Intro to repro pathology Flashcards
Why is the Reproductive system important?
- Survival of a species
- In production animals - continued
supply of product (meat, fibre, milk, etc.)
- Study of reproductive diseases – historically focused on cattle
- More recently diseases of companion animals studied in more detail
Portals of entry for pathogens?
•Ascending infection (through cervix)
–At oestrus (e.g. spermatozoa or venereal infection)
–Postpartum infections
–Equine placenta during pregnancy
•Haematogenous infection
–Mostly specific infections during pregnancy e.g. brucellosis
•Descending from ovary
–Rare
•Transneural infection
–Rare recrudescence of herpesvirus
Defense Mechanisms of repro tract?
•Innate immunity- sterile environment for the foetus but allowing entry of semen (antigenic):
–Physical barriers (e.g. cervix, positioning)
–Neutrophils, macrophages, complement, cytokines
•Adaptive immunity- response to pathogens but tolerate spermatozoa and foetus:
–Humoral immunity e.g. local and systemic antibodies
–Cellular immunity e.g. T-lymphocytes
What is the Influence of hormones on immunity?
- At oestrus - better drainage through open cervix
- In short:
- Oestrogen: E2 = good guy (regarding immunity only!)
- Progesterone: P4 = bad guy
- Disease resistance under influence of oestrogen e.g. upregulation of T- and B-lymphocytes under oestrogen in ruminants
- Uterus more susceptible to infection during progestational (progesterone influence) or luteal phase, including pregnancy
- Inflammation with epithelial and mucosal surface loss in the uterus results in decreased PGF2α production → no lysis of Corpus luteum → increased susceptibility to infection
Subdivisions of disorders of female genital tract?
Discuss ovarian disease?
Name the different types of ovarian disease
•Developmental anomalies
Agenesis, duplication, hypoplasia, vascular hamartoma
**•Cysts – relatively common** Periovarian (paraovarian) cysts Intraovarian cysts (within the ovary)
•Inflammation (Oophoritis)
•Miscellaneous diseases
Supernumerary follicles, adhesions between infundibulum and ovary, ovarian haematoma, atretic follicles
•Neoplasia
Germ cell neoplasms (dysgerminoma, teratoma)
Sex cord stromal neoplasms (granulosa cell tumour, thecoma)
Epithelial neoplasms (adenoma, carcinoma)
Which one is clinically significant?
Cystic lesions
Left – periovarian – usually cystic remnant of embryonic structures (paramesonephric ducts or mesonephric tubules or duct ), not associated with clinical signs
Right – intraovarian – numerous and common, many derived from Graafian follicles; others are epithelial cysts arising from surface epithelium or intraovarian rete ovarii (embryonic structures of mesonephric tubular origin). Can result in failure of ovulation
Discuss Follicular cysts/ cystic ovarian (Graafian) follicles?
How do they form?
What can the development possibly be due to?
Main consequence?
Failure of mature follicle to ovulate (COD –cystic ovarian degeneration)
–>2.5cm (cow); >1cm (sow)
–Persistence for >10 days (with or without functional CL)
Development possibly due to
–Abnormality in hypothalamo-hypophyseal-ovarian axis that causes deficiency of LH or of LH receptor in ovary
Main Consequence:
Failure of ovulation
Discuss a Anovulatory luteinised cyst (luteal cyst)?
- Develop from follicular cysts by delayed or insufficient release of LH (part of COD)
- Occur in cows and sows more often than in other species
- Luteinized cells line the cystic cavity
Discuss cystic corpora lutea?
- Corpus luteum with a cystic centre
- Normal ovulation but large cystic centre develops
- Ovulation papilla on surface
- No infertility
- Can be confused with luteal cysts
Discuss ovarian neoplasms?
What are the different types of them?
Germ cell neoplasm
- Dysgerminoma
- Teratoma
–will see hair and bone and other types of tissues
Gonadal stromal neoplasm
•Granulosa cell tumour –>
–Usually cystic or polycystic
–Can sometimes be more solid
- Thecoma
- Luteoma
Epithelial neoplasm
- Cystadenoma
- Cystadenocarcinoma (bottom pic)
–Common to affect both ovaries. Surface is irregular and covered with neoplastic masses
Secondary tumours
- Lymphomas
- Mammary carcinomas bitch
- Intestinal carcinomas cow
Discuss Germ cell neoplasms - rare?
Teratoma
- Totipotential germ cells (elements of 2-3 embryonic germ layers)
- Solid and cystic areas can include bone, hair, cartilage, fat, nervous tissue
- Mostly benign and well differentiated, however they can rarely be malignant
- Malignant teratomas are very rare, poorly differentiated
Discuss Sex cord-stromal tumours?
Granulosa-theca cell tumour:
- some produce steroids (androgen/ oestrogen/ inhibin)
- smooth surface with solid or cystic cut surface
- Mare, cow unilateral and benign (sometimes malignant in the bitch and often malignant in the queen)
Discuss Epithelial neoplasms?
(Cyst)adenoma and (cyst)adenocarcinoma (esp bitch)
Malignant forms:
- Often bilateral, multifocal and shaggy surface
- Transcoelomic spread possible (lateral extension and seeding on peritoneal surfaces)
- May result in ascites
Discuss Uterine Diseases?
What are the different groups?
•Inflammation
Endometritis (inflammation of the endometrium)
Metritis (inflammation of all layers of the uterine wall)
Pyometra (“pus present”)
•Non-inflammatory disorders
Torsion, rupture, prolapse, subinvolution of placental sites, pseudopregnancy, endometrial atrophy, endometrial polyps, endometrial hyperplasia, adenomyosis, mucometra
•Neoplasia
Uterine leiomyoma
Endometrial carcinoma
Lymphoma
Discuss non-inflammatory uterus disorders?
Non-inflammatory disorders
- Physical factors (e.g. torsion, rupture, prolapse)
- Endometrial growth disturbances (e.g. endometrial hyperplasia, mucometra/ hydrometra, pseudopregnancy)
What’s your diagnosis?
