Respiratory Labs Flashcards
History: Tissue from a 5 week old Charolais calf that presented for a 3 day history of respiratory distress. She had a respiratory rate around 100 bpm, her neck was extended, had white foam coming from her mouth. Describe the lesion.
Lung: The cranioventral aspects of approximately 80-85% of the left lung are very firm (consolidated), extensively red to tan in color (hyperemia) and have multifocal regions that are black in color (hemorrhage). The interlobular septa are mild to moderately expanded by a cloudy, cream to tan colored material (exudate).
History: Tissue from a 5 week old Charolais calf that presented for a 3 day history of respiratory distress. She had a respiratory rate around 100 bpm, her neck was extended, had white foam coming from her mouth. Provide an appropriate morphologic diagnosis.
Lung: Acute, locally extensive, anteroventral hemorrhagic bronchopneumonia
History: Tissue from a 5 week old Charolais calf that presented for a 3 day history of respiratory distress. She had a respiratory rate around 100 bpm, her neck was extended, had white foam coming from her mouth. Outline the classic gross features of this type of pneumonia.
Texture - very firm
Location - anteroventral distribution
Other features: lung may sink in formalin, express an exudate from airways when sectioning a portion of consolidated lung, may observe a free, coughed-up exudate in trachea
History: Tissue from a 5 week old Charolais calf that presented for a 3 day history of respiratory distress. She had a respiratory rate around 100 bpm, her neck was extended, had white foam coming from her mouth. Describe risk factors that have the potential to contribute to the development of this type of pneumonia in a feedlot bovine.
Stress (weaning, shipping, feed change, castration)
Dust / ammonia (decreases mucociliary clearance)
Exposure to new pathogens (mixing)
Viral infection (following exposure to new pathogens)
History: This is tissue from a steer with dyspnea and a “red nose” Describe this lesion.
Diffuse to multifocally, there is a layer of tan friable material (fibrin) adherent to the mucosal surface of the trachea. When this material is removed, the underlying submucosa is dark grey-black in color (which would be bright red in a recently dead, non-fixed specimen). These changes also involve the larynx.
History: This is tissue from a steer with dyspnea and a “red nose”
Give a morphologic diagnosis.
Trachea and larynx: Acute, diffuse, fibrinous (or fibrinonecrotic) laryngotracheitis
History: This is tissue from a steer with dyspnea and a “red nose”
What is the most likely causative agent?
The most likely agent is IBR (infectious bovine rhinotracheitis) which is also known as bovine herpesvirus 1 (BHV-1).
History: This is tissue from a steer with dyspnea and a “red nose” During the necropsy you also identify a bronchopneumonia.
How might the observed lesions have predisposed the animal to develop a bronchopneumonia?
Pneumonia is either caused by direct aspiration of the exudates from the trachea or as a result of impairment of the pulmonary defense mechanisms
History: Tissue from a 14 year old female spayed domestic long hair cat with a 2-3 week history of nasal discharge and an apparent upper respiratory infection that developed a seizure last evening
Describe the lesion.
Nearly the entire nasal cavity is extensively effaced and replaced by a tan, firm, relatively homogeneous, cream-colored mass, approximately 5x7 cm that tapers rostrally. The mass appears to have infiltrated through the cribiforme plate, which is cram-colored a softer than the adjacent bone of the cranial vault.
History: Tissue from a 14 year old female spayed domestic long hair cat with a 2-3 week history of nasal discharge and an apparent upper respiratory infection that developed a seizure last evening
Provide an appropriate morphologic diagnosis.
Nasal cavity: Chronic, locally invasive nasal mass
History: Tissue from a 14 year old female spayed domestic long hair cat with a 2-3 week history of nasal discharge and an apparent upper respiratory infection that developed a seizure last evening
What is your most likely diagnosis and how might you confirm this in practice in your clinic?
Mass is solid and homogeneous, so likely a neoplasm, most likely a nasal lymphoma, which is the most common nasal tumor in cats.
