2015 Descriptive Vet Path Course. Histo Exam #3 KEY

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1 2015 Descriptive Vet Path Course Histo Exam #3 KEY

2 Test 3, Slide 1 Tissue from a guinea pig. MORPHOLOGIC DIAGNOSIS: Heart: Multifocally and randomly (1 pt), within the left and right ventricular myocardium and the interventricular septum (1 pt), cardiomyocytes are hyalinized with loss of cross-striations, vacuolated (degenerate) (1 pt), and fragmented and or shrunken with pyknosis or karyorrhexis (necrosis) (1 pt), and necrotic myocardiocytes exhibit varying degrees (1 pt) of mineralization (1 pt) from a light basophilic dusting to replacement by crystalline mineral. Rarely, necrotic and mineralized myofibers are infiltrated by low to moderate numbers of macrophages (1 pt) which are occasionally multinucleated (1 pt). Multifocally, clusters of myocytes within the proximal interventricular septum are swollen up to 5 times normal size (1 pt) by abundant coalescing clear cytoplasmic vacuoles (1 pt) (glycogen) in which nuclei are central and eosinophilic bands of cytoplasm extend to cell borders (1 pt) (rhabdomyoma) (2 pt). MICROSCOPIC DIAGNOSIS: 1. Heart, myocardium: Degeneration and necrosis, multifocal, moderate, with dystrophic mineralization. (3 pt) 2. Heart: Rhabdomyoma, focal. (1 pt) CAUSE(S): Vitamin E deficiency (2 pt) O/C: (1 pt)

3 Test 3, Slide 2 Tissue from a dog. MICROSCOPIC DESCRIPTION: Small intestine (multiple sections): Villar epithelial cells are diffusely vacuolated and swollen (1pt.). Approximately 10% of villar lacteals are dilated (2pt.) up to 150um, and the lamina propria is multifocally edematous (1pt.). Lymphatics in the submucosa are widely dilated (2pt.), as well as those in the tunica muscularis, and contain abundant eosinophilic granular material (protein) and fibrin admixed with few erythrocytes, (1pt.) and multifocally within the submucosa, large foamy macrophages. The submucosa is infiltrated by aggregates of lymphocytes and fewer plasma cells. (1pt.) Vessels within the submucosa and muscularis are surrounded by low to moderate numbers of lymphocytes and plasma cells, and fewer histiocytes (1pt.) Lymphatics within the adventitia and occasionally in the muscularis are replaced by lipogranulomas (1pt.) composed of many lipid-laden macrophages (1pt.) (which occasionally occlude the lumen) (1pt.), admixed with fewer lymphocytes, plasma cells, and occasional foreign-body type multinucleated giant cells that surround amorphous pale eosinophilic to clear material, (1pt.) and are surrounded by lamellations of mature collagen and fibroblasts (1pt.). The serosa is multifocally expanded by extensive fibrosis. (1pt.). MORPHOLOGIC DIAGNOSIS: Small intestine: Lymphangiectasia, multifocal, moderate, with granulomatous lymphangitis. (4pt.) NAME A LIKELY BREED: Soft Coated Wheaten Terrier, Yorkshire Terrier, Norwegian Lundehund (1pt.)

4 Test 3, Slide 3 Tissue from a tamarin. MICROSCOPIC DESCRIPTION: Colon: Multifocally, approximately 15% of the mucosa is replaced (1 pt.) by an unencapsulated, poorly demarcated, infiltrative (1 pt.) neoplasm composed of polygonal epithelial cells (1 pt.) which efface the lamina propria and deeper glands. Neoplastic cells arranged in nests and poorly formed acini (1 pt.) on a fine fibrovascular matrix (1 pt.). Neoplastic cells have variable amounts of vacuolated eosinophilic cytoplasm (mucous) (1 pt.) which displaces the nucleus peripherally. Nuclei are irregularly round with finely stippled chromatin and 1-2 nucleoli (1 pt.). Mitotic figures are rare.(1 pt.) There is widespread single cell necrosis. (1 pt.) The mucosal surface is multifocally eroded (1 pt.) and there are moderate numbers of neutrophils (1 pt.) infiltrating the neoplasm. Neoplastic cells rarely extend through (1 pt.) muscularis mucosa into the underlying edematous submucosa, however, submucosal lymphatics are often dilated and filled with rafts of viable and necrotic neoplastic cells (1 pt.), often admixed with low numbers of neutrophils, lymphocytes, and cellular debris. Within the adjacent mucosa, glandular epithelium is often necrotic and sloughed into the lumen, and the lamina propria is expanded by increased numbers of lymphocytes and plasma cells with fewer neutrophils which separate colonic glands. (1 pt.). Vessels and lymphatics within the submucosa and multifocally in the superficial muscularis are surrounded by low to moderate numbers of lymphocytes (1 pt.), and there is multifocal crypt herniation into underlying lymphoid tissue. Remaining colonic glands often have aggregates of filamentous bacilli within their lumina. MORPHOLOGIC DIAGNOSIS: Colon: Colonic adenocarcinoma (3 pt.), with lymphatic invasion (1 pt.) O/C: (1pt)

