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Giant cell pneumonia: light microscopy, immunohistochemical, and ultrastructural study of an autopsy case
S M Rahman1, H Eto, S A Morshed
1Department of Pathology, Institute of Tropical Medicine, Nagasaki University, Japan.
Abstract:
An autopsy case of measles giant cell pneumonia with intranuclear inclusion bodies is reported. This case of giant cell pneumonia was studied by light microscopy and immunohistochemistry using monoclonal and polyclonal antibody to measles and by electron microscopy (EM). Light microscopic examination showed multinucleated epithelial giant cells with intranuclear and intracytoplasmic inclusions. The giant cells contained prominent, sharply marginated, eosinophilic intranuclear inclusions typical of classic measles pneumonia. Presence of measles antigen was confirmed using both monoclonal and polyclonal antibodies by peroxidase antiperoxidase method. Monoclonal antibody stained positively for intracytoplasmic and intranuclear inclusions. Electron microscopic examination of lung tissue showed intranuclear inclusions of filamentous or worm like nucleocapsid materials in multinucleated epithelial giant cells. The results suggest that this is a case of measles giant cell pneumonia and the intranuclear inclusion bodies are measles viral particles.
Insights
This autopsy case confirms measles giant cell pneumonia by identifying measles viral particles within intranuclear inclusions using advanced microscopy and immunohistochemistry.
Area of Science:
- Pathology
- Virology
- Immunohistochemistry
Background:
- Giant cell pneumonia is a severe form of pneumonia characterized by multinucleated giant cells.
- Measles virus infection can lead to giant cell pneumonia, particularly in immunocompromised individuals.
- Intranuclear inclusion bodies are a hallmark of certain viral infections.
Observation:
- An autopsy case presented with features of giant cell pneumonia.
- Microscopic examination revealed multinucleated epithelial giant cells with intranuclear and intracytoplasmic inclusions.
- Inclusions were eosinophilic and sharply marginated, characteristic of measles pneumonia.
Findings:
- Immunohistochemistry confirmed the presence of measles antigen using monoclonal and polyclonal antibodies.
- Both intracytoplasmic and intranuclear inclusions stained positive for measles antigen.
- Electron microscopy identified filamentous nucleocapsid material within intranuclear inclusions, consistent with measles viral particles.
Implications:
- This study provides definitive evidence of measles giant cell pneumonia in the reported case.
- The findings reinforce the diagnostic utility of immunohistochemistry and electron microscopy in identifying viral pathogens.
- Understanding the ultrastructural characteristics of viral inclusions aids in diagnosing complex respiratory infections.