A)Cystic endometrial hypoplasia
B)Endometrial emphysema
C)Endometrial cyst
D)Cystic endometrial hyperplasia
E)Emphysematous cysts
Cystic endometrial hyperplasia
Uterus from a dog
Photo - endometrium is thickened, and there is cystic distention of endometrial gland lumens.
Increased progesterone in late oestrus or easy dioestrus and aberrant hormonal function may alter hormonal receptor expression –> may prime the uterus so that inflammation or irritation by bacteria or other substances stimulates the uterus to undergo hyperplasia
Discuss pyometra in bitches?
In bitch (queen less common)
–Infection independent of or supervening upon Cystic Endometrial Hyperplasia
–Mainly in older, entire nulliparous bitches
–Usually a few weeks (mostly 3-8) after oestrus under progesterone exposure (luteal phase)
–Bacterial infection of the endometrium (e.g. E.coli, Strep sp)
–Acute or chronic disease
–Can be life threatening (toxaemia, bacteraemia)
- Macroscopically there is distension of the cornua, the serosal surface of the uterus is darker, and the vessels are prominent.
- The nature of the uterine content is variable. In the more severe cases, usually those infected with E. coli
- and Proteus spp., the exudate is thick, opaque, red-brown, and with a characteristic fetid odour.
- In other cases, usually those infected with streptococci and staphylococci, the exudate is more typically suppurative.
How does a pyo appear macroscopically?
Macroscopically there is distension of the cornua, the serosal surface of the uterus is darker, and the vessels are prominent.
The nature of the uterine content is variable. In the more severe cases, usually those infected with E. coli
and Proteus spp., the exudate is thick, opaque, red-brown, and with a characteristic fetid odor.
In other cases, usually those infected with streptococci and staphylococci, the exudate is more typically suppurative.
Discuss pyometra in the cow?
In cow
–Mostly early postpartum (following endometritis/ metritis) or
–At various times after breeding (venereal infections)
–Persisting CL and high progesterone levels => increased susceptibility of the uterus to infection, functional closure of the cervix, inhibition of myometrial contractility
–Functional cervical closure but usually some discharge
–Rarely systemic signs
»Compared to the bitch
Discuss endometritis?
- Limited to uterine mucosa (endometrium)
- Post mating (seminal fluid) or Postpartum (dystocia)
- Mild cases usually self-limiting
- Severe cases can become chronic and fibrous
- Persistent CL in mare and cow in chronic endometritis (due to decreased PGF2alpha release)
- Contagious equine metritis -temporary infertility; clinical disease now rare
- Photo: The endometrium is swollen and red-brown and irregular/wavy. The uterus is open and we are seeing the endometrium inside.The endometrium is swollen and red-brown and irregular/wavy.
What’s your diagnosis?
A)Carcinoma
B)Lymphoma
C)Rhabdomyoma
D)Lipoma
E)Leiomyoma
F)Endometroma
A)Leiomyoma
We have a well demarcated mass in uterus
Most common tumours of the tubular genitalia of the bitch; smooth muscle in the wall of the uterus, cervix or vagina. Less common in other species
Characteristic gross features: solitary or multiple, not encapsulated but well demarcated, form, light tan to white and easily shelled out
Discuss Uterine adenocarcinoma
(epithelial neoplasia with glandular pattern)?
- Mainly in cow (has to be considered EBL suspect and notified - uterus one of tetrad of affected organs!)
- Metastases to regional lymph nodes, lungs and seeding in peritoneum
- Most common spontaneous tumour in rabbits!
Adenocarcinomas:
- On gross examination, the tumors are nodular, can be multicentric masses that often involve both uterine horns.
- On the cut surface, masses are firm, red to cream and may have paler areas of central necrosis.
- Typical microscopic features are the formation of acinar and tubular structures by the neoplastic cells. There may be also a large amount of fibrous tissue (which is part of what is called a scirrhous reaction). Metastases occur to the regional (medial iliac) lymph nodes and lungs, and they can seed the serosal surfaces of the abdomen.
Discuss Vagina/ vulval disorders?
Vulvar swelling (tumefaction)
Exposure to endogenous or exogenous estrogen
(ovarian cysts, estrogen-producing tumours, mycotoxins)
Inflammation
Granular vulvitis, infectious pustular vulvovaginitis of cattle (IPV), necrotic vaginitis and vulvitis, dourine
Neoplasias common here:
Leiomyoma, leiomyosarcoma
Squamous cell carcinoma
Canine transmisible venereal tumour
Fibropapilloma of the vulva
Transmissible genital papilloma of the pig
Discuss Neoplasia of Vagina/ Penis?
Canine transmissible venereal tumour
- Rare in the UK, but common in some other countries
- TVT cells have 59 chromosomes instead of normal 78 in dogs
- Transmission by transfer of neoplastic cells during coitus (xenotransplantation)
- Histo: large, round neoplastic cells with occasional large bizarre nuclei
- Vincristine responsive
- Metastases in dogs with poor health
Discuss Fibropapilloma (BPV-1)?
- Common tumour of the bovine vulvar and affects young animals primarily
- Single or multiple warty masses
- Macroscopically, there are single or multiple warty masses that have a papillary epithelial covering and a fibrous core. Surface ulceration is often extensive.
Discuss Squamous Cell Carcinomas?
- Mostly in stallions and geldings
- Associated with Equine Papillomavirus-2
- Frequent ulceration
- Recurrence if incomplete removal
- Low-grade malignancy usually
- Keratin pearl formation
- Histologically – polygonal, squamous cell like cells and have with formation of keratin pearls – typical histological feature
Discuss disorders of sexual development?
