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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