PMC9037848_01
A - The abdominal CT scan shows unevenly distributed liver steatosis and hepatomegaly; B - CT scan of the lungs shows peribronchial parenchymal consolidation and a small amount of fluid in both pleural cavities.
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AST 9026 U/l (RR: 38U/I)) (Table 1). A thoracic and abdominal contrast-enhanced CT scan was performed, which showed hepatomegaly (longitudinal dimension of the right lobe - 150.5mm (RR: 105mm), diffuse steatosis (liver attenuation was approximately 30 Hounsfield Units (HU) less than the spleen (RR: <10HU) (Figure 1A), and bilateral pulmonary parenchymal consolidations consistent with bronchopneumonia (Figure 1B).
Photomicrographs of: A - Liver - the areas of centrilobular necrosis and passive and passive sinusoidal congestion with relatively preserved periportal hepatocytes (H&E, 4X); B - Early hepatocyte necrosis and passive sinusoidal congestion (left side) and preserved hepatocytes with features of steatosis (right side) (H&E, 20X); C, D - The areas of petechial bleedings in liver parenchyma and the subcapsular area (H&E, 40X).
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The overall picture corresponded to hypoxic hepatitis (Figure 2A-D).
Photomicrographs of: A - Pancreas - pancreatic islet with disturbed architecture, surrounded by lymphocytic infiltrate (H&E, 40X); B - Pancreas - abnormal pancreatic islet structure highlighted by synaptophysin staining (20X); C - Lungs - area of early bronchopneumonia (H&E, 20X); D - Lungs - signs of passive congestion with hyaline membranes formation (H&E, 40X).
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Lungs showed features of ARDS/DAD (acute respiratory distress syndrome/diffuse alveolar damage) with deposits of hyaline membranes, areas of intra-alveolar hemorrhages, pulmonary edema, and early bronchopneumonia (Figure 3C, D). Pancreatic ducts were filled with thick mucus deposits (Figure 3A, B).