Microorganisms in tissues

1. A SHORT VOYAGE ON INFECTIOUS DISEASE
AGENTS IN PATHOLOGIC TISSUE SPECIMENS
Professor N Engin AYDIN, MD Pathologist

4. YUTAKA TSUTSUMI, M.D.
Professor, Department of Pathology
Fujita Health University School of Medicine
Toyoake, Aichi 470-1192, Japan
phone: +81-562-93-2439
e-mail: tsutsumi@fujita-hu.ac.jp
URL: http://info.fujita-hu.ac.jp/pathology1/

5. YUTAKA TSUTSUMI, M.D.
Professor, Department of Pathology
Fujita Health University School of Medicine
Toyoake, Aichi 470-1192, Japan
phone: +81-562-93-2439
e-mail: tsutsumi@fujita-hu.ac.jp
URL: http://info.fujita-hu.ac.jp/pathology1/

24. • Pseudomembrane formed in the larynx of a
68 y-o male patient with fatal dyspnea

25. The pharyngeal squamous mucosa is
densely covered with faintly basophilic
material

26. Diphtheria
Numbers of large-sized Gram-positive rods are embedded
within the pseudomembrane (Gram stain).

27. Club-shaped, large-sized rods are often seen in a Y or V-shaped (non-parallel) arrangement.
Non-diphtherial Corynebacteria are non-pathogenic, and are distributed in the oral cavity,
skin, conjunctiva and vagina as normal flora.

28. Biopsied axillary lymph node, 40 y-o F, swollen 2 weeks after bite by a cat
Epithelioid granulomas are randomly distributed in the enlarged lymph node (HE, low power).

29. In the center of the granuloma, small abscess is formed
(suppurative granuloma). Langhans-type giant cells are
not prominent. Similar suppurative granulomas are seen in
tularemia, yersiniasis, lymphogranuloma venereum

30. Bartonellosis (cat scratch disease)
The causative agent of this infection is Bartonella henselae.
Warthin-Starry's silver shows a few short rods in the central necrosis.

31. Autopsied lung with severe pneumonia in a 76 y-o M
Numerous large and long pathogens are dispersed within the edematous alveolar space.
The pathogens are not phagocytized by neutrophils (HE, low power

32. The long and thick microbes contain centrally located rod-like core (oil immersion, HE).
They were negative with PAS, GMS and Gram stains

33. Klebsiella pneumonia
The centrally situated rods are recognizable by Warthin-Starry's silver stain (oil immersion).

34. Biopsy from a painless penile ulcer, 45 y-o M
Reactive squamous epithelial thickening with downward elongation is noted,
in association with marked lymphoplasmacytic infiltration (HE, low power).

35. In the dermis, plasma cell infiltration predominates,
and endothelial cells are swollen (HE, high power).

36. Highly coiled spiral microbes are identified (Warthin-Starry's silver).

37. Multiple red-colored infiltrative papules on the
neck and face of a lymphoma patient in complete
remission (biopsy from the neck skin), 45 y-o M
The papules are eroded, and biopsy was performed from one of the neck papules.
Clinically, cutaneous recurrence of malignant lymphoma was suspected

38. Dense infiltration of small lymphocytes and plasma cells is observed in the dermis.
Hyperkeratotic acanthosis and exocytosis are associated (HE, low power).

40. Immunostaining using a commercially available antibody to Treponema pallidum
identifies coiled pathogens. After the histopathological diagnosis, strongly positive
Wassermann's reaction was serologically reconfirmed.

41. Surgically resected liver mass, 51 y-o M

42. Surgically resected liver mass, 51 y-o M

43. The background amorphous substance
"Splendore-Hoeppli material",
is strongly PAS-reactive
Thin filamentous argyrophilic bacteria are
discernible by silver stain GMS

44. Biopsy from multifocal ulcerative inflammation of the bladder,
after BCG therapy for superficial bladder cancer, 56 y-o M

45. Biopsy from multifocal ulcerative inflammation of the bladder,
after BCG therapy for superficial bladder cancer, 56 y-o M

46. Numerous acid-fast bacilli are observed within
the granulomatous lesion (Ziehl-Neelsen).

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