新型冠状病毒肺炎1例病理特征报道并其他病毒感染性肺炎文献复习

摘要：目的 探讨新型冠状病毒肺炎的临床病理学特征及鉴别诊断。方法 回顾性分析1例新型冠状病毒肺炎的临床病理学特征、影像特点等并复习相关文献。结果 患者71岁,胸部CT平扫示两肺多发大片状磨玻璃密度影,符合病毒性肺炎表现,新型冠状病毒核酸检测阳性。眼观：肺标本表面呈暗红色,弥漫充血,局部褐色。镜检：肺泡上皮细胞表现为增生、萎缩、脱屑,部分肺泡间隔增宽,肺泡上皮坏死,脱落,肺泡腔及支气管腔内可见纤维素性、黏液性渗出坏死物,支气管黏膜上皮坏死剥脱,呈坏死性细支气管炎表现。大量的肺间质纤维化局部伴透明变性,多灶充血及出血性梗死,血管壁增厚,管腔狭窄;间质内炎细胞弥漫浸润,包括淋巴细胞,浆细胞,中性粒细胞及嗜酸性粒细胞。结论 本例病例符合《新型冠状病毒肺炎诊疗方案（试行第七版）》中关于肺病理改变的特征。目前对于突发的新型冠状病毒感染的病理学证据尚不多,对新型冠状病毒肺炎的病理特征进行分析,依据临床和病理组织学特点,结合实验室检查可以对我们认识新冠病毒感染有所帮助。

A case report of novel coronavirus pneumonia and literature review

Abstract: Objective To study the clinicopathological characteristics and diagnosis of new Corona Virus Disease 2019(COVID-19).Methods Retrospectively analyzed the clinical pathological characteristics and imaging characteristics of a case of COVID-1 and reviewed literatures. Results The patient was 71 years old. CT scan of the chest revealed multiple large-scale ground glass density shadows on both lungs, which was consistent with the disease. The nucleic acid test was positive. The surface of the lung specimen is dark red, diffusely congested, and partially brown. alveolar epithelial cells showed hyperplasia, atrophy, desquamation, and some alveolar intervals were wide, alveolar epithelial necrosis, shedding, fibrinous, mucous exudative necrosis visible in the alveolar cavity and bronchial cavity, exfoliation of bronchial epithelial necrosis. A large number of pulmonary interstitial fibrosis with hyaline degeneration, multifocal congestion and hemorrhagic infarction, thickened blood vessel wall, narrowed lumen; diffuse infiltration of interstitial inflammatory cells, including lymphocytes, plasma cells, neutrophils and eosinophilia Acidic granulocytes. Conclusion This case is consistent with the characteristics of lung pathological changes in the New Coronavirus Pneumonia Diagnosis and Treatment Program (Trial Version 7). At present, there is not many pathological evidences for sudden new coronavirus infection. The analysis of the pathological characteristics of new coronavirus pneumonia, based on clinical and histopathological characteristics, combined with laboratory examinations can help us understand the new coronavirus infection. .