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COVID-19: Histopathological correlates of imaging patterns on chest computed tomography.
Kianzad, Azar; Meijboom, Lilian J; Nossent, Esther J; Roos, Eva; Schurink, Bernadette; Bonta, Peter I; van den Berk, Inge A H; Britstra, Rieneke; Stoker, Jaap; Vonk Noordegraaf, Anton; van der Valk, Paul; Thunnissen, Erik; Bugiani, Marianna; Bogaard, Harm Jan; Radonic, Teodora.
  • Kianzad A; Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Meijboom LJ; Department of Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Nossent EJ; Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Roos E; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Schurink B; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Bonta PI; Department of Pulmonary Medicine, Amsterdam UMC, AMC, Amsterdam, The Netherlands.
  • van den Berk IAH; Department of Radiology and Nuclear Medicine, Amsterdam UMC, AMC, Amsterdam, The Netherlands.
  • Britstra R; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Stoker J; Department of Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Vonk Noordegraaf A; Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • van der Valk P; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Thunnissen E; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Bugiani M; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Bogaard HJ; Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Radonic T; Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Respirology ; 26(9): 869-877, 2021 09.
Article in English | MEDLINE | ID: covidwho-1280373
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Patients with coronavirus disease 2019 (COVID-19) pneumonia present with typical findings on chest computed tomography (CT), but the underlying histopathological patterns are unknown. Through direct regional correlation of imaging findings to histopathological patterns, this study aimed to explain typical COVID-19 CT patterns at tissue level.

METHODS:

Eight autopsy cases were prospectively selected of patients with PCR-proven COVID-19 pneumonia with varying clinical manifestations and causes of death. All had been subjected to chest CT imaging 24-72 h prior to death. Twenty-seven lung areas with typical COVID-19 patterns and two radiologically unaffected pulmonary areas were correlated to histopathological findings in the same lung regions.

RESULTS:

Two dominant radiological patterns were observed ground-glass opacity (GGO) (n = 11) and consolidation (n = 16). In seven of 11 sampled areas of GGO, diffuse alveolar damage (DAD) was observed. In four areas of GGO, the histological pattern was vascular damage and thrombosis, with (n = 2) or without DAD (n = 2). DAD was also observed in five of 16 samples derived from areas of radiological consolidation. Seven areas of consolidation were based on a combination of DAD, vascular damage and thrombosis. In four areas of consolidation, bronchopneumonia was found. Unexpectedly, in samples from radiologically unaffected lung parenchyma, evidence was found of vascular damage and thrombosis.

CONCLUSION:

In COVID-19, radiological findings of GGO and consolidation are mostly explained by DAD or a combination of DAD and vascular damage plus thrombosis. However, the different typical CT patterns in COVID-19 are not related to specific histopathological patterns. Microvascular damage and thrombosis are even encountered in the radiologically normal lung.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Tomography, X-Ray Computed / COVID-19 / Lung Type of study: Observational study Limits: Humans Language: English Journal: Respirology Year: 2021 Document Type: Article Affiliation country: Resp.14101

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Tomography, X-Ray Computed / COVID-19 / Lung Type of study: Observational study Limits: Humans Language: English Journal: Respirology Year: 2021 Document Type: Article Affiliation country: Resp.14101