Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen
Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen
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DOI：
10.1007/s00428-020-02829-1
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发表时间：
2020-04-30
期刊：
影响因子：
3.5
通讯作者：
D'Amati, Giulia
中科院分区：
文献类型：
--
作者：
Pernazza, Angelina;Mancini, Massimiliano;D'Amati, Giulia
尽管目前正值大流行季节，但目前有关冠状病毒病 19 (Covid-19) 病理特征的报道极为罕见。在这里，我们描述了手术样本中 Covid-19 早期肺部受累的病理特征，该样本是从手术后不久出现 SARS-CoV-2 感染的患者身上切除的癌症样本。观察到的主要组织学发现是肺细胞损伤、肺泡出血伴巨噬细胞聚集、间隔血管内突出且弥漫的中性粒细胞边缘以及间质炎症浸润（主要以 CD8+ T 淋巴细胞为代表）。这些特征与之前在 SARS-CoV-2 感染中描述的特征相似。在常规病理学实践中，特别是在进行广泛的组织学采样时，可能会偶然遇到表明 Covid-19 肺部受累的细微组织学变化。应根据患者的临床情况仔细解释这些发现，并可能提示进行咽拭子 PCR 检测，以排除无症状患者感染 SARS-CoV-2 的可能性。
Despite the current pandemic season, reports on pathologic features of coronavirus disease 19 (Covid-19) are exceedingly rare at the present time. Here we describe the pathologic features of early lung involvement by Covid-19 in a surgical sample resected for carcinoma from a patient who developed SARS-CoV-2 infection soon after surgery. The main histologic findings observed were pneumocyte damage, alveolar hemorrhages with clustering of macrophages, prominent and diffuse neutrophilic margination within septal vessels, and interstitial inflammatory infiltrates, mainly represented by CD8+ T lymphocytes. These features are similar to those previously described in SARS-CoV-2 infection. Subtle histologic changes suggestive pulmonary involvement by Covid-19 may be accidentally encountered in routine pathology practice, especially when extensive sampling is performed for histology. These findings should be carefully interpreted in light of the clinical context of the patient and could prompt a pharyngeal swab PCR test to rule out the possibility of SARS-CoV-2 infection in asymptomatic patients.