Normal sexual development
Levels at which sex can be defined:
- Genetic/ Chromosomal (xx/ xy) - sex chromosome type is established at conception
- Gonadal (testis/ ovary) - established early in development
- Phenotypic - type and arrangement of tubular genitalia and external genitalia established after the gonadal type is set
→ Disorders of sexual development (DSD) due to genetic/ chromosomal abnormalities or inappropriate hormone exposure during development
What are the 3 major categories of disorders of sexual development?
- An abnormal or missing sex chromosome
- A normal female karyotype
- A normal male karyotype
Sex chromosome DSD
Abnormal number and/or mixture of sex chromosomes, including XXY (Klinefelter syndrome), X_ (Turner syndrome), and XX/XY (chimerism).
XY DSD - disorders of testicular development, disorders of androgen synthesis or action
XX DSD - disorders of ovarian development, androgen excess, or miscellaneous disorders
(Note: SRY (sex-determining region Y protein) status)
The classification of DSD is now based on a complete as possible description of the underlying abnormality as possible, beginning with:
- the sex chromosome type,
- presence of SRY (sex-determining region Y (SRY) protein)
- gonad type,
- tubular genitalia, and
- external genital phenotype
Look at these common disorders of sexual development?
What is the bovine freemartin?
The bovine freemartin is a genetic female born co-twin with a male => anastomoses develop between the placental vascular systems of the 2 foetuses => development of the gonads, tubular, and external genitalia of the female embryo altered by hormones and cells received through the common circulation with her male twin.
If anastomoses fail to develop, the female is not affected, but almost all male-female twinning in cattle results in the female becoming a freemartin.
What is your diagnosis?
A.Female Pseudohermaphrodite
B.Male Pseudohermaphrodite
C.True Hermaphrodite
B.Male Pseudohermaphrodite
Female outer genitalia and uterus as well, but also have things that are not ovaries, we have testes – epididymis.
The gonads are testes
what is your diagnosis?
A.Female Pseudohermaphrodite
B.Male Pseudohermaphrodite
C.True Hermaphrodite
C.True Hermaphrodite
Have uterus, may have ovaries on the left and the right ‘ovary’ doesn’t look like an ovary, it has endometria from 2 different gonadal tissues – some testicular tissue and areas with ovarian cortex, so have oval testes.
It is a true as have mixed gonadal tissue
Define Hermaphroditism?
Ambiguous genitalia, with part or all of the genital organs of both sexes present
Define True hermaphrodite?
Presence of both male and female gonadal tissue
Define Pseudohermaphrodite?
Presence of only a single type of gonadal tissue
→ Male pseudohermaphrodite (with testes)
→ Female pseudohermaphrodite (with ovaries)
Discuss Male reproductive system
Pathologies?
Disorders of sexual development
Cryptorchism, testicular hypoplasia, spermatic granuloma of the epididymal head, ambiguous genitalia…
Disorders of the scrotum
Disorders of the vaginal tunic
Disorders of the testis and epididymis
Decreased size
Cryptorchism, hypoplasia, segmental aplasia, testicular atrophy/degeneration
Increased size (including masses)
Spermatic granuloma of epididymal head, epididymitis, orchitis, periorchitis, testicular neoplasia, torsion…
Disorders of the accessory genital glands
Disorders of the penis and prepuce
Developmental anomalies, haemorrhage/haematoma, inflammation, neoplasia
Discuss disease of the scrotum?
Dermatitis is common
- •Trauma
- •Frost bite
- •Environmental irritants (e.g. cement dust)
- •Dermatophilus congolensis,
- •Besnoitia besnoiti (bull)
- •Choriotes bovis (ram)
→ Thermoregulatory failures
→ Testicular degeneration
Neoplasia:
- –Mast cell tumours (dog)
- –Haemangiosarcoma (dog)
- –Papilloma (boar)
*
Discuss Tunica vaginalis?
→ Thin layer of mesothelium around testis continuous with the
peritoneum.
- –Hydrocoele in ascites. (Image:Pig, scrotum: Hydrocoele.)
- –Periorchitis e.g. FIP, Glasser’s
- –Tumours (extension peritoneal tumour) very rare
Discuss disorders of Testis and Epididymis?
- Developmental anomalies
- Degeneration
- Inflammation
- Neoplasia
Discuss Cryptorchidism (small testis)?
- Incomplete descent of the testis
- Retained between kidney and inguinal canal
- Likely polygenetic basis
- Often hypoplastic
- Increased risk of tumour formation
Discuss testicular hypoplasia?
- Congenital or pre-puberty
- Often not observed until after puberty
- Nutrition, Zn def, genetic, endocrine abnormalities
- Occurs mostly cattle, sheep, goat
- Unilateral or bilateral
- Hypoplastic - normal consistency
- Microscopy: absent/ incomplete spermatogenesis with hypoplastic and normal tubules often intermingled
Discuss Testicular atrophy/
degeneration?
- After puberty
- Common cause for male infertility
- Causes: infections, ↑scrotal temperature, decreased testicular blood supply, vitamin A/ Zn deficiency, drug reactions, radiation damage, obstruction, hyperoestrogenism
- Unilateral or bilateral
- Small –firm consistency (chronic)
- Microscopic: similar to hypoplasia, (+/- fibrosis, multinucleated spermatids )
Photos:
A) TOP Ram: interstitial fibrosis that separates the seminiferous tubules. Spermatogenic arrest at the spermatocyte stage, vacuolation of Sertoli cells, and a wavy basement membrane caused by a reduction in tubular diameter are present.
B) BOTTOM Dog: In addition to reduced spermatogenesis, there is formation of multinucleated spermatids (arrows) as a result of failure of spermatids to separate. This is a common change in testicular degeneration.
Discuss Testis and epididymis
Inflammation?
Epididymitis >> orchitis (!)
Epididymitis:
- Important in rams (Brucella ovis – notifiable!) and dogs
- Almost always affects the tail of the epididymis
- Can cause secondary testicular degeneration/atrophy
- Mostly ascending infection (accessory glands, urinary tract)
- Rarer haematogenous (e.g. Brucella spp) or trauma
Discuss Spermatic granuloma of the epididymal head?
