Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients With Lung Cancer

Abstract

There is currently a lack of pathologic data on the novel coronavirus (severe acute respiratory syndrome coronavirus 2) pneumonia, or coronavirus disease 2019 (COVID-19), from autopsy or biopsy. Two patients who recently underwent lung lobectomies for adenocarcinoma were retrospectively found to have had COVID-19 at the time of the operation. These two cases thus provide important first opportunities to study the pathology of COVID-19. Pathologic examinations revealed that apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Hyaline membranes were not prominent. Because both patients did not exhibit symptoms of pneumonia at the time of operation, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia.

Exuberant Plasmocytosis in Bronchoalveolar Lavage Specimen of the First Patient Requiring Extracorporeal Membrane Oxygenation for SARS-CoV-2 in Europe

“…Due to the urgent turnaround time that the clinical contest of these particular tests requires, we would report to clinicians the following peculiar findings, adding them to your previously published list of the pathological findings related to SARS-CoV-2 infection. 1 On February 17th, a 66-years-old male patient presented to the emergency department of a hospital in the north of Italy with a 2-days history of fatigue and fever. He had no respiratory symptoms, chest x-ray was negative.…”

Coronaviruses: Facts, Myths, and Hypotheses

“…In this issue of JTO, Tian, et al 1 , provide the first description of early pathology of coronavirus disease-2019 (COVID-19). As of today, Feb 26, 2020, there have been over 78,000 confirmed cases, and over 2,500 deaths in China, based on the official figure by the National Health Commission of China.…”

“…Only recently the Chinese government allowed autopsies to be performed in P3-biosafety level facilities -P3-suites for autopsy are not available in Wuhan. The first report of a postmortem biopsy in a single patient who died of COVID-19 was published a few days ago 10 , after the paper by Tian et al 1 , had been submitted to JTO. These two papers allow us to see how the diseases develops and progresses.…”

“…The paper by Tian et al 1 was a result of an international collaboration between the senior author, Dr. Xiao, a Professor at the University of Chicago, US, who also works several months of the year at Wuhan University where he Chairs the department of Pathology, and his colleagues in Wuhan. Dr. Xiao was in Wuhan when the city found itself at the center of an epidemic, and the hospitals were suddenly hit with an overwhelming number of patients, many of them severely ill: healthcare authorities and workers scrambled to offer as much care as possible to those who needed it, several of them got infected and died of COVID-19.…”

“…In these pre-symptomatic SARS CoV-2-infected lungs, Xiao and colleagues observed edema with proteinaceous exudates. 1 The high quality figures show patchy changes of fibrin plugs mixed with macrophages and other inflammatory cells. In one of the two cases, abundant intraalveolar pulmonary macrophages are present.…”