Background: High lethality of hospitalized patients with CAP is well known fact, but mortality because of lung thrombosis had not been investigated.

Aims: To study microscopically changes in lung autopsy in patients who died because of severe CAP.

Methods: Electronic microscopy of lung tissue in 5 patients died because of severe CAP, 3-D computer modeling.

Results: Microscopically were found mixed thrombi in the lumen of the arteries, more often in average caliber. These thrombus had a head (the structure of a white thrombus), a body (actually a mixed thrombus) and a tail (the structure of a red thrombus), which were isolated. The head was attached to the endothelial lining of the vessel, which distinguishes a thrombus from a posthumous blood clot or from an embolus.
On three-dimensional model of the lung vessel wall fragment (top view): gray color – the stroma of the vessel wall; brown – smooth myocytes; yellow – endothelial cells; red – erythrocytes; blue – lymphocytes, histiocytes, macrophages. Cytoplasmic endothelial cell membrane is intense; change in the strength of the contacts between the endothelial cells and the basal membrane (phenomenon of the “picket fence of endothelial cells”), signs of swelling in the places of defects; extension of subendothelial space.

Conclusions: Thrombus, which were found microscopically in the lumen of the arteries in patients with severe CAP, were differ from embolus or post-mortem blood clots. Therefore, these changes can reflect systemic thrombosis at patients with severe CAP and could be one of the reason of mortality in patients with severe CAP.

[3D model of thrombi]

« Back to ISTH 2020 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/lung-vessels-thrombosis-induced-by-severe-cap-3d-model-of-thrombus/