HEMATOPOETIC LAB Heather Fenton/S. Martinson VPM 222 March, 2013
Diffuse Splenomegaly: Bloody vs Meaty Photos: Pathologic basis of veterinary disease Bloody Spleen: Swollen margins Dark red Oozes blood on cut surface Congestion Meaty Spleen: Swollen margins Often dark red Bulge on cut surface (rubbery) Cellular infiltrates
Diffuse Splenomegaly Diffuse splenomegaly with a bloody consistency = Bloody Spleens Septicemia Anthrax, Salmonella Acute hemolytic anemia Splenic torsion Barbiturate euthanasia* Diffuse splenomegaly with a firm consistency = Meaty Spleens Septicemia Salmonella Hemolytic disease Lymphoma Mast cell neoplasia Histiocytic sarcoma Granulomatous disease Histoplasmosis Amyloidosis
Splenomegaly Bloody Spleen Diffuse splenomegaly with a bloody consistency = Bloody Spleens Septicemia Anthrax, Salmonella Acute hemolytic anemia Bloody spleens are enlarged due to congestion/hyperemia Normal spleen Splenic torsion Barbiturate euthanasia* Swollen margins Dark red Oozes blood on cut surface Fragile capsule Congested spleen Photo: source unknown
Splenomegaly Meaty Spleen Diffuse splenomegaly with a firm consistency = Meaty Spleens Septicemia Salmonella Meaty spleens are enlarged due to cellular infiltrates Hemolytic disease Lymphoma Mast cell neoplasia Histiocytic sarcoma Granulomatous disease Histoplasmosis Amyloidosis Swollen margins Firm to rubbery texture Bulges on cut surface
Diffuse Splenomegaly: Bloody vs Meaty Bloody or Meaty?
Diffuse Splenomegaly: Bloody vs Meaty Bloody or Meaty? Meaty the spleen bulges on cut section with no oozing of blood. This dog had lymphoma with diffuse infiltration of the spleen.
Diffuse Splenomegaly: Bloody vs Meaty Normal dog spleen Spleen from a dog with gastric torsion Bloody or Meaty? Photo: source unknown
Diffuse Splenomegaly: Bloody vs Meaty Normal dog spleen Spleen from a dog with gastric torsion Photo: source unknown Bloody oozing blood. Spleen often twists along with the stomach leading to splenic congestion
Red nodular masses within the spleen Splenic nodules Hematoma Hemangioma Hemangiosarcoma Splenic infarcts Incompletely contracted areas of the spleen Nodular hyperplasia (not always red) Grossly can look very similar, therefore histology is necessary!
SPLENIC NODULES WITH A FIRM CONSISTENCY Nodular hyperplasia Primary neoplasia Metastatic neoplasia Abscess Granuloma
SPLENIC NODULES WITH A BLOODY/SOFT CONSISTENCY Hematoma Hemangoima Hemangiosarcoma Acute splenic infarct Incomplete contraction
Red nodular masses within the spleen Splenic hematoma often very large Hemangiosarcoma single to multiple masses Infarcts often triangular or wedge shaped Nodular hyperplasia variegated appearance on cut surface
Mink Description: Spleen B is diffusely, markedly enlarged B A Morph: Marked splenomegaly S. Martinson
DIFFERENTIALS FOR SPLENOMEGALY IN A MINK Aleutian mink disease virus(parvovirus) Congestion (e.g. euthanasia with barbiturates) Round cell neoplasia (lymphoma and mastocytosis are common in ferrets) Extramedullary hematopoesis
3 YEAR OLD, MALE CASTRATED LABRADOR RETRIEVER Describe the changes: What are some differentials?
3 YEAR OLD, MALE CASTRATED LABRADOR RETRIEVER Describe the changes: The spleen is diffusely enlarged, meaty and mottled tan. The dorsal surface appears to be covered in irregular siderotic plaques.
3 YEAR OLD, MALE CASTRATED LABRADOR RETRIEVER Differentials: - Siderotic plaques (Gamna gandy bodies) incidental finding - Splenomegaly with a meaty spleen: - Round cell neoplasia (lymphoma, mastocytosis, histiocytic sarcoma) - Nodular hyperplasia - Infection - Hemolytic Disease - Amyloidosis This dog had a leukemia of unknown origin
Layer Hen
Describe the changes Give a morphologic diagnosis What is a potential etiology?
