Unusual histopathological picture of acute lung injury in different stages of resorption with predominance of organizing pneumonia in a young man with influenza A (H1N1)

Czech version

Authors: Daniel Farkaš ¹; Radoslav Matěj ²; Marián Švajdler ml. ³; Marcela Sluková ⁴; Jana Seligová ⁵; Lucia Fröhlichová ⁶; Silvia Farkašová Iannaccone ⁷; Vlasta Vyhnálková ¹; Alžbeta Ginelliová ^1,7
Authors‘ workplace: Úrad pre dohľad nad zdravotnou starostlivosťou, SLaPA pracovisko, Košice ¹; Oddělení patologie a molekulární medicíny, Thomayerova nemocnice, Praha ²; Šiklův ústav patologie, Univerzita Karlova v Praze, Lékařská fakulta v Plzni a Fakultní nemocnice Plzeň ³; Oddelenie anesteziológie a intenzívnej medicíny, Univerzitná nemocnica Louisa Pasteura, Košice ⁴; Regionálny úrad verejného zdravotníctva, Košice ⁵; Oddelenie patológie, Univerzitná nemocnica Louisa Pasteura, Košice ⁶; Ústav súdneho lekárstva UPJŠ LF, Košice ⁷
Published in: Čes.-slov. Patol., 53, 2017, No. 1, p. 38-42
Category: Original Article

Overview

In this case report the authors describe histomorphological findings of acute lung injury with laboratory-confirmed influenza type A(H1N1) pneumonia leading to the death of a 30 year-old unvaccinated man after 27 days of hospitalisation. Histologically all three types of acute lung injuries were unusually present (diffuse alveolar damage, acute interstitial pneumonia, organizing pneumonia) in different phases of resorption and reparation with transition to extensive fibrosis.

Keywords:
influenza – organizing pneumonia – fibrosis – pneumocytes hyperregeneration

Sources

1. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, et. Al. INER Working Group on Influenza. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009; 361: 680–689.

2. Pandemic (H1N1) 2009 - update 81 http://www.who.int/csr/don/2009_12_30/en/

3. Vyhodnotenie chrípkovej sezóny 2014/2015 v Slovenskej republike http://www.uvzsr.sk/docs/info/epida/Vyhodnotenie_chripkovej_sezony_2014_2015.pdf

4. Skálová H, Povýšil C, Hofmanová J, Goldová B, Jakša R, Jandová K, Galko J. Histopathological autoptic findings in 8 patients with pandemic influenza A (H1N1) pneumonia. Cesk Patol 2012; 48(3): 161-164.

5. Petrů V. Postavení specifické alergenové imunoterapie v léčbě alergií Remedia 2007; 17: 21–25.

6. Weidner N, Cote RJ, Suster S, Weiss LM. Modern Surgical Pathology (2nd ed.). Saunders, Elsevier 2009: 409-414.

7. Vašáková M, Polák J, Matěj R. Intersticiální plícní procesy. Praha: Maxdorf ; 2011: 77-161.

8. Banka R, Ward MJ. Bronchiolitis obliterans and organising pneumonia caused by carbamazepine and mimicking community acquired pneumonia. Postgrad Med J 2002; 78: 621-622.

9. Taus-García A, Sánchez-Font A, Servitja-Tormo S, Pijuan L, Maiques-Llácer JM, Curull V. Organizing pneumonia associated with the use of trastuzumab. Arch Bronconeumol 2010; 46(8): 442-444.

10. Cordier JF. Cryptogenic organising pneumonia. Eur Respir J 2006; 28(2): 422-446.

11. Vasu TS, Cavallazzi R, Hirani A, Sharma D, Weibel SB, Kane GC. Clinical and Radiologic Distinctions Between Secondary Bronchiolitis Obliterans Organizing Pneumonia and Cryptogenic Organizing Pneumonia. Respir Care 2009; 54(8): 1028 –1032.

12. Cornejo R, Llanos O, Fernández C, et al. Organizing pneumonia in patients with severe respiratory failure due to novel A (H1N1) influenza. BMJ Case Rep 2010; 2010: bcr0220102708.

13. Torrego A, Pajares V, Mola A, Lerma E, Franquet T. Influenza A (H1N1) organising pneumonia. BMJ Case Rep 2010; 2010: bcr1220092531.

14. Brun-Buisson C, Richard JC, Mercat A, Thiébaut AC, Brochard L; REVA-SRLF A/H1N1v 2009 Registry Group. Early corticosteroids in severe influenza A/H1N1 pneumonia and acute respiratory distress syndrome. Am J Respir Crit Care Med 2011; 183(9): 1200-1206.

15. Matsubara O, Tamura A, Ohdama S, Mark EJ. Alveolar basement membrane breaks down in diffuse alveolar damage: an immunohistochemical study. Pathol Int 1995; 45(7): 473-482.

16. Dinis-Oliveira RJ, Duarte JA, Sánchez-Navarro A, Remião F, Bastos ML, Carvalho F. Paraquat poisonings: mechanisms of lung toxicity, clinical features, and treatment. Crit Rev Toxicol 2008; 38(1): 13-71.

17. Emsley J. Molecules of Murder. Criminal Molecules and Classic Cases. RSC Publishing, Cambridge, UK; 2008: 187-188.

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Anatomical pathology Forensic medical examiner Toxicology

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Article was published in

Czecho-Slovak Pathology

2017 Issue 1