SARS-CoV-2 Pozitif Olgularda Dalak ve Bölgesel Lenf Düğümlerinde Ölüm Sonrası Histopatolojik Bulgular

Year 2022, Volume: 36 Issue: 3, 119 - 126, 14.12.2022

Aytül Buğra , Taner Daş , Erdoğan Kara , Nihan Ziyade , Yalcin Buyuk

Abstract

Amaç: SARS-CoV-2 virüsü dalak ve lenf düğümlerini etkileyebilir. Bu çalışmada bölgesel lenf nodları ve dalakta histomorfolojik değişiklikleri, immünohistokimyasal bulguları ve gerçek zamanlı polimeraz zincir reaksiyonu testi (rt-PCR) sonuçlarını değerlendirmeyi amaçladık. Yöntemler: SARS-Cov-2 pozitif olan 12 postmortem nazofaringeal sürüntü vakasının bölgesel lenf düğümleri ve dalak örnekleri değerlendirildi. Üst paratrakeal, alt paratrakeal ve hiler lenf nodları ve dalak örnekleri ışık mikroskobu altında H&E boyalı kesitler ve immünohistokimyasal olarak boyanmış kesitler ile incelendi.
Bulgular: Dokuz olguda yaygın alveoler hasar görüldü. Konjesyon, immünoblastik ve plazmablastik hücrelerin varlığı, subkapsüler sinüslerin genişlemesi, apoptotik hücrelerin varlığı ve sinüs histiositozu en sık görülen değişikliklerdi. Dört olguda üst paratrakeal lenf düğümlerinde, yedi olguda alt paratrakeal lenf düğümlerinde ve beş olguda hiler lenf düğümlerinde SARS-CoV-2 rt-PCR testi pozitifti. Beyaz pulpa atrofisi ve kırmızı pulpa kanaması dalakta en sık görülen bulgulardı. Dalakta dört vakada SARS-CoV-2 rt-PCR testi pozitifti.
Sonuç: SARS-CoV-2 virüsü lenf düğümlerine ve dalağa yayılarak dokuları tahrip edebilir.

Keywords

SARS-CoV-2, dalak, lenf nodu, otopsi, forensic patoloji

Postmortem histopathological findings in the spleen and the regional lymph nodes in SARS-Cov-2 positive cases

Abstract

Objective: SARS-CoV-2 virus can affect the spleen and lymph nodes. In this study, we aimed to evaluate the histomorphological changes, immunohistochemical findings and real-time polymerase chain reaction test (rt-PCR) results in regional lymph nodes and spleen. Methods: The regional lymph nodes and spleen samples of 12 cases of postmortem nasopharyngeal swabs that were positive for SARS-Cov-2 were evaluated. Upper paratracheal, lower paratracheal, and hilar lymph nodes and spleen samples were examined under a light microscope with H&E stained sections and immunohistochemically stained sections.
Results: Diffuse alveolar damage was seen in nine cases. Congestion, presence of immunoblastic and plasmablastic cells, expansion of subcapsular sinuses, presence of apoptotic cells, and sinus histiocytosis were the most common changes. The SARS-CoV-2 rt-PCR test was positive in four cases in the upper paratracheal lymph nodes, in seven cases in the lower paratracheal lymph nodes, and in five cases in the hilar lymph nodes. White pulp atrophy and red pulp hemorrhage were the most common findings in the spleen. The SARS-CoV-2 rt-PCR test was positive in four cases in the spleen.
Conclusion: SARS-CoV-2 virus can spread to the lymph nodes and spleen and destroy the tissues.

Keywords

SARS-CoV-2, spleen, lymph node, autopsy, forensic pathology

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