Spermatic granuloma of the epididymal head– congenital.
Abnormal blind-ended efferent ductules at puberty fill with spermatozoa à spermiostasis à spermatocele and then spermatic granulomas
Note on spermatic granulomas of the epididymal head: All efferent ductules should connect to the single epididymal duct in the head of the epididymis, but some are blind-ended. At puberty, the blind-ending ductules fill with spermatozoa and the resultant spermiostasis proceeds to spermatocele and then spermatic granulomas.
Look at theses pics of spermatic granuloma and epididymitis?
LEFT PIC - Spermatic granuloma, head of the epididymis, dog. A, The head of the epididymis is tremendously enlarged because of spermatic granulomas (white-yellow masses). The body and tail of the epididymis (ventral) are small, as the spermatic granulomas have obstructed the flow of spermatozoa from the testis to the epididymis.
RIGHT PIC - Epididymitis (Brucella ovis), tunic adhesions, epididymis, ram. Note the dramatic enlargement of the epididymis (left half of the image) and the adhesion of the parietal vaginal tunic to the visceral vaginal tunic around the affected epididymis.
Discuss Testicular neoplasia?
Which animals are they most common in?
What are the 3 main types?
- Most common in older dogs (>> horses)
–Common in older dogs, much less frequent in horses, and rare in o.ther species
- Three main primary types:
1. Interstitial (Leydig) cell tumour
2. Sertoli cell tumour.
3. Seminoma (germ cell tumour; also teratoma)
→ almost always benign!
- May also occur in combination
Discuss a Seminoma?
- Derived from spermatogonia
- 2nd most common dog; most common in aged stallions
- May cause swelling and pain
- Gross: cream bulging mass (looks like lymphoid tissue)
- Microscopy: sheets of polyhedral cells with a large nucleus and a thin rim of cytoplasm
- Mitoses are frequent
- More prevalent in retained testes
Discuss Sertoli cell tumours?
- 3rd most common testicular tumour in dogs
- 50% occur in retained testes
- Firm, white, lobulated mass.
- Testicular enlargement
- Colour: varies white to brown, often fibrous and may contain cysts.
- Microscopy: Sertoli cells multilayered in tubules or invading interstitial tissue. Abundant fibrous tissue
- Around 1/3 secrete oestrogen (and/ or inhibin) and cause feminisation of the affected dog (hyperoestrogenism).
- A possibly life-threatening effect of hyperestrogenism is myelotoxicity, resulting in a poorly regenerative anaemia, granulocytopenia, and thrombocytopenia.
Discuss Interstitial (Leydig) cell tumours?
- Most common testicular tumour dog, cat, bull
- Gross: single or multiple spherical, tan to orange or haemorrhagic masses (bulging on cut surface)
- No enlargement of the testis
- Microscopy: polyhedral cells packed in small groups by fine fibrous stroma
- Some produce hormones and cause aggression
Note: Aggression may be related to production of androgens by the tumour but most do not cause signs of hyperandrogenism.
Discuss Prostatic disease?
Mostly affecting dog
Frequency:
- Hyperplasia> Inflammation (prostatitis) > Neoplasia
- Other: cysts, squamous metaplasia
Discuss Hyperplasia of the prostate?
- Old entire dogs
- Can cause constipation/ urinary stasis
- Gross: prostate is bilaterally and symmetrically larger
- Microscopy: hyperplasia and papillary proliferation of the glandular tissue (glandular epithelium); stromal hyperplasia
- Castration causes atrophy:
oOestrogens act synergistically with androgens to potentiate hyperplasia of the epithelium
oUnclear to what extent oestrogen induces accompanying stromal changes
Discuss Prostatitis?
- When found in older dogs, often together with hyperplasia
- Mostly ascending bacterial infection
- Gross: asymmetrical enlargement; may contain abscesses
- Untreated cases can develop into peritonitis or septicaemia/ toxaemia.
- Chronic cases may be subclinical
Photos:
Left: The prostate is enlarged with oedema, and there are many white foci of inflammatory cells instead of the usually smooth whitish-pink surface.
Right: Acute prostatitis. Glands and interstitium contain large numbers of neutrophils. Most of these infections are of bacterial origin and develop after bacteria ascend the urethra. H&E stain
Mostly neutrophils infiltrating the stroma
Discuss Prostatic carcinomas?
- Usually occurs in older dogs
- Castration: neither prevention nor treatment
- Gross: asymmetrical mild enlargement, usually surface of lesion looks quite irregular
- Microscopy: haphazardly arranged glandular cells invading interstitium and marked fibrosis.
- Metastasis common (lymph node, lung, bone); prognosis guarded
- Clinical signs: constipation, urinary stasis, cachexia and locomotor abnormalities
Discuss Metaplasia of the prostate?
- Oestrogen – dependent (e.g. dog with Sertoli cell tumour, oestrogenic implants/ ingestion of phytoestrogens (e.g. red clover) in cattle / sheep)
- Glandular or duct epithelium changes to stratified squamous epithelium
- This condition predisposes to inflammation
- Can see hypercellular parts in the picture (apparently) lol
Discuss Pathology of the penis and prepuce?
Non-infectious
Infectious (examples)
- Venereal infections (e.g. Tritrichomonas foetus, Campylobacter foetus ssp venerealis)
- Herpesviruses (e.g. Equine Coital Exanthema (EHV-3), Infectious Balanoposthitis (BHV-1))
- “Pizzle rot” (ulcerative posthitis sheep – Corynebacterium renale)
- Habronemiasis horse
Neoplasia
Define Phimosis?
Inability to extrude the penis
Define Paraphimosis?
Inability to retract the penis into the prepuce
Define Priapism?
Persistent erection
Define Phallitis?
Inflammation of the penis
Define Balanitis?
Inflammation of the head (glans) of the penis
Define Posthitis?
Inflammation of the prepuce
Define Spermatocele?
