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SYSTEMIC PATHOLOGY 2 > 3 - Liver III > Flashcards

3 - Liver III Flashcards

1
Q

What is a viral disease of the liver? What is it caused by?

A
  • Herpesvirus infection
    o Bovine, equine, canine, and feline herpesvirus-1
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2
Q

What does a herpesvirus infection cause

A
  • *fetal ABORTION or neonatal death
    o Will be autolyzed, but can use histo!
    o Equine: FRESH (so can see WHITE SPOTS ON LIVER)
  • Liver: multifocal haptic necrosis
    o *eosinophilic intranuclear inclusions!
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3
Q

What is a bacterial disease of the liver in all species (commonly foals)?

A
  • Tyzzer’s disease
  • affects neonates in almost all species
    o MOST COMMON in foals
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4
Q

What is the cause of Tyzzer’s disease?

A
  • Clostidium piliforme
    o Do silver stain!
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5
Q

What does Tyzzer’s disease cause?

A
  • *multifocal haptic necrosis (white spots)
  • Colitis
  • Sometimes myocarditis
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6
Q

What is the ideal sample type?

A
  • *FRESH for bacteriology
  • Samples in formalin and send for histo
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7
Q

What are other bacteria that cause multifocal hepatic necrosis in neonates?

A
  • EHV-1
  • Salmonella
  • Rhodococcus
  • Listeria
  • Arcanobacterium pyogenes
  • Many others.
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8
Q

Why take frozen samples?

A
  • Need frozen (unfixed) tissues to isolate viruses
  • *if see another xick animal, collect a blood sample
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9
Q

Fusobacterium necrophorum: steps due to grain overload

A
  1. Grain overload
  2. Chemical rumenitis and mucosal injury
  3. Bacteria enter the portal circulation
  4. Liver necrosis
  5. Liver abscess
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10
Q

What is the Fusobacterium necrophorum mixed infection usually with?

A
  • Trueperella pyogenes
  • Mucor
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11
Q

Liver abscess are usually incidental UNLESS

A
  • Open into central vein or vena cava and cause PULMONARY THROMBOEMBOLISM
  • Cause central vein THROMBOSIS and OCCLUSION causing hepatic passive congestion and portal hypertension
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12
Q

What does neonatal umbilical infection cause in a wide variety of animals?

A
  • *causes multifocal hepatic necrosis or abscesses
  • *Multiple causes (mixed infections are common)
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13
Q

Neonatal umbilical infection: sheep

A
  • Campylobacter
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14
Q

Neonatal umbilical infection: calves

A
  • T. pyogenes
  • F. necroforum
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15
Q

Neonatal umbilical infection: foals

A
  • Rhodococcus equi
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16
Q

*Tuberculosis: caused by and what does it cause

A
  • Caused by Mycobacterium bovis
  • causes hepatic granulomas that are CALCIFIED
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17
Q

**Leptospirosis

A
  • From rodents
  • *loves the KIDNEY but causes INTRAVASCULAR HEMOLYSIS and HEPATIC necrosis
  • *depends on serovar (one can cause abortion)
  • **CULTURE THE KIDNEY
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18
Q

Protozoal diseases

A
  • Toxoplasma and neospora can infect liver and cause NECROSIS
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19
Q

Fungal diseases

A
  • Can cause liver GRANULOMAS
  • Aspergillus
  • Blastomyces
  • Coccidioides
  • Histoplasma
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20
Q

Ascaris suum and liver

A
  • Larval stages migrate through liver of pigs creating migration tracts
  • *tracts heal by fibrosis producing “milk spot liver”
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21
Q

Strongylus in horses and liver

A
  • Produce fibrous tags on capsule=incidental finding
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22
Q

Dirofilarial immitis (vena caval syndrome)

A
  • If large number in vena cava can cause:
    o DIC
    o intravascular hemolysis
    o acute hepatic failure
  • *blockage leading to severe PASSIVE CONGESTION WITHIN LIVER
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23
Q

Cysticercus cyst on liver (and other organs)

A
  • Food animals and wild herbivores
  • Adult stage Taenia is in dogs
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24
Q

Hydatid cyst

A
  • Food animals and wild herbivores
  • *much bigger than cysticercus
  • Adult stage is Echinococus
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25
Q

Trematodes and the liver

A
  • Fasciola hepatica: biliary system of ruminants
  • Fascioloides magna: migrate through the parenchyma of ruminants
  • Metorchis: inhabits the bile duct of dogs and cats
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26
Q

Why is the liver a target for toxicity?

