Influenza A (H1N1) virus-associated pneumonia: high-resolution computed tomography-pathologic correlation |
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Authors: | Marchiori Edson Zanetti Gláucia Fontes Cristina Asvolinsque Pantaleão Santos Maria Lúcia Oliveira Valiante Paulo Marcos Mano Cláudia Mauro Teixeira Graça Helena Canto Hochhegger Bruno |
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Institution: | aFluminense Federal University, Rio de Janeiro, Brazil;bFederal University of Rio de Janeiro, Rio de Janeiro, Brazil |
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Abstract: | ObjectiveThe purpose of this study was to describe the high-resolution computed tomography (HRCT) features of fatal cases of Influenza A (H1N1) virus-associated pneumonia and to correlate them with pathologic findings.MethodsThe study included six adult patients who died following Influenza A (H1N1) virus-associated pneumonia. All patients had undergone HRCT, and the images were retrospectively analyzed by two chest radiologists, who reached decisions by consensus. Two experienced lung pathologists reviewed all pathological specimens. The HRCT findings were correlated with the histopathologic data.ResultsThe predominant HRCT findings included areas of airspace consolidation (n = 6) and ground-glass opacities (n = 3). The main pathological features consisted of diffuse alveolar damage with hyaline membrane formation (n = 5), associated with various degrees of pulmonary congestion, edema, hemorrhage, inflammatory infiltration and bronchiolitis. A patient who survived longer showed findings of organizing pneumonia.ConclusionFatal cases of Influenza A (H1N1) virus-associated pneumonia can present as areas of consolidation on CT, with or without ground-glass opacities. These abnormalities can be pathologically correlated with diffuse alveolar damage. Patients with longer survival may present with findings of organizing pneumonia. |
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Keywords: | Influenza A (H1N1) Viral pneumonia Pulmonary infection Computed tomography Pathology |
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