Retention cyst of a tubule of the rete testis or the head of the epididymis distended with spermatozoa containing fluid
Name some ovarian diseases
•Developmental anomalies
- Agenesis, duplication, hypoplasia, vascular hamartoma
•Cysts
- Periovarian (paraovarian) cysts
- Intraovarian cysts
- Inflammation (Oophoritis)
- Miscellaneous diseases
- Supernumerary follicles, adhesions between infundibulum and ovary, ovarian haematoma, atretic follicles
•Neoplasia
- Germ cell neoplasms (dysgerminoma, teratoma)
- Sex cord stromal neoplasms (granulosa cell tumour, thecoma)
- Epithelial neoplasms (adenoma, carcinoma)
Whats your diagnosis
A)Ovarian abscess
B)Ovarian granuloma
C)Ovarian cyst
D)Periovarian cyst
E)Periovarian abscess
F)Periovarian granuloma
→ Periovarian cysts are usually cystic remnants of embryonic structures (here: of paramesonephric ducts → hydatid of Morgagni)
What are periovarian cysts?
What are intraovarian cysts?
- Periovarian (paraovarian) cysts are cysts that are external to the ovary. They are common findings in dogs and cats during ovariohysterectomy. Intraovarian cysts are the cysts within the ovary
- Intraovarian cysts are numerous and common. Many are derived from Graafian follicles, but others are epithelial cysts arising from surface epithelium or from intraovarian rete ovarii—that is, embryonic structures of mesonephric tubular origin. The most common cyst in the mare is an epithelial inclusion cyst; the most common cyst in dogs and cats is cystic rete ovarii.
What is this?
Periovarian (paraovarian) cysts
What is this?
Ovarian (intraovarian) cysts
What has happened here?
Which animal can this be extensive in?
Ovarian Haematoma
→ The physiologic large corpus haemorrhagicum in mares can be extensive and cause an ovarian haematoma
Small amount of hemorrhage is normal at the time of ovulation in all species. The mare is an exception because the follicles are large and the cavity of the ovulated follicle fills with blood to form a large corpus haemorrhagicum. In rare cases, the haemorrhage can be extensive enough to form an ovarian haematoma or even haemoperitoneum, which can be fatal.
What is this?
A)Carcinoma
B)Teratoma
C)Folliculoma
D)Hairatoma
E)Dermatoma
B)Teratoma
An ovary with hair!
→ Ovarian teratomas have disorganized elements of at least two of the three embryonic germ layers (ecto-, meso-, endoderm)
Ovarian teratomas are rare and usually well differentiated and benign. They have disorganised elements of at least two of the three embryonic germ layers: ectoderm, including neuroepithelium; mesoderm; and endoderm. Skin with hair is often present.
Name some ovarian neoplasias?
- Germ cell neoplasms - (dysgerminoma, teratoma)
- Sex cord stromal neoplasms - (granulosa cell tumour, thecoma)
- Epithelial neoplasms - (adenoma, carcinoma)
What is this neoplasia here?
Ovarian Carcinoma
What is this neoplasia here?
Granulosa cell tumour (ovary)
What is the most common ovarian neoplasia in large animals?
What are they like?
Granulosa cell tumors are the most common ovarian neoplasms reported in large animals. They are unilateral, smooth surfaced, and round and can be 20 to 30 cm in diameter. They can be solid, cystic, or polycystic. The cysts can vary from microscopic size to several centimeters in diameter. Often, the fluid within the cysts is red-brown.
Which neoplasia of the ovary occur most commonly in the bitch?
What do they look like?
Neoplasms of the ovarian epithelium, adenoma and carcinoma, occur commonly in the bitch. In dogs, they originate from the subsurface epithelial structures that are invaginations of the epithelium into the capsule of the ovary. Macroscopically, the affected ovary is large and multinodular and has a cystic or shaggy appearance.
Describe this histology here and what it is?
→ The most common ovarian tumour in large animals; usually benign in the mare and cow, sometimes malignant in the bitch, often malignant in the queen
Microscopically, the neoplastic cells resemble normal granulosa cells and often are arranged as they would be in normal Graafian follicles: in single or multiple rows of round to columnar cells lining fluid-filled spaces. In less differentiated areas, the neoplastic cells are arranged in sheets. Call-Exner bodies (i.e., rosettes of granulosa cells around a central space) may be present. The stroma can be sparse or abundant.
Describe what is on this histology slide here and what is your diagnosis
→ Commonly in the bitch; usually metastatic spread over the peritoneal surface by both lateral extension and seeding, or metastasis to lymph nodes and other organs
Histologically, they have a combination of papillary and cystic regions. When predominantly papillary, they are called papillary adenoma or adenocarcinoma; if they are mostly cystic, they are called cystadenoma or cystadenocarcinoma.
Name some inflammatory diseases of the uterus
- Endometritis (inflammation of the endometrium)
- Metritis (inflammation of all layers of the uterine wall)
- Pyometra
Name some non-inflammatory diseases of the uterus?
Torsion, rupture, prolapse, retention of foetal membranes, subinvolution of placental sites, pseudopregnancy, endometrial atrophy, endometrial polyps, endometrial hyperplasia, adenomyosis, mucometra
Name some neoplasms of the uterus
Endometrial carcinoma
Lymphoma
Uterine leiomyoma
What is your diagnosis?
A)Endometritis
B)Oophoritis
C)Salpingitis
D)Enteritis
E)Orchitis
F)Typhlitis
Severe endometritis, retained placenta, bovine → The physiologic postpartum endometritis can become severe after an abnormal parturition or failure of the uterus to involute
Photo; Endometritis - The uterus is distended and contains red-brown material. The endometrium is swollen, red-brown and irregular/wavy
Label thd 4 white boxes here
What ha happened and what could have caused this?
→ Uterine torsion occurs in pregnant animals or when the uterus is enlarged (by pyometra or mucometra)
The rotation is around the mesometrium and occurs at the level of the cervix in the cow and mare and at the junction of the uterine horn and body in the bitch and queen. Torsion results in circulatory compromise and venous infarction.
