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. 2014 Oct 20;64(11):569–575. doi: 10.1111/pin.12207

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© 2014 The Authors. Pathology International published by Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Clinical images and pathological findings of case 2. (a) Chest X-ray image, (b,c) gross findings in the lungs, (d,e,g–j) hematoxylin and eosin staining, (f) Grocott staining, and (k,l) immunohistochemistry (IHC) using anti-SFTSV-NP antibody. (a) A chest X-ray reveals a bilateral infiltrative shadow without consolidation. (b,c) The cut surface of the right lung shows foci of pulmonary hemorrhage and infarction. (d) Diffuse hemorrhagic infarction (×40) and (e,f) angio-invasion of Mucor (e, ×200; f, Grocott staining ×400) are seen in the lung. (g,h) Necrotizing lymphadenitis is present in the lymph node around the abdominal aorta (g, ×40; h, ×400), and (i) hemophagocytosis is also observed (i, ×400). (j) The liver shows lobular necroses and mild portal fibrosis (×100). (k) IHC of the lymph node (×400) shows numerous SFTSV-NP-positive cells and positive signals for the SFTSV-NP antigen in the cytoplasm of atypical lymphoid cells. (l) IHC of the liver shows SFTSV-positive cells, but hepatocytes were negative for the SFTSV-NP antigen (×100).