Pathology of the Respiratory System 5: Lung and Thoracic Cavity

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Pathology of the Respiratory System 5: Lung and Thoracic Cavity Shannon Martinson, Jan 2017 http://people.upei.ca/smartinson/ VPM 222 Systemic Pathology

DISORDERS OF THE LUNG Congenital Pigmentary deposition Circulatory Disturbances Inflation disturbances Pneumonia Neoplasia

LUNG PNEUMONIA Examples of Diseases that Cause Granulomatous Pneumonia in Domestic Animals Granulomas / Nodular texture

LUNG GRANULOMATOUS PNEUMONIA HORSE Rhodococcosis Etiology: Rhodococcus equi Respiratory Intestinal Bacteriologic culture

LUNG GRANULOMATOUS PNEUMONIA CAT/DOGS Systemic mycoses Histoplasmosis Blastomyces dermatitides Cryptococcus neoformans / gatti Histoplasma capsulatum Coccidiodes immitis Blastomycosis

LUNG GRANULOMATOUS PNEUMONIA CAT/DOGS Feline Infectious Peritonitis (FIP) Etiology: Mutated Feline enteric coronavirus

LUNG TUMOURS 1 lung tumours are relatively uncommon 2 tumours (metastases) in the lung are common Epithelial Round cell Mesenchymal Carcinoma > Adenoma

LUNG TUMOURS Diagnosis FNA Biopsy

LUNG TUMOURS Pulmonary Carcinoma (primary) Clinical signs: Weight loss Lethargy Dyspnea (effusion) Tachypnea Non productive cough Hemoptysis Wheezing Biopsy

LUNG TUMOURS Pulmonary Carcinoma (primary) In cats pulmonary carcinoma commonly metastasize to the digits* Biopsy

LUNG TUMOURS Ovine Pulmonary Adenocarcinoma (Pulmonary Adenomatosis) (Jaagsietke) Etiology: Jaagsietke sheep retrovirus (JRSV) Transmissible retrovirus induced neoplasia of sheep Clinical signs: Weight loss, coughing, respiratory distress Nasal discharge Copious when tilted ** Dr. Marcelo de las Heras, Zaragoza

LUNG TUMOURS Ovine Pulmonary Adenocarcinoma (Pulmonary Adenomatosis) (Jaagsietke) Etiology: Jaagsietke sheep retrovirus (JRSV) May look like bronchopneumonia grossly Need histology Histology papillary growths of epithelial cells Dr. Marcelo de las Heras, Zaragoza

LUNG TUMOURS Lung Metastases Mammary carcinoma UNAM

LUNG TUMOURS Lung Metastases Dark masses in the lung 2 main differentials Hemangiosarcoma UNAM-FMZ PATOLOGIA Melanoma

LUNG TUMOURS Lung Metastases Dark masses in the lung 2 main differentials Hemangiosarcoma

THE THORACIC CAVITY Pneumothorax Pleural effusions Neoplasia

THORACIC CAVITY

THORACIC CAVITY

Pneumothorax = Air in the thoracic cavity Lesion atelectasis

Pneumothorax Etiology Punctured lung (rib fracture) Penetrating wound Ruptured emphysematous bullae Ruptured esophagus Idiopathic

Pneumothorax Pneumomediastinum

Pleural Effusions Transudate Lymph Blood Exudate

Pleural Effusions Handbook of Veterinary Cytology, Rebar AH. Purina Thoracocentesis Transudate Hydrothorax Clear fluid, low cellularity and low protein Lymph Chylothorax Milky fluid, lymphocytes and lipid Blood Hemothorax RBCs and protein Exudate Pleuritis Turbid fluid, high cellularity and high protein

Pleural Effusions Transudate Hydrothorax Clear fluid, low cellularity and low protein quizlet.com Lesions: Clear, straw coloured fluid in thorax +/- Atelectasis +/- Pleural fibrosis Chronic pleural irritation

Pleural Effusions Transudate Hydrothorax Clear fluid, low cellularity and low protein Underlying Causes: Congestive heart Hypoproteinemia: failure Starvation Lymphatic obstruction Renal disease Intestinal disease Liver failure quizlet.com

Pleural Effusions Gunshot wound Blood Hemothorax RBCs and protein Birthing trauma Hit by car Lesion: Blood in the thorax Most common causes: Trauma Aneurysm Coagulopathy

Pleural Effusions Blood Hemothorax RBCs and protein Cytology Ruptured aortic aneurysm Lesion: Blood in the thorax Most common causes: Trauma Aneurysm Coagulopathy

Pleural Effusions Lymph Chylothorax Milky fluid, lymphocytes and lipid Lesions: Milky fluid in the thorax Often has fat droplets

Pleural Effusions Lymph Chylothorax Milky fluid, lymphocytes and lipid Underlying cause: Rupture/leaking from a major lymphatic vessel Trauma Iatrogenic (surgery) Neoplasia Idiopathic Increased pressure in the vena cava Heart failure

Pleural Effusions Lymph Chylothorax Milky fluid, lymphocytes and lipid Cytology Image: Dr C Gilroy Image: Dr C Gilroy Triglyceride analysis

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Alone or in combination with pneumonia According to exudate: Purulent (suppurative) = Pyothorax Fibrinous Granulomatous Lesions: Cloudy to opaque yellow tinged fluid/viscous exudate in the thorax Often smells bad

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Underlying cause: Penetrating trauma with implantation Rupture of the esophagus Rupture of a pulmonary abscess Hematogenous dissemination / Sepsis

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Cattle: Mannheimia hemolytica Histophilus somni Cats Pasteurella multocida

Pleural Effusions Dogs and Cats Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein tomato soup pyothorax

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Pigs

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Horses

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Videos Courtesy of Dr. Marco Lores, AVC VTH

Pleural Effusions Exudate Pyothorax/Pleuritis Cytology Turbid fluid, high cellularity and high protein

Pleural Effusions Exudate Pyothorax/Pleuritis Turbid fluid, high cellularity and high protein Chronic pleuritis typically results in extensive pleural adhesions

Mesothelioma Neoplasia Rare tumour of serosal membranes Malignant tumour Disseminates by implantation Asbestos in humans FMVZ-UNAM