5 Test 3, Slide 4 Tissue from a cat. MICROSCOPIC DESCRIPTION: Cerebrum (diencephalon at level of hippocampus): Expanding the hippocampus (1 pt), extending into the adjacent ependymal (1 pt), and effacing the neuropil there is a 1cm nodular well-demarcated area (1 pt) of pyogranulomatous (1 pt) inflammation which contains innumerable large numbers of neutrophils (1 pt), admixed with large numbers of macrophages (1 pt), lymphocytes, and plasma cells (1 pt) admixed with moderate amounts of cellular debris. Macrophages range from um and occasionally spindle, and rare foreign body macrophages are seen. There are multifocal areas of necrosis (1 pt) scattered throughout the inflammatory nodule. Randomly scattered through the inflammatory infiltrate are moderate numbers of 8-15um (1 pt) diameter yeasts (2 pt) with a 1cm thin hyaline wall, purple granular cytoplasm, occasionally starch granules, and occasional broad-based budding (1 pt). Yeasts are both extracellular as well as contained within macrophages. Within the inflammatory nodule, proliferating capillaries are lined by hypertrophic endothelium. Blood vessels within the adjacent neuropil are surrounded by low to moderate numbers of plasma cells with fewer lymphocytes and macrophages (1 pt), and astrocyte nuclei are hypertrophic and increased in number as are microglia (gliosis). (1 pt) MICROSCOPIC DIAGNOSIS: Cerebrum, hippocampus: Encephalitis, pyogranulomatous and necrotizing, focally extensive, severe, with numerous budding yeasts. (3 pt) CAUSE(S): Blastomyces dermatitidis (2 pt) O/C: (1 pt)

6 Test 3, Slide 5 Tissue from a mouse. MICROSCOPIC DESCRIPTION: Cross section of mandible (1 pt). Multifocally, the walls of arterioles (1 pt) within the skeletal muscle, periosteum and medullary cavity of the palatine bone (1 pt)are moderately to markedly thickened (1 pt). The demarcation between the tunica intima and media is often lost (1 pt), and the media is expanded (1 pt) by moderate amounts of a pink hyaline to homogenous protein (1 pt). Smooth muscle nuclei of the tunica media are contracted and pyknotic (1 pt), and small numbers of neutrophils are present within the arteriolar wall, where they are admixed with small amounts of cellular debris (1 pt) (fibrinoid necrosis) (2 pt). The adventitia is expanded by lamellated fibrous connective tissue (1 pt) and occasionally proliferating capillaries, and contains l moderate numbers of neutrophils, macrophages, lymphocytes (1 pt), and plasma cells. the interstitium of an adjacent seromucous salivary gland is expanded by low numbers of lymphocytes and plasma cells. MORPHOLOGIC DIAGNOSIS: Mandible and adjacent skeletal muscle: Arteritis, proliferative and necrotizing, chronic, multifocal, moderate. (3 pt) NAME THE CONDITION: Periarteritis nodosa (2 pt) O/C: (1 pt)

7 Test 3, Slide 6. Dog. Mediastinum. MICROSCOPIC DESCRIPTION: H&E: Mediastinum: Infiltrating (1 pt.) the mediastinal connective tissue is an unencapsulated, well demarcated, moderately cellular neoplasm (1 pt.) composed of polygonal (1 pt.) cells arranged in tubules, acini, and cords (1 pt.) on a densely collagenous stroma. Neoplastic cells have variably distinct borders, moderate eosinophilic, vacuolated cytoplasm (1 pt.), irregularly round to oval nuclei (1 pt.) with finely stippled chromatin, occasionally prominent nucleoli, and a few mitotic figures. Anisocytosis and anisokaryosis is marked (1 pt.). The neoplastic cells have lost polarity and are disorganized (1 pt.), and multifocally have cilia (inset) (2 pt.). TTF1: There is no internal control (1 pt.). Neoplastic cells demonstrate diffuse, strong positive nuclear immunoreactivity (1 pt.). Thyroglobulin: There is no internal control (1 pt.). Neoplastic cells are negative with no immunoreactivity (1 pt.). Calcitonin: There is no internal control (1 pt.). Neoplastic cells are negative with no immunoreactivity (1 pt.). MORPHOLOGIC DIAGNOSIS(ES): Pulmonary carcinoma. (3 pt.) O/C: (1 pt.)

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