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A SELECTIVE REVIEW OF POSTMORTEM LESIONS IN CATS
By
Paul C. Stromberg DVM, PhD
Diplomate, American College of Veterinary Pathologists
Professor of Veterinary Pathology
Ohio State University
[email protected]
OBJECTIVES
A.
B.
C.
D.
E.
Reinforce or broaden your feline pathology experience
See some “neat”, common and not-so-common lesions from cats
Practice applying the principles of gross pathology interpretation
Develop appropriate morphologic diagnoses for the observed lesions
Learn how to play the “Gross Pathology Game” correctly or
“When is a response not responsive?”
CARDIOVASCULAR SYSTEM
1.
96-1421 Heart fixed w/ thick Lt ventricle and Rt ventricular mass
2 Mx
1. Lt ventricular myocardial hypertrophy 2. Rt ventriculat FSA
Name the Disease = Hypertrophic cardiomyopathy
2.
88-532 Heart w/ thickened Lt ventricular endocardium
Mx = Lt ventricular endocardial fibrosis
3.
81-732 Heart
Mx = atrial thrombosis and ventricular hypertrophy
Name a related lesion – aortico-illac thromboembolism
4.
89-1101 Mtn Lion Heart with white mural masses and mitral vegetative lesion
Mx = 1. Fibrinonecrotic valvular endocarditis 2. Multifocal mural abscesses
Cause = Aspergillus sp.
1
5.
97-2411 Aortic bifurcation
Mx – Aortico-illiac thrombosis (“Saddle thrombus”)
Name a related clinical sign = 1. Hard gastrocnemius muscles 2) Cool hind limbs
3) Painful patient 4) Rear limb paresis 5) Lack of femoral pulses
ENDOCRINE SYSTEM
6.
91-735 Ventral neck exposing thyroid glands and trachea
Mx = Bilateral multinodular thyroid follicular adenomas
Name a common related clinical condition = hyperthyroidism
7.
9728 Lateral view of the Lt thyroid and parathyroid gland
2 Mx 1. Chief cell hyperplasia/Parathyroid hypertrophy
2. Cystic remnant of Kursteiner’s Duct
8.
96-2056 Adrenal gland from a jaguar with nodules
Mx = Multinodular adrenal cortical nodular hyperplasia
HEMATOPOIETIC SYSTEM
9.
9517 Cat with open abdomen and “Blackberry jam” spleen and yellow fat
Mx = Icterus and splenomegaly
Name the associated clinicopathologic condition = hemolytic anemia
Name the Disease = Hemobartonellosis
2
Cause = Mycoplasma felis (Hemabartonella felis)
Name a common underlying associated problem = FeLV +
Most likely sex = male
When does he liver = outside
10.
081985A Lateral view of open Lt thorax w/ white cranial mediastinal mass
4 Mx 1. Thymic LSA 2. Pleural effusion or hydrothorax 3. Pulmonary
congestion and edema. 4. Pericardial effusion or hydropericardium
11.
86-383 Large smooth reddish mass at heartbase or mediastinum
Mx = thymoma
Name a related lesion = pleural effusion
12.
X section of spleen with multiple white nodules
Mx = LSA
13.
X-section of spleen with prominent white pulp
Mx = **LSA or lymphoid hyperplasia
GASTROINTESTINAL SYSTEM
14.
81-1481 X-section of tongue w/ opague white ventrolateral area
Most likely Dx = Glossal SCCA
DDx = foreign body granuloma or pyogenic granuloma.
Eosinophilic ulcer/granuloma
3
15.
En face view of mouth w/ ulceration on lip
Name the Condition = Eosinophilic ulcer (Rodent ulcer)
16.
TM29798 Tongue w/ vesicles
Mx = Multifocal vesicular glossitis/stomatitis
Cause = Feline calicivirus
17.
91-1181 Cheetah close up of gastric mucosa w/ “Morocco Leather” look
Mx = Diffuse glandular hypertrophy and hyperplasia
Cause = Helicobacter sp.
18.
RKH25 Open abdomen showing reddish colored small intestine
Mx = Hemorrhagic enteritis
Name the Disease = Feline infectious enteritis
Cause = Feline parvovirus
Name a common related lesion = myeloid atrophy of the bone marrow
19.
80608H Open small intestine with segmented flatworm
Cause = Taenia taeniformis
How is this transmitted? Rats
20.
81-1190 Open small intestine with worms
Cause = 1. Taenia taeniaformis 2. Toxascaris leonina or Toxocara cati
4
21.
80863B Open small intestine w/ “Morocco Leather” appearance
Mx = Diffuse granlomatous enteritis
Cause = Histoplasma capsulatum
22.
Open small intestine w/ linear ulceration and string
Mx = Intestinal placation and linear ulceration
Cause = string foreign body
23.
