Colby T V, Zaki S R, Feddersen R M, Nolte K B
Department of Pathology and Laboratory Medicine, Mayo Clinic Scottsdale, Scottsdale, AZ 85259, USA.
Arch Pathol Lab Med. 2000 Oct;124(10):1463-6. doi: 10.5858/2000-124-1463-HPSIDF.
Hantavirus pulmonary syndrome (HPS) and acute interstitial pneumonia (AIP) can share similar clinical presentations. AIP is an acute, diffuse lung disease that has some clinical features suggesting a viral infection, although causative agent(s) have not been identified.
To clinically, histologically, and immunohistochemically compare cases of HPS to cases of AIP and to determine if any cases of AIP were actually examples of HPS.
Seven cases of HPS and 9 cases of AIP were compared clinically and histologically by semiquantitative grading of features in lung tissue. The cases were also evaluated immunohistochemically for the presence of hantaviral antigens.
Hantavirus pulmonary syndrome had a shorter clinical duration and more acute changes histopathologically; AIP was of longer clinical duration and was usually accompanied by histologic evidence of organization. Hantavirus pulmonary syndrome was distinguished by the presence of immature leukocytes in the pulmonary vasculature. No hantaviral antigens were identified immunohistochemically in the 9 case of AIP. Hantaviral antigens were identified in all 7 cases of HPS.
Cases of AIP and fatal cases of HPS can generally be distinguished on clinical and histologic grounds, and this distinction can be further confirmed immunohistochemically.
汉坦病毒肺综合征（HPS）和急性间质性肺炎（AIP）可具有相似的临床表现。AIP是一种急性弥漫性肺部疾病，具有一些提示病毒感染的临床特征，尽管尚未确定病原体。
从临床、组织学和免疫组化方面对HPS病例与AIP病例进行比较，并确定是否有AIP病例实际上是HPS病例。
通过对肺组织特征进行半定量分级，对7例HPS病例和9例AIP病例进行临床和组织学比较。还对这些病例进行免疫组化评估，以检测汉坦病毒抗原的存在情况。
汉坦病毒肺综合征临床病程较短，组织病理学变化更急性；AIP临床病程较长，通常伴有机化的组织学证据。汉坦病毒肺综合征的特征是肺血管中存在未成熟白细胞。在9例AIP病例中，免疫组化未检测到汉坦病毒抗原。在所有7例HPS病例中均检测到汉坦病毒抗原。
AIP病例和HPS致死病例通常可根据临床和组织学特征加以区分，这种区分可通过免疫组化进一步证实。
