A study on intraalveolar exudates in acute mycoplasma pneumoniae infection.
Pathologic features of Mycoplasma pneumoniae infection (M. pneumonia) are generally non-specific, and the literature regarding the pathologic features of M. pneumonia with intraalveolar exudates is limited. Clinical and histopathological studies were performed in 3 patients with M. pneumonia which did not respond to erythromycin and minocycline, but all rapidly recovered after corticosteroid therapy. In pathologic findings, we observed intraalveolar exudates and focal organization in M. pneumonia, and its intraalveolar lesions were compared between M. pneumonia and bronchiolitis obliterans organizing pneumonia containing fibrin (BOOP). Immunohistochemical studies were performed using the streptavidin biotin peroxidase complex method with anti-alpha-smooth muscle actin antibody and anti-pancytokeratin AE1/AE3 antibody. In pathologic findings, more fibrin deposits in intaalveolar lesions were observed in M. pneumonia than in BOOP. In intaalveolar lesions of M. pneumonia, a larger amount of nuclear debris, more neutrophils, and more erythrocytes were noted. Myofibroblasts were observed in the organization of BOOP, while in the intaalveolar lesions of M. pneumonia, myofibroblasts were not observed. These results suggest that M. pneumonia with intraalveolar exudates responds well to corticosteroid and its intraalveolar lesions apparently differed from those in BOOP.
Yoshinouchi
Takeo
T
Department of Internal Medicine II, Nagoya City University, Medical School, Nagoya, Japan.
Ohtsuki
Yuji
Y
Fujita
Jiro
J
Sugiura
Yoshiki
Y
Banno
Shogo
S
Sato
Shigeki
S
Ueda
Ryuzo
R
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D018549:Cryptogenic Organizing Pneumonia / Q000473:pathology; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy / Q000473:pathology*; D011650:Pulmonary Alveoli / Q000473:pathology*
D000305:Adrenal Cortex Hormones