Histiocytic hyperplasia with hemophagocytosis and acute alveolar damage in COVID-19 infection
| Autor: | Marcela Valverde-Monge, Soraya de la Fuente, Carlos Soto, Laura Astilleros Blanco de Cordova, Álvaro Trascasa, Miguel Górgolas, Alberto Lazaro-Garcia, Elizabet Petkova, Socorro María Rodríguez-Pinilla, Ánxela Vidal-González, Marina Alonso-Riaño, Itziar Fernández-Ormaechea, Miguel A. Piris, Diana Fresneda, Germán Peces-Barba, María José Cortti, Sheila Recuero, Ignacio Cornejo, Raul Cordoba, Anabel Antonio, Alfonso Cabello, Silvia Calpena, Rafael Rubio-Martín, Marina Castellanos, Andrés M. Silva, B. Alvarez, Laura Prieto-Pérez, María José Díez Medrano, Irene Carrillo, Miguel Lafarga, Oderay Cedeño, José Fortes, Marta Lopez de las Heras, Ramón Pérez-Tanoira |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine ARDS Pathology medicine.medical_specialty Pneumonia Viral Article Lymphohistiocytosis Hemophagocytic Pathology and Forensic Medicine Betacoronavirus 03 medical and health sciences 0302 clinical medicine Bone Marrow medicine Humans Diffuse alveolar damage Lung Pandemics Histiocyte Aged Aged 80 and over Respiratory Distress Syndrome Hyperplasia SARS-CoV-2 business.industry COVID-19 Diagnostic markers Histiocytes Middle Aged medicine.disease Histiocytosis 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Macrophage activation syndrome Infectious diseases Female Bone marrow Hemophagocytosis Coronavirus Infections business |
| Zdroj: | Modern Pathology |
| ISSN: | 0893-3952 |
| Popis: | The spectrum of COVID-19 infection includes acute respiratory distress syndrome (ARDS) and macrophage activation syndrome (MAS), although the histological basis for these disorders has not been thoroughly explored. Post-mortem pulmonary and bone marrow biopsies were performed in 33 patients. Samples were studied with a combination of morphological and immunohistochemical techniques. Bone marrow studies were also performed in three living patients. Bone marrow post-mortem studies showed striking lesions of histiocytic hyperplasia with hemophagocytosis (HHH) in most (16/17) cases. This was also observed in three alive patients, where it mimicked the changes observed in hemophagocytic histiocytosis. Pulmonary changes included a combination of diffuse alveolar damage with fibrinous microthrombi predominantly involving small vessels, in particular the alveolar capillary. These findings were associated with the analytical and clinical symptoms, which helps us understand the respiratory insufficiency and reveal the histological substrate for the macrophage activation syndrome-like exhibited by these patients. Our results confirm that COVID-19 infection triggers a systemic immune-inflammatory disease and allow specific therapies to be proposed. |
| Databáze: | OpenAIRE |
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