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Herpes Simplex Virus-1 (HSV-1) causing human esophagitis. All images are from the same patient and are: cytology brushing, cytology cell block, tissue biopsy H&E stain and HSV-1 immunostain. Cells show the “3 Ms “ that help make the diagnosis: molding, multinucleation, and margination of nuclear chromatin. HSV-1 infects the mouth and upper GI tract. HSV-2 infects the genitalia, genital skin, and the rectum. Both would look the same under the microscope. Of course individual viral particles would need electron microscopy to see. What we see here is the effect of viral infection on esophageal squamous cells.