Lung, Parainfluenza pneumonia [LMP36095]

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Diagnostic Modality: 
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Disease Category: 
Infectious Diseases
Diagnosis: 
Parainfluenza pneumonia
Species: 
Human
Organ System: 
Lung
Gender: 
Female
Age: 
12 years
Diagnosis Code: 
ICD-10: J12.2
Slide Contributor Information
Wang, T., Chung, C.

Keywords

giant cell pneumonia, parainfluenza virus, diffuse alveolar damage, alveolar hemorrhage, bone marrow transplant, immunosuppression

Clinical History

12 year old girl post bone marrow transplant developed respiratory distress.

Clinical Discussion

Parainfluenza is a paramyxovirus that can cause severe pneumonia in immunocompromised hosts and can be fatal particularly when complicated by diffuse alveolar damage or superimposed bacterial infection. In this case, the pattern is of giant-cell interstitial pneumonia with diffuse alveolar hemorrhage. These giant cells do not originate from macrophages, but from pneumocytes. Cytoplasmic eosinophilic viral inclusions can be seen.

This pattern of giant-cell pneumonia is not specific, and can be seen in a variety of infections (measles, parainfluenza, respiratory synctitial virus, varicella zoster) as well as pneumoconiosis secondary to inhalations of heavy metals. Measles tend to present with both intranuclear and cytoplasmic inclusions, while Varicella zoster would present with only nuclear inclusions. RSV can also present with cytoplasmic inclusions. PCR can provide a more specific diagnosis.