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Vet - notes > Pathology of the liver and pacreas > Flashcards

Pathology of the liver and pacreas Flashcards

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1
Q

Portosystemic shunt

A

congenital or acquired

portal blood bypasses the liver

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2
Q

Portosystemic shunt - congenital

A

shunting into vena cava, azygos or renal vein

usually a single communication between the vessels

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3
Q

portosystemic shunt - acquired

A

shunts secondary to fibrosis in older animals

multiple thin-walled shunts

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4
Q

Congenital cysts

A

most are biliary

can be multiple

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5
Q

displacements

A

congenital or acquired

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6
Q

tension lipidosis

A

focal areas of subcapsular fatty change
may relate to local ischaemia
usually the tip where it touches the diaphram

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7
Q

capsular fibrosis

A

fibrous tags are common on the surface of the liver in older horses

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8
Q

telangiectasis

A

foci of sinusoidal dilatation

cats + cattle

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9
Q

Circulatory disorders - passive venous congestion - presentation

A

usually associated with right-sided heart failure acute or chronic

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10
Q

Circulatory disorders - passive venous congestion - gross pathology

A

liver enlarged with rounded borders and oozes blood on cut surface
enhanced lobular pattern (‘nutmeg liver’)

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11
Q

Circulatory disorders - passive venous congestion - microscopy

A

hepatic venules and sinusoids engorged
periacinar areas are congested with atrophy of hepatocytes (red colour)
periportal areas undergo fatty change (pale colour)

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12
Q

common pigments

A

melanin
haemosiderin
bile
liofuscin

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13
Q

vacuolar hepatopathies

A

degenerative
hydropic change is common, non-specific and reversible
glycogen accumulation (glycogenosis) occurs in
hyperadrenocorticalism
multifocal to diffuse swelling and vacuolation of hepatocytes
enlarged pale liver in severe cases

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14
Q

vacuolar hepatopathies - causes

A

hypoxia, mild toxic damage and metabolic stress

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15
Q

lipidosis - causes

A

dietary factors: obesity and starvation
incr energy demand
disease (e.g. diabetes mellitus, ketosis and pregnancy toxaemia)
abnormal hepatocyte function that prevents fatty acids
complexing with proteins to form low density lipoproteins

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16
Q

Abnormal deposits and accumulations - lysosomal storage diseases

A

inherited deficiencies of lysosomal enzymes – neuro disease
macrophages containing stored material accumulate at multiple sites (liver, lymph nodes, central nervous system)
diagnosed by liver biopsy or post mortem examination

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17
Q

Abnormal deposits and accumulations - amyloidosis

A

substance deposited under the endothelium + basement membranes of a variety of tissues - renal glomeruli, islets of Langerhans in the pancreas + liver
primary, secondary or endocrine-associated

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18
Q

amyloidosis - gross appearance

A

Liver pale, enlarged and friable – prone to rupture

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19
Q

amyloidosis - microscopic appearance

A

homogeneous acidophilic material that shows green birefringence when stained with Congo red

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20
Q

Necrosis of the liver - causes

A

ischaemia
toxic damage
nutritional deficiencies
microbial infection

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21
Q

necrosis - patterns

A

Random: e.g. EHV-1 or salmonellosis
Zonal: e.g. ischaemia or toxic damage
Massive: e.g. hepatosis dietetica