86-1865 Jejunum w/ sewgmental dilation
DDx - 1) **Intestinal LSA 2) Intestinal adenocarcinoma
with bowel obstruction and pre-stenotic dilation
24.
Small intestine with dilation w/ small white mesenteric plaques
Mx = Intestinal adenocarcinoma with peritoneal metastasis
25.
87N9626 Cecum open with large ulcerated white plaques
Mx = Cecal LSA with ulceration
26. In situ surgical photo of colon w/ multiple small white serosal plaques
Mx = Colonic adenocarcinoma with serosal metastasis
27.
J106 Open segment of small intestine with red wall and necrotic mucosa
Mx = necrotizing enteritis or fibrinonecrotic enteritis w/ hemorrhage
Cause = Feline parvovirus
5
28.
Close up of intestine with large segmental white mass
Mx = Leiomyosarcoma or Gastrointestinal Stromal Tumor (GIST)
29. Open abdomen showing markedly distended large bowel
Mx = Megacolon
Cause = atresia ani
30.
Close up of serosal surface of small intestine w/ cloudy plaques
Mx = Fibrinous to pyogranulomatous serositis or peritonitis
Name the Disease = Feline Infectious Peritonitis (FIP)
Cause = Feline Coronavirus
HEPATOBILILARY SYSTEM
31.
86-3749 Open thorax and abdomen of an obese cat
3 Mx: 1. Diffuse hepatic lipidosis 2. Icterus 3. Obesity
(also pulmonary congestion and edema)
Name the Condition = Idiopathic feline hepatic lipidosis syndrome
32.
A&B
93-2861 Whole and X-section of liver
Mx = Diffuse centrilobular or periportal lipidosis or necrosis
6
33.
93-3172 In situ liver w/ accentuated lobular pattern
Mx = Widespread hepatic lipidosis with necrosis and hemorrhage
34.
99-784-1 Whole liver removed diffuse pale
Mx = Diffuse hepatic lipidosis
35.
98-4152 Whole liver with multifocal white umbilicated masses
Mx = chopplangiocellular carcinoma (Biliary Ca)
36.
94-580 Whole liver with cystic mass ~ one lobe
Mx = Biliary cystadenoma or cholangioma
37.
Whole liver with small white cystic mass
Mx = Biliary cystadenoma
38.
91-745 In situ of abdomen showing nodular liver and spleen
2 Mx: 1. Chronic hepatitis with cirrhosis 2. Splenic mast cell tumor
39.
Open abdomen showing firm-looking nodular brown fat
Name the Disease = Steatitis
Cause = Vit E deficiency
40.
Y4867-4 Large mass in pancreas
Mx = Exocrine pancreatic carcinoma
7
41.
99-1973 Open abdomen with many serosal or peritoneal nodules
Mx = Peritoneal carcinomatosis or Mesothelioma
Most likely cause = Exocrine pancreatic carcinoma
2nd Mx = Diffuse hepatic lipidosis
INTEGUMENTARY SYSTEM
42.
A&B
Cat with 2 large skin nodules on Rt pinna
Mx = Multinodular granulomatous auricular dermatitis
Name the Disease = Cutaneous leishmaniasis
Cause = Leishmania mexicana
43.
9971 On Face view with deep ulceration
Mx = SCCA of the eyelid
44.
MCM4 On Face view with raw nose
Name the Condition = Mosquito bite hypersensitivity dermatitis
45.
A&B
Lateral of whole cat with skin mass on the dorsal neck
Name the Condition = Vaccine-associated cutaneous sarcoma (FSA)
46.
Amputated foreleg with whole mass
Mx = Cutaneous FSA
8
47.
“Bug” larva
Cause = Cuterebra sp.
Name the Disease Caused = Cutaneous myiasis
What is the natural host for this? - rabbits and rodents
48.
23287 Ventral abdominal skin with multifical orange-yellow plaques
Mx = Eosinophilic granuloma or Plaque
Cause = cutaneous allergy
49.
Dorsal skin with focal discrete erosion and alopecia
Name the Condition = Psychogenic alopecia
50.
Close up of a swollen footpad with cracks and fissures
Name the Condition = Plasmacytic pododermatitis
51.
13961 Ventral abdomen w/ dark color and wet fur
Mx = Ventral andominal angiosarcoma / lymphangiosarcoma
52.
1-86 Dorsal head and ears of white cat hyperemic ears and blood
Mx = Aural SCCA of the Rt ear
Cause – exposure to UV light
9
MUSCULOSKELETAL SYSTEM
53.
9622 Radius and ulna w/ diffuse brown color
Name the Disease = Congenital Erythropoetic Porphyria
Cause = Uroporphyrinogen III cosnythetase
54.
