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. 2021 Nov;27(11):2914–2918. doi: 10.3201/eid2711.211612

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Histopathologic findings in a fatal case of multisystem inflammatory syndrome in adult after natural severe acute respiratory syndrome coronavirus 2 infection and coronavirus disease vaccination, Tennessee, USA, 2021. A) Lung tissue shows capillaritis characterized by neutrophilic inflammation and necrosis within interalveolar septa (arrowhead). Fibrin and organizing intraluminal microthrombi in small arteries are also seen (arrows). Original magnification 20×. B) Higher magnification of fibrin microthrombus within a lung vessel (arrow). Original magnification 63×. C) Heart tissue shows myocarditis with myocyte necrosis and mixed inflammatory infiltrate. Original magnification 20×. D) Higher magnification cardiac vessel showing microthrombus and perivascular mononuclear inflammatory infiltrate (arrow). Original magnification 40×. E) Stomach tissue shows submucosal microthrombi with perivascular lymphocytic infiltrate. Original magnification 63×. F) Kidney tissue shows multiple fibrin thrombi in glomerular (arrow) and interstitial capillaries (arrow). Original magnification 40×.