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22
Q

Fibrosis of the liver - Patterns of fibrosis

A

Periacinar fibrosis
Biliary fibrosis
Post-necrotic scarring
Cirrhosis

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23
Q

Periacinar fibrosis

A

fibrosis surrounds central vein

chronic passive congestion

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24
Q

Biliary fibrosis

A

accompanying inflammation

centred on the portal triads

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25
Post-necrotic scarring
following massive necrosis
26
cirrhosis
extensive fibrotic lesions end stage liver may be concurrent nodular regeneration
27
hepatitis - define
Inflammation of the liver parenchyma | ften caused by infection
28
cholangitis - define
Inflammation of the bile ducts | may be immune-mediated or associated with infection (e.g. salmonellosis in calves)
29
cholangiohepatitis - define
Inflammation of parenchyma and bile ducts
30
progression of hepatitis
``` necrosis, succeeded by inflammation If the animal survives then progression is: Complete resolution by regeneration Repair by fibrosis and scarring Encapsulation by abscessation Persistence by granulomatous disease ```
31
viral hepatitis
Adenoviruses Herpesviruses Coronaviruses generally occurs in young +/or unvaccinated
32
Infectious canine hepatitis
highly infectious disease of young dogs long-term shedding in urine tropism for endothelium (widespread haemorrhages, particularly on serosal surfaces) and hepatocytes lymph nodes and tonsils enlarged and reddened, sometimes haemorrhagic recovering animals may show an immune-mediated uveitis with corneal opacity
33
Herpesviruses cause which diseases
Equine Viral Rhinopneumonitis Infectious Bovine Rhinotracheitis Feline Viral Rhinopneumonitis Aujezsky's disease
34
herpesvirus infections
Liver lesions occur in aborted fetuses or neonates pinpoint foci of necrosis with intranuclear inclusion bodies Necrosis also occurs in lungs, kidneys, spleen and adrenal glands
35
Feline infectious peritonitis
Enteric coronavirus mutates to cause systemic vasculitis and effusions in cats Pyogranulomatous lesions in multiple organs including the liver ‘wet’ (effusive) or ‘dry’ (granulomatous) forms
36
Bacterial hepatitis - Routes of infection - direct extension
from disease in adjacent tissues
37
Bacterial hepatitis - Routes of infection - haematogenous
via the umbilical vein from infected umbilicus via the portal vein from the alimentary tract via the hepatic artery in bacteraemias and septicaemias
38
Bacterial hepatitis - Routes of infection - hepatic abscessation
is particularly common in cattle from umbilical infections - usually mixed bacteria from rumenitis caused by overfeeding with grain
39
Bacillary necrosis - caused by which bacteria
Fusobacterium necrophorum
40
Bacillary necrosis - aetiology
Umbilical infection in calves | Rumenitis in adult cattle
41
Bacillary necrosis - gross pathology
Multiple pale foci of necrosis throughout the liver | may develop into abscesses if the animal survives
42
Bacillary necrosis - microscopy
coagulative necrosis with bacteria at periphery
43
Infectious necrotic hepatitis
``` aka black disease Sheep (rarely horses or pigs) Migrating immature liver flukes often precipitate disease Animals found dead Post-mortem changes occur rapidly ```
44
Infectious necrotic hepatitis - caused by which bacteria
Clostridium novyi type B
45
Infectious necrotic hepatitis - pathology
extensive subcutaneous venous congestion ('Black disease’) and oedema fibrinous peritoneal, thoracic + pericardial fluid characteristic pale foci of necrosis (containing bacteria) surrounded by a rim of haemorrhage
46
Bacillary haemoglobinuria - caused by which bacteria
Clostridium haemolyticum
47
Bacillary haemoglobinuria
Cattle and sheep | closely related to C. novyi and the pathogenesis is similar to black disease
48
Bacillary haemoglobinuria - pathology
Severe anaemia, jaundice, haemoglobinuria | large necrotic focus in liver + haemoglobin staining of kidneys
49
tyzzers disease - caused by which bacteria
Clostridium piliforme | Bacillus piliformis
50
tyzzers disease
disease of laboratory rodents may affect foals + immunosuppressed dogs and cats initial intestinal lesions can be hard to find at post-mortem exam ‘wheat sheaf’’ appearance of colonies when stained with a silver stain
51
leptospirosis
zoonosis hepatic disease in dogs multiple serovars involved haemolytic anaemia, widespread haemorrhages and icterus hepatocyte dissociation (results in cholestasis) and haemosiderin accumulation (secondary to haemolysis)
