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Interdisciplinary Perspectives on Infectious Diseases
Volume 2014, Article ID 470825, 4 pages
Clinical Study

Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

1Department of Health Science, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, Via Pergolesi 33, 20900 Monza, Italy
2University of Texas Health Science Center at San Antonio, 8300 Floyd Curl Drive, San Antonio, TX 78229, USA
3Anatomia Patologica, AO San Gerardo, Via Pergolesi 33, 20900 Monza, Italy

Received 1 May 2014; Accepted 2 October 2014; Published 14 October 2014

Academic Editor: Sandro Cinti

Copyright © 2014 Paola Faverio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We present the results of bronchoalveolar lavage (BAL) performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS). Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage.