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. 2020 Jun 18;5(12):e138070. doi: 10.1172/jci.insight.138070

Figure 4. Postmortem lung biopsy from case 2.

Figure 4

(A) H&E and (B) Masson’s trichrome staining showing features of early interstitial and alveolar fibrosis and mild pneumocyte hyperplasia, with focal exudative edema and hyaline membranes (arrows) in alveolar spaces. (C) Ultrastructural image showing cytoplasmic viral particles (arrow) characterized by spherical and spike-like projections in type II pneumocytes, with depleted laminar bodies, swollen mitochondria, and dilated endoplasmic reticulum. (D) CK7+ cells showing pneumocytes (original magnification, ×200). (E) SPB+ cells reflecting type II pneumocytes (original magnification, ×200). (F) Abundantly increased CD68+ macrophages in alveolar spaces. (G) Immunohistochemical staining of MPO, indicating numerous polymorphonuclear cells, aggregated in focal areas of bronchiolitis (original magnification, ×200). (H) A few CD4+ and (I) CD8+ T cells were distributed in the alveolar septal walls and interstitial areas (original magnification, ×200). (J) Gasdermin D+ cells representing cell pyroptosis (original magnification, ×200). (K and L) TUNEL staining showing apoptotic cells (original magnification, ×200). (M) RNAscope in situ hybridization indicating SARS-CoV-2 nucleic acids, which manifest as spotted brown particles (original magnification, ×200).