Image: Cat: uterine torsion of the left horn, uterine body and proximal right horn with venous infarction
What is your diagnosis?
Pathogenesis of the disease?
A)Cystic endometrial hypoplasia
B)Endometrial emphysema
C)Endometrial cyst
D)Cystic endometrial hyperplasia
E)Emphysematous cysts
Cystic endometrial hyperplasia
→ Cystic endometrial hyperplasia (CEH) can be localized or generalized; in bitches and queens commonly seen in diestrus (high progesterone); almost always with bacteria
- In the bitch and presumably the queen, cystic endometrial hyperplasia (CEH) is a common response of the uterus in diestrus.
- Pathogenesis likely includes priming of the uterus by increased progesterone concentrations so that inflammation or irritation (bacteria, or other substances) stimulates the uterus to undergo hyperplasia.
Microscopically, what is the main component of endometrial hyperplasia?
Microscopically, the main component of endometrial hyperplasia is an increase in the size and area of glands with no change in the stroma apart from oedema.
The glandular epithelium is progestational in appearance (i.e., the cells are columnar, hypertrophic, and hyperplastic and have a clear vacuolated cytoplasm). As the glands become cystic with increased pressure of retained secretion, the epithelium of the glands becomes flattened and simple squamous in type (compression atrophy).
What is this here?
When is this likely to occur in the bitch?
Pyometra!
•Acute or chronic
–acute or chronic suppurative infection of the uterus with accumulation of pus in the uterine lumen.
•Common in the bitch, queen, cow, and mare
•Bitch:
Typically in diestrus → progesterone plays an essential role in the pathogenesis (!)
- Bitch: Typically a few weeks after oestrus; luteal phase: endometrial hyperplasia → accumulation of secretions → inflammation → secondary bacterial infection (most commonly Escherichia coli)
What is your diagnosis?
Describe your answer and what this neoplasia looks like and is located
A)Carcinoma
B)Lymphoma
C)Rhabdomyoma
D)Lipoma
E)Leiomyoma
F)Endometroma
E)Leiomyoma
Leiomyomas are the most common tumours of the tubular genitalia of the bitch, being located in the smooth muscle in the wall of the uterus, cervix, or vagina. Are less common in other species
Characteristic gross features: not encapsulated but are well demarcated, firm, light tan to white, and easily shelled out.
In almost all cases, the tumours project as globose or elliptical masses or as bulbous polyps into the lumen. Some extend outward from the serosal surface, and a few are found in the mesometrium.
Describe this histology slide
Leiomyoma
Histologically – appearance of well differentiated smooth muscle - composed of whorling bundles of smooth muscle cells with abundant stroma but scant intercellular connective tissue. The organization does not depart much from normal.
What is your diagnosis from this picture and histology?
Uterine leiomyosarcoma
→ Uncommon tumour; Malignant counterpart of leiomyoma with invasive growth and pleomorphic tumour cells
Leiomyosarcoma effacing the uterine body, cervix, and cranial vagina in a Saanen goat, a breed that appears predisposed to develop this tumour – increase invasiveness when compared to benign version.
Increased pleomorphism, anisocytosis, anisokaryosis, increased mitotic figures.
What is your diagnosis?
Describe its morphology
→ Uterine neoplasms are uncommon in domestic animals. Carcinoma in cows and leiomyoma in bitches are most common. Note that the uterine adenocarcinoma is the most common spontaneous tumour in rabbits (!)
Uterine adenocarcinoma, rabbit
Grossly, tumours are nodular, can be multicentric masses that often involve both uterine horns. On the cut surface, masses are firm, red to cream and may have paler areas of central necrosis.
Describe these histology slides and what is the diagnosis?
Typical microscopic features for uterine adenocarcinomas are the formation of acinar and tubular structures by the neoplastic cells, but more solid areas may also be present. There may be also a large amount of fibrous tissue (which is part of what is called a scirrhous reaction). Metastases occur to the regional (medial iliac) lymph nodes and lungs, and they can seed the serosal surfaces of the abdomen.
What is your diagnosis?
A)Mammary hypertrophy/hyperplasia
B)Benign mammary tumour
C)Granulomatous mastitis
D)Malignant mammary tumour
E)Mammary abscesses
A)Mammary hypertrophy/hyperplasia
→ Highly prevalent in young intact female cats; likely caused by high concentrations of progesterone; proliferation of mammary ducts and stroma; spontaneous resolution is possible
Frequent in young intact queens (<2 y)
Usually in the luteal phase of oestrus, early pregnancy or after progestin therapy.
High concentrations of progesterone or progesterone-like substances are the common link.
Progestogen treatment of an old neutered male or female can also induce this lesion.
All mammae, only one mamma, or one mammary gland may be affected.
Histo:
Mammary ducts have proliferated and are surrounded by abundant loosely arranged stromal tissues. Typically, cats with mammary hypertrophy are young and develop enlargement of one or several mammary glands in the spring. H&E stain.
What do benign canine mammary tumours contain terms of cells types?
→ Common in dogs; contains a mixture of cell types (epithelial and myoepithelial proliferation), with foci of cartilage and/or bone
What do malignant canine mammary tumours contain terms of cells types?
→ Common in dogs; most often epithelial (carcinoma) or combined epithelial and myoepithelial (complex carcinoma) tumours;
→ Cats: Rare, but often highly malignant
→ Usually increased pleomorphism, higher numbers of mitotic figures
Name some male reproductive system pathologies
- Disorders of sexual development
- Cryptorchism, testicular hypoplasia, spermatic granuloma of the epididymal head, ambiguous genitalia…
- Disorders of the scrotum
- Disorders of the vaginal tunic
- Disorders of the testis and epididymis
- Decreased size
- Cryptorchism, hypoplasia, segmental aplasia, testicular atrophy/degeneration
- Increased size (including masses)
- Spermatic granuloma of epididymal head, epididymitis, orchitis, periorchitis, testicular neoplasia, torsion…
- Decreased size
- Disorders of the accessory genital glands
- Disorders of the penis and prepuce
- Developmental anomalies, haemorrhage/haematoma, inflammation, neoplasia
Name the 3 common primary testicular neoplasias
- Seminoma
- Sertoli cell tumour
- Interstitial (Leydig) cell tumour
What is your diagnosis?