Could do an impression smear to differentiate lymphoma from carcinoma from sarcoma from inflammation
History: Tissue from a 14 year old female spayed domestic long hair cat with a 2-3 week history of nasal discharge and an apparent upper respiratory infection that developed a seizure last evening
What is the expected biologic behavior for your most likely diagnosis?
Slow growing, locally invasive, but limited metastatic potential. About 20% of cats with nasal lymphoma have or develop lymphoma elsewhere in the body.
History: Tissue from a 14 year old female spayed domestic long hair cat with a 2-3 week history of nasal discharge and an apparent upper respiratory infection that developed a seizure last evening This animal was reported to have had a seizure.
Describe two ways in which this lesion could potentially cause seizures.
Possible mechanisms that would produce neurologic signs include: 1) neoplastic infiltration into brain, or 2) bacterial meningitis (disruption of cribiforme plate by tumor leading to bacteria from non-sterile nasal cavity enter cranial vault leading to meningitis). In this case, option 2 was more likely.
History: Tissue from a 10 week old pigs with respiratory distress. Describe this lesion.
Tan colored anteroventral consolidation involving approximately 40% of the right lung. There are moderate numbers of multifocal random firm white nodules varying in size from 2-6 mm in diameter scattered throughout all lung lobes. Nodules have a cream-color friable center surrounded by a firm, white (fibrous) capsule. Multifocally, patchy areas of the pleural surface are thickened by opaque, white material that cannot be readily removed by manual manipulation (pleural fibrosis). The caudal aspect of the right middle lung lobe is firmly adhered to the cranial aspect of the right caudal lung lobe by firm adhesions that cannot be readily separated (fibrous pleural adhesions).
History: Tissue from a 10 week old pigs with respiratory distress.
Provide an appropriate morphologic diagnosis.
Lung: Chronic, locally extensive, anteroventral bronchopneumonia with multifocal abscesses, pleural fibrosis and fibrous pleural adhesions.
History: Tissue from a 10 week old pigs with respiratory distress. These animals have a bronchopneumonia.
What other type of pneumonia is present and what type of pre-existing condition(s) may have contributed to the development of this type of pneumonia?
These pigs also have an embolic pneumonia. Embolic pneumonia is preceded by bacterial infection and suppuration at another location. Common sources:
- liver abscesses,
- navel infection,
- contaminated catheters
- vegetative valvular endocarditis
History: Tissue from a 10 week old pigs with respiratory distress.
Are these pneumonias acute or chronic and why?
The bronchopneumonia is chronic: tan instead of red (hyperemia). Abscesses have a fibrous capsule and are chronic. There is pleural fibrosis and fibrous pleural adhesions = chronic
History: Tissues from a 5 day old Boer goat kid named Liza which had failed to gain weight and then developed respiratory distress.
Describe the lesions.
There is a diffuse longitudinal cleft in the palate approximately 2cm in width allowing communication between the oral and nasal cavities. Approximately 40% of the left anteroventral lung is very firm and there is a band of redness (hyperemia) between normal and consolidated lung.
History: Tissues from a 5 day old Boer goat kid named Liza which had failed to gain weight and then developed respiratory distress.
Provide appropriate morphologic diagnoses.
Head: Diffuse, chronic palatoschisis (cleft palate)
Lung: Acute locally extensive anteroventral bronchopneumonia (aspiration pneumonia)
History: Tissues from a 5 day old Boer goat kid named Liza which had failed to gain weight and then developed respiratory distress. In this case, the lesion involving the palate was helpful in determining the likely type of pneumonia.
In general, what additional gross changes might we see to help confirm this type of pneumonia?
Might observe milk in the trachea or large airways. In an older animals you might observed plant material / rumen contents in airways.
History: Tissues from a 5 day old Boer goat kid named Liza which had failed to gain weight and then developed respiratory distress.
What histologic changes might help to confirm this type of pneumonia?
