Inflammation Laboratory 1

Transcription

1 Inflammation Laboratory 1 Lab1 Emphasis: The exudates of acute inflammation Descriptions Morphologic Diagnoses Shannon Martinson: VPM 152: February 2012

2 Describing Lesions tell me what s abnormal! This is simply stating what you see that is abnormal When you describe something - I should be able to make a morphologic diagnosis without ever seeing the sample! IMPORTANCE

3 Describing Lesions tell me what s abnormal! Distribution Spatial arrangement of the lesions : random, focal, multifocal, coalescing, diffuse, symmetrical, etc Contour and shape Raised, depressed, round, square, irregular Colour I m pretty sure you know what these are Size Texture / Consistency Size of the lesions, increases/decreases in organ size What does the surface look like and how does it feel (soft, firm, hard, friable, fluctuant, crepitous)

4 Creating a Morphologic Diagnosis for Inflammatory Lesions Organ and Process Exudate Distribution Duration Severity Generally speaking = Organ + itis Egs: Hepatitis, Pleuritis, Nephritis, Gastritis.. Serous, Fibrinous, Suppurative, Necrotizing, Hemorrhagic, Granulomatous Focal, multifocal, locally extensive, coalescing, diffuse Peracute, Acute, Subacute, Chronic, Chronic-active Mild, Moderate, Severe

5 Fibrinous VS Fibrous! They are different and represent two ends of a spectrum of change Acute inflammation Blood vessels become hyperemic and permeable FIBRIN leaks out Forms strands, sheets, loose adhesions Fibroblasts migrate out organization New blood vessels form granulation tissue Organizes into dense FIBROUS connective tissue (scar)

6 Fibrinous adhesions = ACUTE This is a serofibrinous exudate Delicate and friable strands of yellow material form loose adhesions between the parietal and visceral pleura Abundant clear yellow fluid fills the thorax Fibrin Serous fluid

7 Fibrous adhesions = CHRONIC This is scarring and it is always chronic Sheets of pale tan to white material form firm adhesions between the visceral and parietal pleura and the diaphragm Fibrous connective tissue

8 Acute Inflammation Exudates Suppurative exudate = pus (made of neutrophils) It s yellow-tinged, often smells bad, and can be watery, viscous, or crumbly

9 Acute Inflammation Exudates Hemorrhagic exudate = bloody Fibrinous exudate = friable tan-yellow material You can combine the 2: fibrinohemorrhagic

10 Acute Inflammation Exudates Mucoid exudate = gelatinous clear exudate This is typical in mild forms of inflammation

11 Acute Inflammation Exudates Necrotizing - not an exudate per say Fibrinonecrotizing

12 Erosive - not an exudate per say Acute Inflammation Exudates

13 Acute Inflammation Example Adult, MC, Lab Limping, swelling and pain affecting the right front leg Skin turned black and ulcerated Swelling became marked and the dog became systemically ill

14 Inflammation Example Description? Upon incision and reflection of the skin, abundant viscous yellow opaque fluid exudes from the subcutis and connective tissues of the right front limb

15 Inflammation Example Morphologic Diagnosis? Cellulitis, suppurative, locally extensive, acute, severe Additional Info: Disease name = Necrotizing fasciitis Etiology: Streptococcus sp (Lancefield G)

16 Inflammation Case 1 Liver from a calf History of an umbilical abscess and swollen joints

17 Inflammation Case 1 Description? Sheets and tags of friable tan material are loosely adhered to the hepatic capsular surface covering a large portion of the diaphragmatic surface

18 Inflammation Case 1 Morphologic Diagnosis? Hepatitis, fibrinous, locally extensive, acute, severe Technically speaking this is peri-hepatitis, a form of peritonitis, because the liver itself is not inflamed common finding in sepsis!

19 Inflammation Case 2 Heart from a calf History of an umbilical abscess and swollen joints

20 Inflammation Case 2 Description? Sheets and tags of friable tan material are loosely (to firmly) adhered to the entire epicardial surface

21 Inflammation Case 2 Morphologic Diagnosis? Pericarditis (epicarditis), fibrinous, diffuse, (sub)acute, severe

22 Inflammation Case 3 Limb (joint) from a lamb The syringe contains material collected from the joint

23 Inflammation Case 3 Description? The stifle joint is distended containing friable tan-yellow material and viscous yellow fluid (in the syringe). Similar material dissects the surrounding soft tissues. Fibrosis expands the joint capsule and surrounds the exudate

24 Inflammation Case 3 Morphologic Diagnosis? Arthritis and periarthritis, fibrinosuppurative, diffuse (stifle), chronic, severe

25 Abomasum from a calf Inflammation Case 4

26 Inflammation Case 4 Description? Scattered multifocally within the abomasal mucosa are round to irregular, slightly depressed areas of pale discolouration and mucosal roughening (erosions/ulcers) with a surrounding thin dark rim (hemorrhage).

27 Inflammation Case 4 Morphologic Diagnosis? Abomasitis, erosive/ulcerative, multifocal to coalescing, acute, severe

28 Inflammation Case 5 Liver and umbilicus from a calf The syringe contains material collected from umbilical vein

29 Inflammation Case 5 Description? Near the umbilicus, the umbilical vein is markedly distended and contains yellow tinged viscous opaque fluid The wall of the umbilical vein is thickened

30 Inflammation Case 5 Morphologic Diagnosis? Omphalophlebitis, suppurative, segmental, acute /subacute severe

31 Small intestine from a snake Inflammation Case 6

32 Inflammation Case 6 Description? Throughout the length of this segment of SI, there is thickening of the wall, roughening of the serosal surface and replacement of the mucosa by an adherent layer of friable tan material. When removed, this leaves a raw ulcerated mucosa. Deeper in the wall, hemorrhage and edema are present.

33 Inflammation Case 6 Morphologic Diagnosis? Enteritis, fibrinonecrotizing, segmental, acute, severe

34 Stomach from an adult cat Inflammation Case 7

35 Inflammation Case 7 Description? In the body of the stomach, near the pylorus, the mucosal surface is locally bright red with a roughened granular appearance. The affected area measures ~ 4 x 4 cm.

36 Inflammation Case 7 Morphologic Diagnosis? Gastritis, hemorrhagic, locally extensive, acute severe

37 Uterus from a dog Inflammation Case 8

38 Inflammation Case 8 Description? The walls of the uterine horns are diffusely thickened and the lumen is distended containing viscous yellow tinged opaque fluid.

39 Inflammation Case 8 Morphologic Diagnosis? Pyometra, (Suppurative endometritis), diffuse, acute, severe

40 Lungs from a cow Inflammation Case 9

41 Inflammation Case 9 Description? Covering the lungs, especially the cranioventral lung fields, is a thin layer of friable yellow material The underlying lung is dark red to green-tinged, firm and consolidated

42 Inflammation Case 9 Description? On cut section the lung lobules are pale and dry and the interlobular septa are mildly expanded by pale yellow-tan material

43 Inflammation Case 9 Morphologic Diagnosis? Pleuritis, fibrinous, locally extensive, acute, severe Necrotizing bronchopneumonia, locally extensive, acute, severe

44 Questions?