Ciliocytophthoria: Cytomorphologic Modifications in Viral Infections of the Nasal Mucosa Gelardi M 1* , Iannuzzi L 1 , Seccia V 2 and Quaranta N 1 1 Department of Basic Medical Science, Section of Otolaryngology, Neuroscience and Sensory Organs, University of Bari, Italy 2 Department of Neuroscience, 1st Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy * Corresponding author: Gelardi M, Department of Basic Medical Science, Section of Otolaryngology, Neuroscience and Sensory Organs, University of Bari, Italy, Tel: +393393286982; E-mail: gelardim@inwind.it Received date: Dec 03, 2015; Accepted date: Feb 09, 2016; Published date: Feb 11, 2016 Copyright: © 2016 Gelardi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract The term ciliocytophthoria (CCP) (Greek etymology) describes a degenerative phenomenon of the ciliated cells secondary to respiratory viral infections and characterized by specific morphological changes. In the winter 2014-2015, we examined 12 patients, aged between 12 and 32 years (mean age 21, F/M: 4/8) who attended the clinic of Rhinology of the University Hospital Center of Bari (Italy) with a viral infection of the upper airways. All subjects underwent nasal cytology for microscopic examination and preparations were stained using the technique of May-Grünwald Giemsa. Our study describes CCP precisely in all its developmental stages by means of microscopic examination of the nasal mucosa (nasal cytology). Keywords: Virosis; Ciliocytophthoria; Nasal cytology; Rhinitis Introduction “Ciliocytophthoria” (CCP) is a term that describes a degenerative process of the ciliated cells secondary to viral infections and characterized by specific morphological changes. Already in the1800s, the naturalist Joseph Leidy (1823-1891) described “Asmathosis ciliaris” in samples of the respiratory epithelium of asthmatic patients and determined that those features were no more than respiratory cells [1]. Later on, in 1930, Hilding noticed aberrant nasal cells, apical and anucleated remains of the epithelial cells similar to parasitic cells. In 1956 George N Papanicolau coined the term “Ciliocytophthoria” (CCP) to refer to the degenerative process observed in the ciliated cells of the bronchial epithelium, secondary to clinical virosis and bronchial carcinoma [2,3]. Since then, many other publications have been written on CCP, although in some of them the Authors used terms as “pseudoprotoza” and “pseudomicrobe” rather than CCP: this testifies the confusion between the degenerative process of the ciliated cells and the presence of flagellated protozoa frequently found in the respiratory tract [4-7]. Several in vitro studies using electron microscopy clearly highlighted the characteristics of CCP and correctly included it among the degenerative phenomenon typically present in respiratory infections [8], with the bronchial mucosa being the target of the cytopathological changes in cases of respiratory infections (with major involvement of the ciliated cells) [9]. CCP has been reproduced experimentally by exposing porcine respiratory epithelium to a wide variety of pathogens and has also been associated to respiratory affections in horses [10,11]. In humans, CCP can be seen in acute tonsillitis and viral infections [12,13], as well as in respiratory tract specimens, gynecologic samples and peritoneal washings [3,14-16]. e majority of the articles present in the current literature describe CCP as characterized by “cellular fragments”, with no nuclei, with a regular rhythmic movement of the cilia at one edge and a well distinguishable “terminal bar”, hence the difficulty of distinction with parasitic flagellates. In our paper we studied and illustrated the distinct and characteristic phases of CCP by means of the optical microscopy of the nasal mucosa (nasal cytology). Materials and Methods During the winter season 2014-2015, 12 patients, aged between 12 and 32 years (mean age: 21 years; M/F: 8/4-66, 7%), attended the outpatient Center of Rhinology of the University Hospital of Bari (Italy). All patients were affected by viral infections of the upper airways. Serological data confirmed the clinical virosis in all cases (Influenza virus type A). From a clinical point of view, all patients referred nasal congestion, sneezes, watery rhinorrhea, cough, fever, headache and chills, all signs of an on-going viral infection. Anterior rhinoscopy generally showed hyperemia of the inferior turbinates and presence of clear, abundant, nasal mucous while, at the oropharyngoscopy, hyperemia of the tonsillar pillars and of the oropharyngeal posterior wall were noticed [17,18]. Gelardi et al., J Cytol Histol 2016, S5:1 DOI: 10.4172/2157-7099.S5-005 Research Article Open Access J Cytol Histol Fine Needle Aspiration Cytology in Disease Diagnosis ISSN:2157-7099 JCH, an open access journal Journal of Cytology & Histology J o u r n a l o f C y t o l o g y & H i s t o l o g y ISSN: 2157-7099