A)Lipoma
B)Leydig cell tumour
C)Lymphoma
D)Sertoli cell tumour
E)Seminoma
F)Teratoma
E)Seminoma
What is a Seminoma? Describe it
Which species is it most common in?
→ The most common neoplasia in the aged stallion and the second most common canine testicular tumour; More prevalent in cryptorchid testes; White or pink-gray and firm
Seminoma, testis, bisected and reflected section, dog. A, Note the pale pink to beige circumscribed homogeneous mass. The cut surface has a gelatinous texture and has bulged slightly on incision. The contralateral testis was atrophic
Histology:
Seminoma, testis, bisected and reflected section, dog. B, Seminomas consist of round germinal cells with a high nuclear-to-cytoplasmic ratio and frequent mitoses (not shown here). Note how the cells have filled and expanded the seminiferous tubules. Inset: Higher magnification of the neoplastic cells. Note the mitoses. Despite this “malignant” appearance, most are behaviourally benign. H&E stain.
What is wrong here?
Describe it and sau which species its most common in
Sertoli cell tumour
→ The third most common testicular neoplasia in the dog;
>50% are located in retained testes in the dog; About one third produce a feminising effect (via oestrogen or inhibin production);
Firm, white, and lobulated by fibrous bands
What is wrong her ?
Which animals is it most common in?
→ The most common testicular tumour of the bull, dog, and cat; Can produce hormones (including oestrogenic substances); spherical, tan-to-orange, often with haemorrhage
Interstitial cell tumour, testis, bisected and reflected section, dog. A, Note the well-demarcated, yellow-tan mass, which has bulged on incision. Such masses become haemorrhagic when they become large. Atrophy of an affected testis as the result of pressure is common when the tumour is large. B, Cells are arranged in packets surrounded by a fine fibrous stroma typical of endocrine cells. Their cytoplasm is pale, eosinophilic, and abundant and often has fine vacuoles. Mitoses are rare. H&E stain.
Where does epididymitis affect and which species is it important in?
What can it cause seondary?
Epididymitis:
- Very important in rams and dogs
- Almost always affects the tail of the epididymis
- Can cause secondary testicular degeneration/atrophy
- Typically infectious
Where does spermatic granuloma affect?
What can it cause seondary?
Spermatic granuloma:
- Affects the head of the epididymis
- Congenital disease of most species (non-infectious) → Blind-ended efferent ductules that fill with spermatozoa → spermatocele → spermatic granuloma
- Can cause secondary testicular degeneration/atrophy
What is this?
Spermatic granuloma
Spermatic granuloma, head of the epididymis, dog, The head of the epididymis is tremendously enlarged because of spermatic granulomas (white-yellow masses). The body and tail of the epididymis (ventral) are small, as the spermatic granulomas have obstructed the flow of spermatozoa from the testis to the epididymis.
What is wrong here?
Epididymitis
Epididymitis (Brucella ovis), tunic adhesions, epididymis, ram. Note the dramatic enlargement of the epididymis (left half of the image) and the adhesion of the parietal vaginal tunic to the visceral vaginal tunic around the affected epididymis.
What are some things that can cause prostatic disease, which is most frequently found?
- Mainly affecting the dog
- Frequency:
- Hyperplasia > inflammation > neoplasia
Other:
- Prostatic/paraprostatic cysts, squamous metaplasia, atrophy
What’s your diagnosis?
What can it be caused by?
A)Chronic prostatitis
B)Prostatic cysts
C)Prostatic hyperplasia
D)Prostate carcinoma
E)Prostatic abscess
F)Prostatic atrophy
Prostatic hyperplasia
→ Develops spontaneously in old dogs; in intact dogs; can be caused by both oestrogens (e.g. Sertoli cell tumour!) and androgens; usually uniform enlargement; can be cystic
What is wrong here? Which species is it most common in?
Desribe the histology slide
Prostatitis
→ In older dogs, often together with prostatic hyperplasia, or in young dogs without hyperplasia; can be acute or chronic; abscesses can form; often caused by bacterial infection
- Prostatitis, prostate, dog. A, Acute prostatitis, cut surface. The prostate is enlarged with oedema, and there are many white foci of inflammatory cells instead of the usually smooth red surface. Clinically, this condition is usually painful.
- B, Acute prostatitis. Glands and interstitium contain large numbers of neutrophils. Most of these processes are of bacterial origin and develop after bacteria ascend the urethra. H&E stain
What is wrong here?
Is metastasis common or uncommon?
Prostatic carcinoma
→ The only prostatic neoplasia of importance in domestic animals; asymmetric and often only minimal prostatic enlargement; Metastasis is common
- A Carcinoma, prostate, dog. A, Prostatic carcinomas are usually asymmetric and lobulated white-to-grey masses that expand the size of the gland and may compress the urethra (dysuria) and the colon (difficulty defecating, ribbon stools).
- Hitso: C, Anaplastic prostatic epithelial cells arranged in acini (upper right) and solid lobules (lower left). Mitoses can be frequent in some cases. There also may be stromal or lymphatic invasion and desmoplasia (scirrhous response). H&E stain.
What is prostatic squamous metaplasia and what can induce/cause it?
