Lab Session - Hematopoietic System Flashcards
Case 1
* Fifi is a 7-year-old cat presented to you. Owner said that the
patient has been losing weight for 3 months. Fifi has recent
history of vomiting.
1. What do you want to ask the owner?
2. What diagnostics do you want to do?
- When did the vomiting start?
What did the cat vomit up? Food, bile
Changes in diet recently?
Is it an indoor/outdoor cat? - CBC with electrolyte panel, full body X-ray (foreign body, masses), chemistry panel (kidney and liver disease), fecal (parasites, eggs), painful abd, lymph node enlargement
- The findings on X-ray is unremarkable. You did an ultrasound
examination of the small intestine and found that the small
intestinal loops are thickened, and the mesenteric lymph nodes
are enlarged.
1. What are your differential diagnosis?
2. What diagnostics can you use to rule in/out your differential
diagnosis?
- Lymphoma (small intestinal lymphoma), IBD, parasitic infection, bacterial infection, food allergy –> Chronic inflammatory enteritis.
- Biopsy/scope. Take samples from duodenum, jejunum, colon, etc. Even though we believe disease is in SI, want to take samples from multiple sites.
The biopsy report came back. Morphologic
diagnosis: Chronic lymphoplasmacytic
enteritis with atypical lymphocytes. The
pathologist suggested you performing IHC
and PARR to rule out lymphoma.
1. How would you explain to the owner the
purpose of doing IHC and PARR in this case?
For lymphoma, looking to see if lymphocytes? are invading submucosa and therefore confirms diagnosis. Also look for lymphocytes infiltrating enterocytes (epithelial tropism).
IHC = marker used to detect
PARR = neoplastic vs. inflammatory
T lymphodcytes
CD 20 = B cell
- PARR result: Clonal for T-cell receptor
1. What does the result mean?
2. What is your diagnosis?
- T cell, small intestinal/small cell (evaluate cell size - small, intermediate, enlarged) lymphoma
Case 2
Sugar is a 2-month-old, intact male, Standardbred colt who
presented to you for difficulty breathing and colic. The patient became agonal and was euthanized, so you performed an autopsy
During autopsy, there are some lesions on large intestinal tract.
Describe your findings.
Hemorrhagic/dark red nodules. Multifocal to coalescing on serosal surface of the cecum.
2-3 cm in diameter; soft, firm, hard.
Process here:
1. Neoplasia
2. Inflammation (top differential when you see nodules like this with fibrous tissue on top)
3. Granulomas
Multifocal to focally coalescing tan nodules that are 1-3 cm in diameter.
- Inflammatory –> could be granuloma
cranial portion is Consolidated –> bronchopneumonia –> animal inhaled bacteria
- R. equi = coccobacilli
- Respiratory and inflammatory form - Salmonella = rods
- Enteritis is commonly seen; More intestine than lymph node
3.
Differential diganosis?
Degenerative neutrophils
Bottom left = MQ with cocci
Top left =
Process here is suppurative because majority of cells are neutrophils. If majority MQ = pyogranulomatous
Streptococcus equi (equine strangles). b/c they are dulploid
Gram stain, culture (no sensitivity b/c animal is dead), PCR
After autopsy, you performed histopathologic examination of
these tissues, and found pyogranulomatous inflammation in
multiple organs. Based on the clinical presentation and
pathologic findings, what are your differential diagnoses?
Spleen appears mottled and enlarged.
Get diagnosis from lecture
Get diagnosis from lecture
Thymic lymphoma/thymoma
Cause FeLv associated lymphoma
Splenic Hemangiosarcoma (hemangiosarcoma = usually dark red).
Splenic Hemangioma
Splenic Hematoma
Nodular hyperplasia
Nodular - White tan appearance
Meaty consistency
Multi-centric lymphoma (lymphoma are usually white tan nodules)
Granuloma
abscess
Lymphoid nodular hyperplasia
Bloody consistency
White strands = trabeculae (collagan make up). Architecture preserved.
Splenomegaly
Morpho Dx: splenomegaly diffuse RBC congestion.
Cause: GDV, Pulmonary hypertension, heart failure, euthanasia solution (top)
Ciderotic plaque = brown crusted/rusted appearance
Periphery of spleen
Significance? Common in older/senile dogs. Incidental finding. Very benign, nothing to worry about it
Chronic infarct
whitish in color = chronic, not acute. Also on periphery
Splenic infarct in pig: Swine fever OR ASF = similar gross appearance that we can not tell apart
Diffuse splenomegaly with blood consistency/congestion.
Etiology = ASF.
Spleen is segmented; meaty in consistency
From torsion? But most likely from trauma = HBC, After animal is stabilized and then heals –> spleen looks like this
White fibers= FCT = sign of healing.
Spleen is also adhered to mesentery or omentum = common during healing
GDV
Diffuse splenomegaly with bloody consistency and congestion
Gastric dilitation
Large breed and deep chested dogs
Lymph nodes, specifically ?
White = suppurative
Strangles = cause S. equi
Caseous lymphadenitis
nodular with yellow material
Etiology = Mycobactreium bovis
Granulomatous lymphadenitis
Etiology = Mycobacterium ___
Johnne’s Disease
Caseous lymphadenitis
Etiology = Corynebacterium pseudotuberculosis
Lymphadenomegaly
Porceine circovirus 2
Abnormal pigmentation
Melanoma
melanoma in grey horses is common
Can be metastatic or benign, but usually metastatic.
Diffusely jaundice,
Dark liver
Splenomegaly
IMHA = RBC destruction causes icterus and