Cervical spinal column with ventral fusion of vertebral bodies
Mx = Ankylosing cervical spondylosis or hyperostosis
Cause = Vitamin A deficiency
Name an associated lesion = Squamous metaplasia in respiratory tract, salivary
glands, conjunctiva and endometrium
55.
81985D Longitudinal section of femur w/ irregular pale soft marrow in head
Mx = LSA
56.
325 Longitudinal section of femoral head w/ irregular white mass extending thru
cortexx
Mx = Osteosarcoma
NERVOUS SYSTEM
57.
90-2140-2 Coronal section of brain w/ dilated ventricles and opaque fluid
Mx = Bilateral hydrocephalus
Name the associated lesion = Pyogranulomatous ependymitis/choroiditis
Cause = Feline Corona Virus
10
58.
Coronal section of frontal lobes of cerebrum with gelatinous masses
Name the Disease = Cerebral cryptococcosis (“Soap bubble” lesions)
59.
Coronal section of cerebrum with black friable mass
Mx = Focal cerebral hemorrhage and necrosis with adjacent edema
Cause = 1) Trauma 2) Uremia
60.
Coronal section of cerebrum with large firm mass
Mx = Meningioma with compression atrophy
61.
86121C Whole brain dorsal aspect, asymmetrical,
Mx = Lt unilateral diffuse cerebral coagulation necrosis (infarction)
Name the Disease = Ischemic encephalopathy
Cause = Cuterebra sp. aberrant migration
62.
A&B
En face view of the foramen magnum w/ brain tissue visible
Mx = Cerebellar prolapse or herniation through the foramen magnum
Name the predisposing condition = Increased intracranial pressure
63.
A&B
Lateral view of eye in situ and white mass in the anterior chamber
Mx = Ocular LSA
64.
En face view of enucleated eye with cloudy anterior segment
Mx = Pyogranulomatous anterior uveitis or iridocyclitis
Cause = 1) Feline Corona Virus 2) Toxoplasma gondii
11
65.
9631 Dorsal view of brain in situ w/ only Rt cerebral hemisphere
Mx = Lt unilateral cerebral atrophy/hypoplasia
Cause = In utero infection with feline parvovirus
66.
98-4149 Coronal section of cerebellum and brainstem
Mx = Pyogranulomatous periventricular encephalitis of the 4th ventricle
Name the Disease = Feline Infectious Peritonitis
67.
93-3116 Open dorsal view of spinal cord in situ w/ discolored root
Mx = Spinal LSA ~ nerve root
REPRODUCTIVE SYSTEM
68.
89-1914 In situ of peritoneal cavity with uterus; asymmetrical, dark horn
Mx = unilateral uterine torsion with venous infarction
Name the predisposing condition = pregnancy
69.
2632 Open uterus w/ diffuse cystic nodular endometrium
Mx = Cystic endometrial hyperplasia
Name the predisposing condition = persistent CL on ovary
70.
99-3607 Whole uterus removed, enlarged w/ brown fluid
Mx = Suppurative endometritis or pyometra
12
71.
97-84213 Fluids filled Uterus and cystic kidneys in situ
2 Mx: 1) Hydrometra 2) Polycystic kidneys
72.
Ventral aspect of mammary chain; enlarged bulging glands
Name the Condition = Feline mammary hypertrophy/ fibroepithelial hyperplasia
Cause = synthetic progestins like Ovaban
RESPIRATORY SYSTEM
73.
56376 Longitudinal section of nasal cavity w/ gelatinous material
Mx = Granulomatous rhinitis
Cause = Cryptococcus neoformans
74.
M1602 Coronal section of nasal cavity with mucoid exudates
Mx = Mucopurulent rhinitis / catarrhal rhinitis
Name the Disease = Feline Viral Rhinotracheitis (FVR)
Cause = Feline Herpesvirus
75.
081985C Lateral view of Lt lung diffuse red and wet
Mx = Diffuse pulmonary congestion and edema
Cause 1) Shock 2) Heart failure 3) Mediastinal mass (Thymic LSA)
13
76.
A&B
87658 Lateral view of lung with dark red color and military white foci
2 Mx: 1. Diffuse pulmonary congestion 2. miliary interstitial pneumonia
Name the Disease = Feline Infectious Peritonitis
Pathogenesis – Infection with feline coronavirus – formation of Ag-Ab complexes –
Circulation and adherence to capillary walls – immune complex vasculitis in
alveolar septal capillaries
77.
080058 Dorsal view of entire lung with multifocal to coalescing white nodules
Mx – Multifocal to coalescing granulomatous pneumonia
Cause = Histoplasma capsulatum
78.
9720244 Dorsal view of entire lung with coalescing pale foci
Mx = Multifocal to coalescing pyogranulomatous pneumonia
Cause = Blastomyces dermatiditis
79.
