Early histologic findings of pulmonary SARS-CoV-2 infection detected in a surgical specimen

Archiv für pathologische Anatomie und Physiologie und für klinische Medicin - 2020
Angelina Pernazza1, Massimiliano Mancini2, Emma Rullo3, Massimiliano Bassi4, Tiziano De Giacomo4, Carlo Della Rocca1, Giulia d’Amati3
1Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
2Division of Morphologic and Molecular S. Andrea Hospital, Sapienza, University of Rome, Rome, Italy
3Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
4Department of General and Specialistic Surgery “P. Stefanini”, Sapienza, University of Rome, Rome, Italy

Tóm tắt

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-1 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.

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