A
  1. All ingested substances are delivered to liver via portal system
  2. Liver is metabolically very active (ex. high energy requirement leading to increased susceptibility)
  3. Anything excreted by kidneys has to be water soluble
    a. Liver is primary stie where chemicals are made water soluble (CYP45- enzymes!)
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27
Q

Do toxins cause lesions in all zones within the liver?

A
  • Can cause random and zonal lesion
  • *most common pattern of acute liver toxicity is “centrilobular necrosis”
28
Q

Why is the most common pattern of acute liver toxicity “centrilobular necrosis”?

A
  • Zone with lowest oxygen tension
  • Highest concentration of metabolic enzymes
29
Q

What are the major mechanisms through which toxicity occurs?

A
  1. Production of injurious metabolites
  2. Formation of neoantigens
  3. Induction of apoptosis
  4. Injury to cell membranes and activation of proteases
  5. Disruption of bile secretion
  6. Mitochondrial damage
30
Q

Production of injurious metabolites

A
  • Most common mechanism
  • Phase I and II enzymes perform action hoping molecules become more water SOLUBLE
  • Metabolites act like free radicals or can form adducts with cellular enzymes
  • *centrilobular necrosis is commonly seen
31
Q

Formation of neoantigens (toxins)

A
  • Toxins bind to cellular proteins which are presented on cell surface (macrophages) as NEOANTIGENS
    o Attacked by immune cells
  • *leads to inflammation and cell deat
32
Q

Induction of apoptosis (toxins): 2 mechanisms

A
  1. Directly
  2. Secondary to activation of apoptotic pathway by immune system (ex. retained bile acids)
33
Q

Injury to cell membranes and activation of proteases (toxins)

A
  • Net result is increased influx of Ca which activates cellular processes
34
Q

Disruption of bile secretion (toxin)

A
  • Disrupt bile secreting pumps
35
Q

Mitochondrial damage (toxins)

A
  • Toxins can effect mitochondrial membranes, enzymes and DNA
  • Disrupt ETC
  • *result in fatty degeneration or cell death by necrosis or apoptosis
36
Q

What are the examples of hepatotoxic agents?

A
  • Blue green algae
  • Hepatotoxic plants
  • Mycotoxins
  • Mushroom poisoning
  • Copper and iron toxicity
37
Q

Blue Green Algae: microcystis

A
  • Toxic algae bloom during hot summer on surface of water
  • Causes severe CONVULSIONS (neurotoxic) +/- liver damage depending on type of algae
  • Usually ACUTE in nature
38
Q

How do you diagnosis blue green algae toxicity?

A
  • Analysis of stomach content
39
Q

Pyrrolizidine alkaloid toxicity

A
  • Alkaloid present in plants (ex. Senico, Crotalaria)
  • CYP450 metabolism result in toxic metabolites
  • Inhibit cell division but NOT DNA synthesis
  • **megalocytes (big hepatocytes) histologically
    o Can be seen with other things
40
Q

How do you diagnose pyrrolizidine alkaloid toxicity?

A
  • Usually chronic in nature
  • By time lesion and signs develop, very little toxic is left for analysis
  • *need to talk to the owner
41
Q

Alfatoxin

A
  • Mycotoxins: metabolites of fungi
  • Food stored at humid conditions allow fungi to proliferate
  • *toxicity is similar to Pyrrolizidine Alkaloid
    o Chronic and megalocytes
42
Q

How do you diagnosis aflatoxin?

A
  • Analyze the feed!
43
Q

Mushroom poisoning

A
  • Acute
  • Dogs and cats
  • Centrilobular to massive hepatic necrosis
44
Q

How do you diagnosis mushroom poisoning?

A
  • Finding mushroom in stomach
45
Q

Copper and iron toxicity

A
  • Usually chronic through FEED
  • Cause oxidative damage to liver and necrosis
  • *causes INTRAVASCULAR hemolysis
46
Q

What are the proliferative lesions of the liver?