•
- Oestrogen (e.g. Sertoli cell tumour!) can induce hyperplasia and/or squamous metaplasia
- Normal epithelium of the ducts (transitional) and glandular acini (columnar) is replaced by stratified squamous keratinizing epithelium
- Image attached - Prostate, squamous metaplasia. Functional Sertoli cell tumours that secrete oestrogen can induce hyperplasia and/or squamous metaplasia of the prostate gland. Normal epithelium of the prostatic ducts (transitional) and glandular acini (columnar) is replaced by stratified squamous keratinizing epithelium. H&E stain
Name some penile neoplasias
- Primary neoplasias of the penis and prepuce are restricted to a few types and species affected:
- Canine transmissible venereal tumour (CTVT)
- Papilloma and squamous cell carcinoma (horses, bulls, and dogs)
- Sarcoids in horses
- Metastatic neoplasias rarely affect penis or prepuce
What is wrong here?
Penile squamous cell carcinoma
→ Typically infiltrative growth; commonly firm (abundant fibrous tissue) and enlarged penis, often with ulceration
- A - Squamous cell carcinoma, penis, ventral surface, horse (gelding). A, A very large ulcerated mass protrudes from the glans penis. The urethral opening is visible (arrow).
- Histo: Neoplastic squamous epithelial cells are often arranged around “keratin pearls.” Mitoses are frequent (arrows). H&E stain.
What is this here?
Penile equine sarcoid
→ The sarcoid consists of an epidermal and dermal component. The hyperplastic epidermis has thin rete pegs that extend into the dermis. The dermis is thickened by proliferating fibroblasts and collagen
- B - Sarcoid, skin, horse. B, Sarcoid. The sarcoid consists of an epidermal and dermal component. The hyperplastic epidermis has thin rete pegs that extend into the dermis (arrows). The dermis (D) is thickened by proliferating fibroblasts and collagen. H&E stain.
Define Phimosis
Inability to extrude the penis
Define paraphimosis
Inability to retract the penis into the prepuce
Define priapism
Persistent erection
Define:
- Phallitis
- Balanitis
- Posthitis
- Spermatocele
•Phallitis
Inflammation of the penis
•Balanitis
Inflammation of the head (glans) of the penis
•Posthitis
Inflammation of the prepuce
•Spermatocele
Retention cyst of a tubule of the rete testis or the head of the epididymis distended with spermatozoa containing fluid
What is the sequential series of events for sexual development?
What are disorders of sexual development caused by?
1.Establishment of genetic sex
2.Establishment of gonadal sex
(modelling of embryonic gonadal tissue)
3.Establishment of phenotypic sex
(early embryo: controlled regression and growth of the indifferent tubular and external genital tissues)
→ Disorders of sexual development are caused by abnormalities of genetic or chromosomal origin or inappropriate hormone exposure
(at fertilization)
Define:
- Hermaphroditism
- True hermaphrodite
- Pseudohermaphrodite
- Hermaphroditism
- Ambiguous genitalia, with part or all of the genital organs of both sexes present
- True hermaphrodite:
- Presence of both male and female gonadal tissue
- Pseudohermaphrodite:
- Presence of only a single type of gonadal tissue
- → Male pseudohermaphrodite (with testes)
- → Female pseudohermaphrodite (with ovaries)
What is your diagnosis
Male pseudohermaphrodite
Disorder of sexual development with testis, male pseudohermaphrodite, reproductive tract. A, Pig. A testis and epididymis are present on each side. Note the well-developed uterus, cervix, and vagina. No ovarian tissue is present
What is your diagnosis?
True hermaphrodite
•Disorder of sexual development with ovotestis, true hermaphrodite, reproductive tract. A, Gilt, an ovotestis is on the left and a testis on the right. Note the well-developed uterus, cervix, and vagina.
- Holstein Friesian cow
- Unknown age
- Female
- Non-cycling cow. Mass in the caudal abdomen.
Diagnosis?
Diagnosis:
Ovary: Granulosa cell tumour
Guinea pig
Unknown age
Female
Chronic abdominal pain. No response to treatment, euthanasia.
Diagnosis?
Diagnoses:
- Right ovary: Ovarian carcinoma with pulmonary metastases
- Bilateral severe ovarian cysts
Dog, Staffie
13 years
Female entire
Presented with lethargy and anorexia, vaginal discharge and tense abdomen. Owner elected euthanasia.
Diagnosis?
Diagnoses:
- Severe diffuse chronic endometritis with moderate cystic endometrial hyperplasia
- Moderate pyometra
Labrador
Female entire
8 years
Chronic history of anorexia and emaciation due to liver cirrhosis. Nodules were palpated in the mammary gland.
Diagnosis?
Diagnosis:
Mammary carcinoma
Greyhound
Female entire
11 years
Episodes of collapse and hind limb weakness. Large haemangiosarcoma in spleen. Also multiple mammary masses.
Histo attached from mammary mass
Diagnosis?
Diagnosis:
Mixed mammary tumour
Horse, Male intact, 2 years
History of cryptorchism. Abnormal finding during castration procedure.
Diagnosis?
Testicular teratoma
American Bulldog, Male entire, 7 years
No signs of disease. Abnormal finding during routine examination on a dog show.
Diagnosis?
Testicular seminoma
Sheep (ram), Abermax, Male entire, 18 months
Acute history of fever, anorexia and apathy. Sudden death.
Diagnosis?
Bilateral severe subacute suppurative-necrotizing epididymitis
Dog, German Shepherd, 7 years
Sudden death caused by small intestinal torsion. Incidental pathologic lesion seen in the male reproductive system.
Diagnosis?
Severe diffuse prostatic hyperplasia
Histology from male species
Diagnosis?
Testicular seminoma
Histology slide from male
Diagnosis?
Severe subacute suppurative-necrotizing epididymitis
Bovine, 5 year. Female (?)
External genitals appear abnormal and the animal behaves aggressive. Euthanasia.
Disorder of sex development (DSD)
(previous: intersex)
→ True hermaphrodite with presence of ovotestes and multiple associated developmental anomalies (freemartinism)
Dog, unknown breed, Suspected female, Unknown age
Abnormal ovaries were detected during routine spay.
Testicular hypoplasia
(From a dog with disorder of sexual development)