52
salmonellosis - clinical features
fever, dehydration and diarrhoea
53
salmonellosis - gross pathology
severe, often haemorrhagic, inflammation in the ileum | pale foci of necrosis in the liver called ‘paratyphoid nodules
54
salmonellosis - microscopy
Foci of necrosis | Mixed mononuclear inflammatory cell infiltrate
55
parasites of the liver
usually incidental findings (excluding liver fluke) ascaris suum migration- 'milk spot' liver strongyle migration in the horse common to find fibrous tags incidentally on the surface of the liver and adjacent diaphragm remnants of fibrous repair following the egress of the parasites from the liver
56
toxic liver disease - acute intoxication
causes widespread haemorrhages in the body due to excessive consumption of the clotting factors in the damaged liver coupled with failure to produce these factors by the damaged liver Examples are blue-green algae, iron and cresols
57
toxic liver disease - chronic intoxication
continual ingestion of toxic compounds at low doses over a period of time there will be evidence of regeneration and repair of the damaged tissue i.e. fibrosis and biliary hyperplasia Examples are ragwort, aflatoxins and copper Certain drugs are also hepatotoxic
58
pathology of the gall bladder
Inflammation (cholecystitis) occurs in Salmonellosis and Infectious Canine Hepatitis Hyperplasia of the mucosa is a common reaction to any irritation of this area Gallstones (choleliths) may be found as an incidental finding
59
pathology of biliary tree - obstruction
occurs due to parasites, sometimes gall stones (choleliths) - rare compression of the ducts by nearby inflammatory and neoplastic processes - more common
60
pathology of biliary tree - rupture of bile duct
serious as omentum is incapable of sealing even the smallest leaks chronic inflammatory process; if infected widespread peritonitis
61
Nodular hyperplasia - gross
spherical nodules in the liver | vary in colour from pale to dark or can be same colour as rest of the liver
62
nodular hyperplasia - micro
cells are larger, may contain more glycogen portal areas still visible within the mass compression of adjacent normal tissue
63
Neoplastic disease of the liver: primary tumours
Principally dogs and cats from hepatocytes (hepatoma or hepatocellular carcinoma) or biliary epithelium (most are cholangiocellular carcinomas) Hepatocellular tumours may resemble normal parenchyma (with haemorrhage or necrosis in malignant tumours) cholangiocellular carcinomas are often white, firm and umbilicate
64
Neoplastic disease of the liver: metastatic tumours - Haemangiosarcoma
can be primary or metastatic in the liver other predilection sites are the spleen and right auricle of the heart prevalent in large breeds
65
Neoplastic disease of the liver: metastatic tumours - secondary tumours
secondary metastatic involvement of the liver is very common: includes melanoma, carcinoma, sarcoma and lymphoma
66
Pancreatic hypoplasia
developmental abnormality German shepherd dogs and calves occurs at about one year of age
67
Pancreatic hypoplasia - clinical signs
steatorrhoea (fat in faeces) and diarrhoea loss of condition despite polyphagia pot-bellied
68
Pancreatic hypoplasia - pathology
intestines distended by bulky fatty ingesta lack of fat in the mesentery and abdomen sparse pink pancreatic tissue microscopy reveals hypoplastic acini
69
Acute pancreatitis - clinical signs
shock and cardiovascular collapse raised lipase and amylase levels some cases subclinical
70
Acute pancreatitis - gross
chalk-like areas of fat necrosis with local reddening around the pancreas a small amount of blood-tinged fluid in the abdomen with fatty globules
71
Acute pancreatitis - micro
haemorrhagic oedema and necrosis affecting pancreas and peripancreatic fat
72
Chronic pancreatitis
often follows acute pancreatitis - replacement fibrosis and atrophy leads to exocrine pancreatic insufficiency (steatorrhoea and loss of condition) may be subclinical in cats and horses
73
Pancreatic hyperplasia
Nodular hyperplasia is common in older dogs and (esp) cats - of no clinical significance
74
Pancreatic hyperplasia - gross
white lobules or plaques projecting from the surface | don't distort adjacent tissue + aren't encapsulated
75
Pancreatic hyperplasia - micro
similar to normal glandular tissue
76
Pancreatic neoplasia
Adenoma - extremely rare Carcinoma -highly invasive and infiltrative with metastases to the liver, peritoneum, abdominal lymph nodes, spleen, adrenals

Vet - notes (32 decks)

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