A STUDY OF PATHOLOGY AND ULTRAMICROSTRUCTURE OF NEEDLE-BIOPSY SPECIMENS OF MULTIPLE ORGANS OF SARS PATIENTS
- VernacularTitle:SARS多脏器穿刺组织病理学及超微结构的研究
- Author:
Ning LI
;
Wei WANG
;
Hongbing CHEN
- Publication Type:Journal Article
- Keywords:
severe acute respiratory syndrome (SARS);
pathology;
coronavirus
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the pathological and ultramicrostructural characteristics of organ tissues in relation to the clinical course of severe acute respiratory syndrome (SARS). Methods Post-mortem tissue samples of organs (lungs, heart, liver, spleen, kidneys, pancreas, stomach ) were obtained by needle biopsy from four SARS patients who died in middle and late stages 3-5 weeks after the onset of the disease. The pathological samples were studied by light and electron microscope, immunohistochemistry, histochemistry and indirect immuno-fluorescent antibody test. Results The main pathological features were early interstitial pulmonary fibrosis or organizing pneumonia. Fibroblasts were increased in the interalveoli septa and young connective tissue was found to fill the alveoli. Diffuse alveolar damage (DAD) with alveolar pneumocytes proliferation and an increase in macrophages were found. Desquamative alveolitis also existed at the same time. Squamous metaplasia and syncytial giant cells with multinuclei could be seen. CD3 + and CD20 + lymphocytes were markedly decreased and CD68 + macrophages and S-100 + dendritic cells increased in spleen. Proliferation of bone marrow cells became restrained . Hepatocytes were vacuolated with fatty degeneration. Electron microscopy showed the presence of coronavirus-like particles 80-60nm in diameter enveloped in the cytoplasm of the type Ⅱ pneumocytes, endothelial cells and lymphocytes. Conclusions A novel coronavirus is the cause of the newly recognized severe acute respiratory syndrom (SARS). The main target organs are lung and immune system. Different pulmonary pathological features were found in patients dying from the disease in different stages. All of specimens showed positive reaction of SARS-fluorescence antibody.
