Unit 4 - Female Repro Labs Flashcards
History:This is a ventral abdominal mass from a 9 year old intact female Golden Retriever.
Describe the lesion(s).
Haired skin and teat have an adjacent, firm, multinodular mass measuring approximately 5cm in diameter. On cut section the mass is heterogeneous with regions that are white, admixed with tan, and brown foci. The texture is also heterogeneous varying from hard and gritty (bone), to firm and smooth (cartilage), to soft and pliable.
History: This is a ventral abdominal mass from a 9 year old intact female Golden Retriever.
Provide an appropriate morphologic diagnosis.
Skin and mammary tissue: Chronic, focal heterogeneous mammary mass
History: This is a ventral abdominal mass from a 9 year old intact female Golden Retriever.
As a general rule, tumors are relatively homogeneous. This mass appears quite heterogeneous. Does this mean it is not a tumor or is there a reason this type of tumor can be heterogeneous?
Mixed or complex mammary tumors are quite common in the dog (60% of mammary tumors)
They consist of epithelium forming glands/ducts + proliferative myoepithelium ± cartilage, and/or bone. So mammary tumors in the dog are commonly heterogeneous
History: This is a ventral abdominal mass from a 9 year old intact female Golden Retriever.
What information could you obtain in practice that could help you to help decide if this was a benign or malignant tumor?
- Rapid growth
- Ulceration
-
Large size
- In both dogs and cats, the larger the tumor the greater the likelihood of malignancy.
- Dogs: tumors >5 cm, 43.5% benign, 56.5% malignant
- Fixation to skin and/or underlying tissue
- Metastasis along lymphatics or to regional LN’s
History: Tissue from an 8.02 year old female Great Pyrenees with bilateral mammary masses.
Describe the lesion.
Mammary gland: There is a poorly demarcated, subcutaneous mass which is approximately 16 x 6 x 6cm and extended to involve three separate teats. The mass was firmly adhered to the overlying skin and subcutaneous tissue with no firm attachments to the abdominal wall.
History: Tissue from an 8.02 year old female Great Pyrenees with bilateral mammary masses.
Provide appropriate morphologic diagnoses.
Skin (mammary gland): chronic, focally extensive, mammary mass
History: Tissue from an 8.02 year old female Great Pyrenees with bilateral mammary masses.
This specimen illustrates at least two potential features of malignancy. What are potential features of malignancy in this mass?
Firmly attached to overlying tissues (skin)
Irregular and poorly demarcated
Large size (> 5 cm)
History: Tissue from an 8.02 year old female Great Pyrenees with bilateral mammary masses.
Where might we want to assess for potential metastatic disease?
Lungs and regional lymph node:
History: This is tissue from a female horse that has become aggressive and stallion-like. The tissue originated from the expected location of the right ovary.
Describe the lesion(s).
The ovary is markedly enlarged measuring approximately 20 cm. in diameter and is composed of multiple variably sized cysts filled with serosanguineous fluid and separated by thick bands of grey-brown tissue. Cystic structures vary in size from 0.5 – 5.0 cm in diameter in diameter.
History: This is tissue from a female horse that has become aggressive and stallion-like. The tissue originated from the expected location of the right ovary.
Do you think this is a cystic ovary or a cystic ovarian neoplasm?
Cystic ovarian neoplasm (Granulosa cell tumor of the ovary)
History: This is tissue from a female horse that has become aggressive and stallion-like. The tissue originated from the expected location of the right ovary.
What is the rationale behind your answer for Question B?
In horses, only one follicle tends to ovulate, so typically there is but a single (maybe 1-3) cystic follicle. These cystic follicles are hormonally active and prevent the progression of additional follicles. With follicular cysts, enlargement is due purely to cyst formation. The uninvolved ovary is relatively normal in size with one to three, large, thin-walled cystic structures. These cysts will not be separated by thick bands of tissue. The presence of such as large mass with numerous cystic spaces surrounded by bands of tissue between cysts, is indicative of a proliferative condition such as a cystic ovarian neoplasm.
History: This is tissue from a female horse that has become aggressive and stallion-like. The tissue originated from the expected location of the right ovary.
Does this lesion have any relationship to the clinical signs, if so how?
Granulosa cell tumors can secrete varying amounts of different sex hormones resulting in clinical signs of anestrus (progesterone), continuous or intermittent estrus (estrogen), or stallion-like behavior (testosterone). It is these behavioral issues that may be the first clinical indication of an ovarian tumor. Alternatively, these tumors may be detected when the ovaries and uterus are palpated in an animal with infertility.