Foreign material in lung (airways):
Examples: plant material, cooked meat protein, milk
± Necrotizing bronchiolitis: aspirated material may be caustic (gastric acid)
History: Tissue from a 14 week old pig with a history of chronic cough and thumping
Describe the lesions.
Approximately 25 of the right anteroventral lung is tan colored and firm. The entirety of the remaining lung is tan-red mottled, rubbery and noncollapsing.
History: Tissue from a 14 week old pig with a history of chronic cough and thumping
Provide an appropriate morphologic diagnosis.
Lung:
- Chronic diffuse interstitial pneumonia.
- Chronic locally extensive anteroventral bronchopneumonia
History: Tissue from a 14 week old pig with a history of chronic cough and thumping This pig had two types of pneumonia. There are a number of mechanisms that can lead to the development of the diffuse lung lesion.
Propose a pathogenesis for the development of the diffuse lung lesion.
Septicemia, especially Gram negative bacteria (ex: Salmonella cholerasuis) → Diffuse injury to alveolar capillary endothelium by endotoxin → Activation of Pulmonary Intravascular MØs → Increased vascular permeability → fibrinosuppurative exudate accumulates in alveolar walls
Agent disseminated via bloodstream to the alveolar wall or alveolar macrophages (e.g. PRRSV) → Macrophages release cytokines which recruit additional inflammatory cells into the alveolar wall and adjacent interstitium
History: Tissue from a 14 week old pig with a history of chronic cough and thumping In our descriptions, we have been describing the severity of today’s pneumonias.
What is a good way to describe the overall severity of lung lesions?
Describe the percentage of each lung involved.
History: Tissue from a 14 week old pig with a history of chronic cough and thumping
Briefly outline the classic gross pattern (distribution) of bronchopneumonia, interstitial pneumonia, embolic pneumonia
Bronchopneumonia and aspiration pneumonia: anterioventral distribution.
Interstitial Pneumonia: diffuse
Embolic pneumonia: multifocal and random lesions throughout all lung lobes
History: Tissue from a 1 month old calf – acute respiratory distress Describe pertinent features.
The caudodorsal lung is uniformly light pink in color, very light weight (like a marshmallow), will retain your figure impression and is slowly collapsing outside the negative pressure of the chest.
Approximately 15% of the cranioventral lung is darker red in color and more firm.
The trachea contains a small to moderate amount of white froth in the tracheal lumen admixed with a small amount of green colored foreign material.
History: Tissue from a 1 month old calf – acute respiratory distress Provide a morphological diagnosis.
Antoventral lung – acute cranioventral aspiration pneumonia (cranioventral consolidation with foreign material in the trachea)
History: Tissue from a grow/finish pig from a production facility undergoing an outbreak of respiratory disease with approximately 12-15% of pigs effected.
Describe the lesion.
The lung is multifocally very firm (consolidated) and dark red to black (hemorrhage) in color. Approximately 30% of the total lung volume affected, including the dorsal portion of the caudal lung lobe in the region of the hilus. The capsular and cut surfaces were mottled dark red-to-black and tan and the interlobular septa were expanded. Diffusely on the visceral pleural surface, there were tags of tan, loosely adherent, friable (fibrinous) material. In cross section, there are irregular pale friable regions (necrosis) varying in size from 3-10mm.
History: Tissue from a grow/finish pig from a production facility undergoing an outbreak of respiratory disease with approximately 12-15% of pigs effected.
Give a morphologic diagnosis.
Acute multifocal fibrinous and necrohemorrhagic pleuropneumonia or severe acute multifocal necrohemorrhagic bronchopneumonia and acute fibrinous pleuritis
History: Tissue from a grow/finish pig from a production facility undergoing an outbreak of respiratory disease with approximately 12-15% of pigs effected.
What is the most likely cause of disease in this population of pigs and what is your next most likely differential?
Actinobacillus pleuropneumonia (APP) or Actinobacillus suis