PMC6431524_01
A chest radiograph obtained on the day of admission showed bilateral diffuse alveolo-interstitial infiltration, particularly in the left lung.
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A chest radiograph revealed bilateral diffuse infiltration (Figure 1).
Chest computed tomography revealed bilateral airspace consolidation and ground-glass opacity.
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Chest computed tomography (CT) revealed bilateral airspace consolidation and ground-glass opacity (Figure 2).
(a) A photomicrograph (original magnification, x40; hematoxylin-eosin staining) of a section of lung tissue. The section showed homogeneous septal thickening and intra-alveolar eosinophilic exudate. (b) A high-power photomicrograph (original magnification, x400; hematoxylin-eosin staining) of a section of lung tissue showed thickening of the alveolar septa due to both chronic inflammation and a small amount of collagen. The intra-alveolar spaces were filled with foamy acellular eosinophilic exudate. (c) A high-power photomicrograph (original magnification, x400; Grocott's methenamine silver staining) of a section of lung tissue. Numerous cysts of Pneumocystis jirovecii were observed within the intra-alveolar foamy exudate.
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A postmortem pathological examination of the lung tissue demonstrated that the alveolar spaces were filled with foamy amorphous material composed of abundant numbers of cystic forms of Pneumocystis jirovecii and cellular debris, as well as an inflammatory reaction with hyaline membranes (Figure 3).
Grocott's methenamine silver staining of bronchoalveolar lavage fluid samples obtained on the day of admission revealed a small number of cystic forms of Pneumocystis jirovecii.
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Retrospectively, Grocott's methenamine silver (GMS) staining of the BALF and TBLB samples obtained on the day of admission revealed a small amount of the cystic form of Pneumocystis jirovecii (Figure 4).