A
  • Nodular hyperplasia
  • Hepatocellular adenoma
  • Hepatocellular carcinoma
  • Bile duct neoplasia
  • Metastatic neoplasms
47
Q

**Nodular hyperplasia

A
  • Raised nodules on surface of liver of OLD dogs
  • NOT significant if DOG is healthy
  • NO fibrosis: nodules are yellow, tan or red
  • *different from regenerative nodules
48
Q

Hepatocellular adenoma

A
  • Somewhat large solitary nodule on liver
  • *need histology to differentiate from nodular hyperplasia
49
Q

Hepatocellular carcinoma

A
  • Friable, grey, white or brown masses on surface of liver
  • *can metastasize to lung and peritoneum
    o Takes a long time
50
Q

What are the bile duct neoplasms?

A
  • Chollangiocellular adenoma: UNCOMMON
  • Chollangiocelllar carcinoma
    Chollangiocellular carcinoma
  • Relatively common in CATS
  • UMBILICATED raised lesions (‘depressed centre’)
    o Why it is a carcinoma=epithelial origin
  • Metastasis is very common
51
Q

Metastatic neoplasm to the liver

A
  • More COMMON than hepatic neoplasia
52
Q

Equine serum hepatitis (Theiler’s disease)

A
  • Acute centrilobular to massive hepatic necrosis
  • Occurs after an injection of a biologic containing equine serum (EQUINE PARVOVIRUS)
  • *hepatic failure and hepatic encephalopathy (life threatening!)
53
Q

What causes bacillary hemoglobinurea in ruminants?

A
  • Clostridium hemolyticum
  • (Clostridium novyi type D)
54
Q

What are the steps of ruminant bacillary hemoglobinurea?

A
  1. Clostridial spores are ingested and reside in liver
  2. Liver injury (fluke migration, liver biopsy) causes HYPOXIA
  3. Spores germinate and bacteria releases toxins (phospholipase C and beta toxin)
  4. Acute liver necrosis, hemolytic anemia and hemoglobin urea
55
Q

What causes infectious necrotic hepatitis (black disease) in ruminants? How is it different from bacillary hemoglobinurea?

A
  • Clostridium novyi type B
  • Similar pathogenesis to bacillary hemoglobinurea but NO INTRAVASCULAR HEMOLYSIS
56
Q

Hepatosis dietetica in pigs

A
  • Acute necrosis and hemorrhage in young, RAPIDLY GROWING pigs
    o Centrilobular to massive
57
Q

What causes hepatosis dietetica in pigs?

A
  • Vitamin E and/or Selenium deficiency
58
Q

Infectious canine hepatitis, cause and age group

A
  • Canine adenovirus 1
    o PREDILECTION FOR ENDOTHELIAL CELLS (systemically sick: diarrhea, vomiting, fever)
  • *dogs less than 2 years of age (usually unvaccinated)
59
Q

Infectious canine hepatitis ‘steps’

A
  • Exposure through oral route
  • Viremia
  • Spread to liver
  • *centriolobular hepatic necrosis with intranuclear inclusion bodies
60
Q

Lymphocytic cholangitis in cats

A
  • Slowly progressive disease of cat >4 years
  • UNKNOWN etiology
  • Lymphocytic infiltration centered on bile ducts with bile duct HYPERPLASIA and FIBROSIS
61
Q

What are the disorders of the gallbladder and extrahepatic bile duct?

A
  • Cholelithiasis (gallbladder stones)
  • Cholecystitis
  • Gall bladder mucocele
  • Cystic mucinous hyperplasia
62
Q

Cholelithiasis (gallbladder stones)

A
  • Bile concretions
  • Can block the extrahepatic duct
  • EXTRAHEPATIC JAUNDICE
63
Q

Cholecystitis

A
  • Usually associated with liver disease
  • Ascending infection from INTESTINE
  • COW: Salmonella Dublin
  • DOG: infectious canine hepatitis
  • *thickening of wall with EDEMA
64
Q

Gallbladder mucocele (dogs)

A
  • Gallbladder filled with mucous (dogs)
    o Goblet cell hyperplasia
    o Surgery to remove it
  • Can cause biliary obstruction
  • *if ruptures=cause severe bile peritonitis
  • *NON-SPECIFIC SIGNS OF ILLNESS
65
Q

Cystic mucinous hyperplasia

A
  • Mucoas thickened with many surface cysts
  • *INCIDENTAL FINDING
    o But may predispose them to gallbladder mucocele

SYSTEMIC PATHOLOGY 2 (8 decks)

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