Qap (Anatomical Pathology) 

QAP Peer Review

AP175
Case History: M/4 Lung shadow. Lobectomy
Intended diagnosis: Necrotizing pneumonia caused by Adenovirus. Contributed by:KFT
Code Diagnosis Comment Score
anonymous Necrotizing pneumonia with presence of viral inclusions suggestive of adenovirus. (100%) Correlate with serology result and EM study. Also need to exclude other infections like tuberculosis, fungal or bacterial infections.  100
anonymous Desquamative interstitial pneumonia nil  0
anonymous Lung - Necrotizing pneumonia. Likely viral aetiology and favouring adenovirus. Immunostains for adenovirus. Should exclude co-existing infections with other special stains (CMV, ZN, Grocott).  100
anonymous Necrotizing pneumonia with nuclear inclusion suggestive of adenovirus pneumonia. Confirm diagnosis with immunostaining and culture. Also perform acid-fast & grocott stain to exclude secondary infection  100
anonymous INFLAMMATION suspicious of ADENOVIRUS infection. 100% Viral culture and PCR to look for adenovirus. Culture, special stains, immunostains etc. to look for other infective agents. Correlate with clinical and radiological findings to exclude congenital abnomalies eg. pulmonary sequestration.  100
anonymous Necrotizing pneumonia, consistent with adenovirus infection. (100%) nil  100
anonymous Lung - Pneumonia 100% Intralobar type of pulmonary sequestration could be the underlying cause leading to pneumonia. Viral aetiology is suggested as a few pneumocytes with smudged nuclei are seen. Special stains (Gram stain, immunostain against adenovirus antigen) may be helpful. To correlate with microbiological culture results (of lung tissue)and serology.  100
anonymous Necrotizing pneumonia, with cytopathic effect of virus, in favour of adenovirus; 100% To be confirmed by immunohistochemical studies (antibody against adenovirus) and/or electron microscopy (to look for viral particles).  100
anonymous Pneumonia by Adenovirus (Interstitial pneumonia). nil  100
anonymous Necrotizing pneumonia consistent with viral infection. (100%) Possible etiologic agents include CMV, herpes virus and adenovirus. Suggest immunohistochemical studies for viruses.  100
anonymous Organizing pneumonitis 100% Organism stains and culture: PAS gram Grocott  50
anonymous Necrotising pneumonia with viral inclusion bodies suggestive of adenovirus infection Suggest correlation with clinical and microbiological findings for definitive diagnosis and reason for lobectomy  100
anonymous Cytomegaloviral pneumonia nil  50
anonymous necrotizing pneumonia with cells of smudged nuclei,suggestive of adenoviral infection. 100% probability nil  100
anonymous Necrotising pneumonia 100% Adenovirus infection has to be considered. Correlation with clinical and radiological findings to exclude bronchopulmonary sequestration.  100
anonymous Necrotizing pneumonitis, secondary to viral infection; adenovirus (80%), HSV. Correlate with microbiology studies. Immunostain with adenovirus, HSV, CMV.  100