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Distinctive pseudopalisaded histiocytic hyperplasia characterizes the transition of exudative to proliferative phase of diffuse alveolar damage in patients dying of COVID-19.
Hum Pathol. 2021 Jul 14; 116:49-62.HP

Abstract

Severe COVID-19 results in a glucocorticoid responsive form of acute respiratory distress (ARDS)/diffuse alveolar damage (DAD). Herein we compare the immunopathology of lung tissue procured at autopsy in patients dying of SARS-CoV-2 with those dying of DAD prior to the COVID-19 pandemic. Autopsy gross and microscopic features stratified by duration of illness in twelve patients who tested positive for SARS-CoV-2 viral RNA, as well as seven patients dying of DAD prior to the COVID-19 pandemic were evaluated with multiplex (5-plex: CD4, CD8, CD68, CD20, AE1/AE3) and SARS-CoV immunohistochemistry to characterize the immunopathologic stages of DAD. We observed a distinctive pseudopalisaded histiocytic hyperplasia interposed between the exudative and proliferative phase of COVID-19 associated DAD, which was most pronounced at the fourth week from symptom onset. Pulmonary macrothrombi were seen predominantly in cases with pseudopalisaded histiocytic hyperplasia and/or proliferative phase DAD. Neither pseudopalisaded histiocytic hyperplasia nor pulmonary macrothrombi was seen in non-COVID-19 DAD cases, whereas microthrombi were common in DAD regardless of etiology. The inflammatory pattern of pseudopalisaded histiocytic hyperplasia may represent the distinctive immunopathology associated with the dexamethasone responsive form of DAD seen in severe COVID-19.

Authors+Show Affiliations

Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Hematology and Oncology, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA.Department of Pathology & Laboratory Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, 02118, USA. Electronic address: ejburks@bu.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34273395

Citation

Kritselis, Michael, et al. "Distinctive Pseudopalisaded Histiocytic Hyperplasia Characterizes the Transition of Exudative to Proliferative Phase of Diffuse Alveolar Damage in Patients Dying of COVID-19." Human Pathology, vol. 116, 2021, pp. 49-62.
Kritselis M, Yambayev I, Prilutskiy A, et al. Distinctive pseudopalisaded histiocytic hyperplasia characterizes the transition of exudative to proliferative phase of diffuse alveolar damage in patients dying of COVID-19. Hum Pathol. 2021;116:49-62.
Kritselis, M., Yambayev, I., Prilutskiy, A., Shevtsov, A., Vadlamudi, C., Zheng, H., Elsadwai, M., Ma, L., Aniskovich, E., Kataria, Y., Higgins, S., Sarita-Reyes, C., Zuo, T., Zhao, Q., Quillen, K., & Burks, E. J. (2021). Distinctive pseudopalisaded histiocytic hyperplasia characterizes the transition of exudative to proliferative phase of diffuse alveolar damage in patients dying of COVID-19. Human Pathology, 116, 49-62. https://doi.org/10.1016/j.humpath.2021.06.008
Kritselis M, et al. Distinctive Pseudopalisaded Histiocytic Hyperplasia Characterizes the Transition of Exudative to Proliferative Phase of Diffuse Alveolar Damage in Patients Dying of COVID-19. Hum Pathol. 2021 Jul 14;116:49-62. PubMed PMID: 34273395.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distinctive pseudopalisaded histiocytic hyperplasia characterizes the transition of exudative to proliferative phase of diffuse alveolar damage in patients dying of COVID-19. AU - Kritselis,Michael, AU - Yambayev,Ilyas, AU - Prilutskiy,Andrey, AU - Shevtsov,Artem, AU - Vadlamudi,Charitha, AU - Zheng,Hanqiao, AU - Elsadwai,Murad, AU - Ma,Lina, AU - Aniskovich,Emily, AU - Kataria,Yachana, AU - Higgins,Sara, AU - Sarita-Reyes,Carmen, AU - Zuo,Tao, AU - Zhao,Qing, AU - Quillen,Karen, AU - Burks,Eric J, Y1 - 2021/07/14/ PY - 2021/05/10/received PY - 2021/06/21/revised PY - 2021/06/24/accepted PY - 2021/7/18/pubmed PY - 2021/7/18/medline PY - 2021/7/17/entrez KW - Autopsy KW - COVID-19 KW - Histiocyte KW - Multiplex immunohistochemistry KW - SARS-CoV-2 SP - 49 EP - 62 JF - Human pathology JO - Hum Pathol VL - 116 N2 - Severe COVID-19 results in a glucocorticoid responsive form of acute respiratory distress (ARDS)/diffuse alveolar damage (DAD). Herein we compare the immunopathology of lung tissue procured at autopsy in patients dying of SARS-CoV-2 with those dying of DAD prior to the COVID-19 pandemic. Autopsy gross and microscopic features stratified by duration of illness in twelve patients who tested positive for SARS-CoV-2 viral RNA, as well as seven patients dying of DAD prior to the COVID-19 pandemic were evaluated with multiplex (5-plex: CD4, CD8, CD68, CD20, AE1/AE3) and SARS-CoV immunohistochemistry to characterize the immunopathologic stages of DAD. We observed a distinctive pseudopalisaded histiocytic hyperplasia interposed between the exudative and proliferative phase of COVID-19 associated DAD, which was most pronounced at the fourth week from symptom onset. Pulmonary macrothrombi were seen predominantly in cases with pseudopalisaded histiocytic hyperplasia and/or proliferative phase DAD. Neither pseudopalisaded histiocytic hyperplasia nor pulmonary macrothrombi was seen in non-COVID-19 DAD cases, whereas microthrombi were common in DAD regardless of etiology. The inflammatory pattern of pseudopalisaded histiocytic hyperplasia may represent the distinctive immunopathology associated with the dexamethasone responsive form of DAD seen in severe COVID-19. SN - 1532-8392 UR - https://www.unboundmedicine.com/medline/citation/34273395/Distinctive_Pseudopalisaded_Histiocytic_Hyperplasia_Characterizes_the_Transition_of_Exudative_to_Proliferative_Phase_of_Diffuse_Alveolar_Damage_in_Patients_Dying_of_COVID-19. L2 - https://linkinghub.elsevier.com/retrieve/pii/S0046-8177(21)00122-2 DB - PRIME DP - Unbound Medicine ER -