SARS-CoV-2 detection in formalin-fixed paraffin-embedded tissue specimens from surgical resection of tongue squamous cell carcinoma

J Clin Pathol. 2020 Nov;73(11):754-757. doi: 10.1136/jclinpath-2020-206635. Epub 2020 May 4.

Abstract

In the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, pathologists can be exposed to infection handling surgical specimens. Guidelines related to safety procedures in the laboratory have been released. However, there is a lack of studies performed on biopsy and surgical resection specimens. Here we report the detection of SARS-CoV-2 in formalin-fixed paraffin-embedded samples from surgical resection of tongue squamous cell carcinoma of a patient who developed COVID-19 postsurgery. RNA of SARS-CoV-2 strain was detected in the tumour and the normal submandibular gland samples using real-time PCR-based assay. No viral RNA was found in metastatic and reactive lymph nodes. We demonstrated that SARS-CoV-2 RNA can be detected in routine histopathological samples even before COVID-19 disease development. These findings may give important information on the possible sites of infection or virus reservoir, and highlight the necessity of proper handling and fixation before sample processing.

Keywords: pathology, molecular; pathology, oral; viruses.

Publication types

  • Case Reports

MeSH terms

  • Betacoronavirus / genetics
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / virology
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / etiology
  • Coronavirus Infections / virology
  • Fixatives
  • Formaldehyde
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Paraffin Embedding
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / virology
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / virology
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification
  • Reverse Transcriptase Polymerase Chain Reaction
  • SARS-CoV-2
  • Tissue Fixation / methods
  • Tissue Preservation / methods*
  • Tongue Neoplasms / complications
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / surgery*
  • Tongue Neoplasms / virology

Substances

  • Fixatives
  • RNA, Viral
  • Formaldehyde