Summary
The author and his collaborators have studied 250 autopsied cases of acute viral respiratory infections and mycoplasma pneumonia chiefly in young children as well as the experimental effects of the inoculation of 400 animals with certain viruses. The present paper first dwells upon the common characteristics of this whole group of diseases, and then in greater detail, elucidates the morphological patterns seen in the separate diseases. The most typical changes develop in the alveolar and tracheobronchial epithelium. The formation of large uninuclear cells with a sharply increased hyperchromatic nucleus is representative of adenoviral infection. Later these cells, as well as other cells of the exudate, degenerate, showing a finely granular appearance. In RS-infections one observes papillary proliferations of the epithelium, particularly of the small and medium bronchi. In A2 (Hong Kong) influenza very large uninuclear and rather light cells develop. In mycoplasma infection the alveolar epithelium cells greatly increase in size, and the cytoplasm around the microorganisms becomes clear. The morphologic patterns of the different diseases of this group are quite specific and are of help in the differential diagnosis of various respiratory infections.
Zusammenfassung
Zur Untersuchung gelangten der Tracheobronchialbaum und die Lungen bei 250 Sektionsfällen des Säuglingsalters mit akuten Virusinfektionen und Mycoplasma-Pneumonien. Außerdem wurden die experimentelle Untersuchungen nach viraler Infektion der Lungen durchgeführt. Neben den charakteristischen gemeinsamen morphologischen Merkmalen werden die Besonderheiten der einzelnen Erkrankungsformen dargelegt. Besonders kennzeichnend sind die Veränderungen im respiratorischen Epithel der Trachea, Bronchien und Alveolen. Bei den Adeno-Virusinfektionen kommt es zur Bildung von großen einkernigen Zellformen mit hyperchromatischen Kernen, wobei im Infektionsablauf die Kerne einem kleinbröckligen Zerfall unterliegen. Bei der RS-Infektion (respiratory syncitial infection) kommt es zu einer papillomatösen Epithelproliferation, besonders in den kleineren und mittleren Bronchien. Bei der Grippe A2 (Hong Kong) finden sich große einkernige Zellen mit hellem Cytoplasma. Bei der Mycoplasma-Pneumonie sind die Alveolarepithelien deutlich vergrößert, wobei es um das infektiöse Agens zu einer deutlichen Aufhellung des Cytoplasmas kommt. Die morphologischen Besonderheiten der einzelnen respiratorischen Infektionen werden als ausreichend spezifisch für die Diagnose angesehen und ermöglichen eine Differentialdiagnose der verschiedenen respiratorischen Infektionen.
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Zinserling, A. Pecularities of lesions in viral and mycoplasma infections of the respiratory tract. Virchows Arch. Abt. A Path. Anat. 356, 259–273 (1972). https://doi.org/10.1007/BF00543159
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DOI: https://doi.org/10.1007/BF00543159