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Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore.
Hum Pathol. 2003 Aug; 34(8):743-8.HP

Abstract

Severe acute respiratory syndrome (SARS) is an infectious condition caused by the SARS-associated coronavirus (SARS-CoV), a new member in the family Coronaviridae. To evaluate the lung pathology in this life-threatening respiratory illness, we studied postmortem lung sections from 8 patients who died from SARS during the spring 2003 Singapore outbreak. The predominant pattern of lung injury in all 8 cases was diffuse alveolar damage. The histology varied according to the duration of illness. Cases of 10 or fewer days' duration demonstrated acute-phase diffuse alveolar damage (DAD), airspace edema, and bronchiolar fibrin. Cases of more than 10 days' duration exhibited organizing-phase DAD, type II pneumocyte hyperplasia, squamous metaplasia, multinucleated giant cells, and acute bronchopneumonia. In acute-phase DAD, pancytokeratin staining was positive in hyaline membranes along alveolar walls and highlighted the absence of pneumocytes. Multinucleated cells were shown to be both type II pneumocytes and macrophages by pancytokeratin, thyroid transcription factor-1, and CD68 staining. SARS-CoV RNA was identified by reverse transcriptase-polymerase chain reaction in 7 of 8 cases in fresh autopsy tissue and in 8 of 8 cases in formalin-fixed, paraffin-embedded lung tissue, including the 1 negative case in fresh tissue. Understanding the pathology of DAD in SARS patients may provide the basis for therapeutic strategies. Further studies of the pathogenesis of SARS may reveal new insight into the mechanisms of DAD.

Authors+Show Affiliations

Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Wshington, DC 20306, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14506633

Citation

Franks, Teri J., et al. "Lung Pathology of Severe Acute Respiratory Syndrome (SARS): a Study of 8 Autopsy Cases From Singapore." Human Pathology, vol. 34, no. 8, 2003, pp. 743-8.
Franks TJ, Chong PY, Chui P, et al. Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore. Hum Pathol. 2003;34(8):743-8.
Franks, T. J., Chong, P. Y., Chui, P., Galvin, J. R., Lourens, R. M., Reid, A. H., Selbs, E., McEvoy, C. P., Hayden, C. D., Fukuoka, J., Taubenberger, J. K., & Travis, W. D. (2003). Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore. Human Pathology, 34(8), 743-8.
Franks TJ, et al. Lung Pathology of Severe Acute Respiratory Syndrome (SARS): a Study of 8 Autopsy Cases From Singapore. Hum Pathol. 2003;34(8):743-8. PubMed PMID: 14506633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore. AU - Franks,Teri J, AU - Chong,Pek Y, AU - Chui,Paul, AU - Galvin,Jeffrey R, AU - Lourens,Raina M, AU - Reid,Ann H, AU - Selbs,Elena, AU - McEvoy,Col Peter L, AU - Hayden,Col Dennis L, AU - Fukuoka,Junya, AU - Taubenberger,Jeffery K, AU - Travis,William D, PY - 2003/9/25/pubmed PY - 2003/10/8/medline PY - 2003/9/25/entrez SP - 743 EP - 8 JF - Human pathology JO - Hum. Pathol. VL - 34 IS - 8 N2 - Severe acute respiratory syndrome (SARS) is an infectious condition caused by the SARS-associated coronavirus (SARS-CoV), a new member in the family Coronaviridae. To evaluate the lung pathology in this life-threatening respiratory illness, we studied postmortem lung sections from 8 patients who died from SARS during the spring 2003 Singapore outbreak. The predominant pattern of lung injury in all 8 cases was diffuse alveolar damage. The histology varied according to the duration of illness. Cases of 10 or fewer days' duration demonstrated acute-phase diffuse alveolar damage (DAD), airspace edema, and bronchiolar fibrin. Cases of more than 10 days' duration exhibited organizing-phase DAD, type II pneumocyte hyperplasia, squamous metaplasia, multinucleated giant cells, and acute bronchopneumonia. In acute-phase DAD, pancytokeratin staining was positive in hyaline membranes along alveolar walls and highlighted the absence of pneumocytes. Multinucleated cells were shown to be both type II pneumocytes and macrophages by pancytokeratin, thyroid transcription factor-1, and CD68 staining. SARS-CoV RNA was identified by reverse transcriptase-polymerase chain reaction in 7 of 8 cases in fresh autopsy tissue and in 8 of 8 cases in formalin-fixed, paraffin-embedded lung tissue, including the 1 negative case in fresh tissue. Understanding the pathology of DAD in SARS patients may provide the basis for therapeutic strategies. Further studies of the pathogenesis of SARS may reveal new insight into the mechanisms of DAD. SN - 0046-8177 UR - https://www.unboundmedicine.com/medline/citation/14506633/Lung_pathology_of_severe_acute_respiratory_syndrome__SARS_:_a_study_of_8_autopsy_cases_from_Singapore_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0046817703003678 DB - PRIME DP - Unbound Medicine ER -