92-1712 Open thorax with white nodule on lung, heart and pleura
Mx = Multifocal metastatic renal carcinoma
80.
A&B
X-section of caudal lung lobe with 3 flukes within cysts
Mx = Multifocal granulomatous pneumonia
Cause = Paragonimus kellicotti
How is this parasite acquired? Eating crayfish
14
81.
Lateral view of open thorax filled with white milky fluid
2
Mx 1. Chylothorax 2. Pulmonary atelectasis
Cause = Ruptured thoracic duct
82.
Lateral view of open thorax with white fluid and opaque granules
Mx = Pyothorax with sulfur granules (“Chunky pyothorax”)
83.
Ventral view of open thorax filled with thick opaque fluid
Mx = Pyothorax (“Smooth”) Also there is pulmonary compression atelectasis
84.
157 Ventral view of open thorax and abdomen
Mx = Diaphragmatric hernia with displacement of the
bowel into the thorax
URINARY SYSTEM
85.
081711B Section of kidney with solitary wedge-shaped cortical mass
Mx = Renal LSA
86.
57523 Two kidneys with numerous pale nodules
Mx = Bilateral multinodular renal LSA
87.
A&B
081435C Longtudinal cut section of kidney with diffuse white
Mx = Diffuse renal LSA, bilateral
15
88.
92-1772 X-section of kidney with ½ kidney obliterated by a pale firm mass
Mx = Renal carcinoma
89.
91-717-1 Whole kidney with military white foci and congested veins
Mx = military pyogranulomatous interstitial nephritis / vasculitis
Name the Disease = Feline Infectious Peritonitis
Cause = Feline Coronavirus
90.
A&B
90-3066 Whole kidney with miliary white nodules
Mx = Multifocal widespread granulomatous interstitial nephritis
Cause = Cryptococcus neoformans
Pathogenesis: immunosuppression → infection with Cryptococcus →
septicemia with spread to the kidney
91.
89-1101 X-section Mtn Lion kidney with 2 wedge shaped areas in the cortex
2
Mx’s : 1. Thrombosis of the radial artery 2. Segmental renal cortical necrosis
( Acute Infarct)
Etiologic Dx = septic thrombosis with renal cortical infarction
Pathogenesis = Immunosuppression → Infection with Aspergillus sp.
→ Development of vegetative lesions on heart valves → Septicemia with spread
to kidney → Thromboembolism of radial artery → Ischemic necrosis of
dependent renal cortex
16
92.
Y4867-1 Whole kidney with focal depression in cortex
Mx = Focal segmental cortical necrosis and atrophy (chronic renal infarct)
93.
92-1791 X-section of kidney with depression in cortex
Mx = Focal segmental cortical necrosis with atrophy (chronic renal infarct)
94.
93-587 X-section of kidney with discrete segmental yellow area in the tip of the
medulla
Mx = Segmental renal papillary coagulation necrosis
Cause – Banamine (NSAIDS)
95.
90-2056 X-section a jaguar kidney with segmental loss of tissue at tip of the medulla
Mx = Segmental renal papillary necrosis
Cause = NSAIDS.
96.
Y4867-3 X-section of kidney with radiating foci in the medulla
Mx – Acute pyelonephritis with necrosis
97.
98-169 X-section of kidney with hemorrhage and tiny pale foci
Name the Disease = Ethylene glycol toxicity
Etiologic Dx = Oxalate nephrosis
98.
01-1165 Both kidneys in situ, pale, irregular surface
Mx = Chronic interstitial nephritis
Name 2 associated lesions 1. Parathyroid hyperplasia 2. Fibrous osteodystrophy
17
99.
87/93 Ventral view of open caudal abdomen
2 Mx = 1. Multifocal renal cortical necrosis (infarcts)
2. Aortico-iliac thromboembolism
Name the Related disease = Hypertrophic cardiomyopathy
Pathogenesis: Atrial thrombosis → embolization → saddle thrombus formation
→ Embolism to the renal artery → segmental ischemic necrosis to renal cortex
100.
00-968-1 Ventral open abdomen with red urinary bladder and kidneys
Name the Condition = Feline lower urinary tract disease
Mx = Cystic hemorrhage and edema / Hemorrhagic cystitis
101.
81298C urinary bladder with dark colored urine
Name the condition = hematuria or cystic hemorrhage
Cause = Blunt force trauma with a full bladder (HBC)
102.
99-293 Open urinary bladder with white plaques and red mucosa
Mx = Fibrinonecrotic cystitis with ulceration and hemorrhage
Cause = Urethral obstruction (“Blocked cat”)
103.
98-1450 Open urinary bladder with red and pale mottled mucosa
Mx = Hemorrhagic cystitis
18