequently, inexplicably, unsuccessful, and possibly even misleading in this disease.

Pulmonary Mucormycosis Caused by Cunninghamella elegans in a Patient with Chronic Myelogenous Leukemia

Abstract: Cunninghamella elegans was cultured from autopsy materials of the infected lung of a patient with chronic myelogenous leukemia. The histologic sections revealed extensive growth of nonseptate, broad hyphae in and about the large and small arteries and veins, occluding the vessels. This case is believed to be the second in which human infection by C. elegans has been documented.

Cell Membrane Receptors for Polypeptide Hormones: Applications to the Study of Disease States in Mice and Men

Abstract: Recent studies have suggested that the first step in the action of polypeptide hormones and catecholamines is binding to surface membrane receptor sites. This interaction can be studied directly using radioactively labeled hormones and a variety of receptor preparations. With these radioreceptor assay technics, it has been possible to define structure-activity relationships and to assay plasma hormones. These studies have also been used to define alterations in the hormone receptors in disease that lead to peripheral resistance to hormonal action and to characterize the factors that regulate receptor concentrations.

Cytomegalovirus studies of autopsy tissue. I. Virus isolation.

Abstract: From January through September 1973, 55 virus isolates were recovered from lung and kidney specimens from 44 (8.8%) of 502 unselected autopsy cases. Cytomegalovirus (CMV) was isolated 42 times in 34 cases (36 from lung, four from kidney, and one each from pleural and bronchial tissues). Virus isolation was approximately six times more sensitive than histologic detection of CMV infections. Major causes of death included solid malignant tumors, leukemia, lymphoma, and renal allograft rejection; 13 patients had a variety of other diseases, predominantly cardiopulmonary. CMV was recovered from more males than females. The mean age of the CMV-positive group did not differ significantly from that of the CMV-negative group. CMV-positive cases were not preselected on the basis of specimen processing time. Serologic results indicate that recovery of CMV from an autopsy case was seven times more likely when the complement- fixing antibody titer was 1:16 or more.