Description: The spleen is markedly irregularly enlarged with multifocal to coalescing raised pale nodules of varying diameter Acid fast bacilli within foamy macrophages Morphologic diagnosis: Multifocal to coalescing granulomatous splenitis and marked splenomegaly Etiology: Mycobacterium avium. Differential: Avian sarcoma/leukosis viral induced sarcoma
Multifocal granulomas in the bone marrow
12 YEAR OLD, GERMAN SHEPHERD Describe the change and give three differentials
12 YEAR OLD, GERMAN SHEPHERD Description: There is a large (6-7cm in diameter), round, dark red soft mass that is bloody and soft on cross section protruding from the capsular surface of the spleen. Where else should you look? Differentials: Hemangiosarcoma Hemangioma Hematoma
RIGHT AURICLE (COMMON LOCATION FOR HEMANGIOSARCOMA)
ADULT HUSKY, WAS KICKED BY A REINDEER Describe the changes Cornell Veterinary Medicine
Description: There is a large, well circumscribed, 3cm, bloody, red mass that protrudes from the capsular surface STILL NEED HISTOLOGY TO RULE OUT HEMANGIOSARCOMA! MX: SPLENIC HEMATOMA Cornell Veterinary Medicine
PIG Description: What do you think caused this Cornell Veterinary Medicine
Description: The spleen is markedly enlarged and dark red with disruption of the capsular surface and gathered apical edges. PIG This is a splenic torsion Cornell Veterinary Medicine
BOVINE Describe the changes: What should be going through your mind? Cornell Veterinary Medicine
BOVINE Describe the changes: The spleen is markedly enlarged and bloody on cross section. What should be going through your mind? - Why did I open this carcass without taking a bloodsmear first? - Phone CFIA Cornell Veterinary Medicine
Bacillus anthracis New Methylene Blue stain Cornell Veterinary Medicine
BERNESE MOUNTAIN DOG Description: www.histiocytosis.ucdavis.edu/images/full_images/hs-spleen.jpg Differentials:
BERNESE MOUNTAIN DOG Description: Multifocal to coalescing raise, tan nodules ranging in size from 1-2cm randomly distributed throughout the spleen Differentials: -Malignant neoplasia (e.g. histiocytic sarcoma) --granulomas -Multifocal abcesses www.histiocytosis.ucdavis.edu/images/full_images/hs-spleen.jpg
HORSE Cornell Veterinary Medicine
HORSE Description: A raised, firm, well-demarcated nodule approximately 1.5 cm in greatest diameter extends from the capsular surface of the spleen Differentials: - Nodular hyperplasia - Benign neoplasm - Hematoma Cornell Veterinary Medicine
INCOMPLETE SPLENIC CONTRACTION Cornell Veterinary Medicine
CAT Description: Differentials: Cornell Veterinary Medicine
CAT Description: The spleen is diffusely, markedly enlarged with a meaty texture Differentials: - Round cell neoplasia (mastocytosis, lymphosarcoma/leukemia) Cornell Veterinary Medicine
Description: The lymph node on the left is diffusely enlarged Morphologic diagnosis: Marked lymphadenomegaly and congestion
Most likely diagnosis: Cornell Veterinary Medicine
Most likely diagnosis: Jowl abscess Mx: Locally extensive, severe, subacute suppurative lymphadenitis Cornell Veterinary Medicine
Description: Morphologic Diagnosis Etiology
Description: The lymph node is expanded by multiple large nodules composed of concentric layers of friable tissue Morphologic Diagnosis: Severe, multifocal, chronic casseous lymphadenitis Etiology: Corynebacterium pseudotuberculosis
BISON, FOUND DEAD Morphologic Diagnosis: What is the significance?
BISON, FOUND DEAD Morphologic Diagnosis: Femur: Serous atrophy of fat What is the significance? This lesion is consistent with emaciation
DOG Describe the changes Give Differentials Cornell Veterinary Medicine
Description: A large (7 x 3 x 5cm), well circumscribed, firm, multilobulated tan mediastinal mass What else might you look for? Differentials: -Thymoma -Thymic lymphosarcoma -Mesothelioma Cornell Veterinary Medicine
Paraneoplastic syndrome of thymoma is myaesthenia gravis (autoimmune attack of Ach receptors) resulting in megaesophagus Cornell Veterinary Medicine
Pig Describe the changes Give a morphologic diagnosis Potential Etiologies
Description: The tonsils are bilaterally ulcerated and covered with fibrin. Morphologic diagnosis: Bilateral, severe, subacute, fibrinonecrotizing tonsillitis Potential Etiologies: African Swine Fever, Classical Swine Fever, Fusobacterium necrophorum
QUESTIONS?