History: Tissue from a mature sow that was culled because she did not become pregnant.
Describe the lesions.
Ovary: Bilaterally, there are multiple, thin-walled, cystic structures on each ovary which appear to be filled with clear fluid. These cystic structures vary in size from 2.5-5 cm in diameter.
History: Tissue from a mature sow that was culled because she did not become pregnant.
Provide an appropriate morphologic diagnosis.
Ovary: Multifocal, chronic, bilateral, ovarian follicular cysts
History: Tissue from a mature sow that was culled because she did not become pregnant.
For each species below, how big does a follicle need to get before it is considered abnormal.
Porcine: >1.1 cm
Bovine: >2.5 cm
Equine: > 6 cm
History: Tissue from a mature sow that was culled because she did not become pregnant.
Why didn’t this sow become pregnant?
Animals are infertile while cyst persists, because the cysts are hormonally active and, when multiple in pigs, prevent normal cycling
History:. Tissue from a 10 year old female golden retriever. She presented with a history of vomiting and PU/PD. Her white blood cell count is 60,000 (way high). Also tissue from a bovine that gave birth 5 days ago and had retained placenta.
Describe the lesion:
The uterine body and uterine horns are markedly dilated, up to 2inches in diameter. The endometrium is extensively covered by grey-tan friable material (fibrinonecrotic exudate). The bovine uterus is moderately distended by thick, brown opaque fluid.
History: . Tissue from a 10 year old female golden retriever. She presented with a history of vomiting and PU/PD. Her white blood cell count is 60,000 (way high). Also tissue from a bovine that gave birth 5 days ago and had retained placenta.
Give a morphologic diagnosis.
Uterus: K9 Severe, chronic diffuse, fibrino(purulent)(fibrinonecrotic) pyometra
Uterus: Bovine Severe, acute, diffuse, fibrino(purulent)(fibrinonecrotic) pyometra
History: . Tissue from a 10 year old female golden retriever. She presented with a history of vomiting and PU/PD. Her white blood cell count is 60,000 (way high). Also tissue from a bovine that gave birth 5 days ago and had retained placenta.
Regardless of species, what are potential risk factors for the development of this lesion (pyometra)?
Abortion, Retained fetus(s), Retained placenta, dystocia, trauma to the canal during birth
History: Tissue taken at the time of spay from a 7 year old mixed breed canine
Describe the lesion(s).
Uterus: The endometrium is diffusely thickened, up to 2 cm, by multiple tan, firm cystic structures filled with clear fluid that measure up to 1 cm in diameter and that markedly narrow the lumen.
History: Tissue taken at the time of spay from a 7 year old mixed breed canine
Give a morphologic diagnosis.
Uterus: Cystic endometrial hyperplasia, chronic, diffuse
History: Tissue taken at the time of spay from a 7 year old mixed breed canine
Describe the pathogenesis of the more diffuse uterine lesion
Repeated estrogen priming → prolonged progesterone stimulation (60 day diestrus) → Progesterone increases growth of endometrial glands and secretion → cysts develop following repeated cycles without pregnancy
History: Tissue taken at the time of spay from a 7 year old mixed breed canine
What is an important sequela to this lesion?
Pyometra
History: Tissue from a newborn ewe lamb born co-twine to a male.
Describe the lesion(s).
The ovaries and uterus are extremely small. The clitoris is markedly enlarged.
History: Tissue from a newborn ewe lamb born co-twine to a male.
Morphologic Diagnosis:
Chronic, Uterine and ovarian hypoplasia, with clitoral enlargement.
History: Tissue from a newborn ewe lamb born co-twine to a male.
Name the abnormality.
ovine freemartin
History: Tissue from a newborn ewe lamb born co-twine to a male.
Briefly, describe the pathogenesis.
The freemartin is the female twin from a set of fraternal twins. Placental vascular anastomoses, which allow exchange of blood between fetuses. Testicular development occurs before ovarian development. Anti-mullarian hormone from the testes of the male twin inhibits mullarian duct development in the female. (Experimental data suggests that regression of Mullerian duct in freemartins is essentially mediated by AMH produced by the testes of the male twin)
The phenotypic characteristics of a freemartin are a small (hypoplastic) uterus that usually does not communicate with the vagina, a short vestibule and vagina, a hypoplastic vulva, and an enlarged clitoris. The ovaries are absent or small, and may range from organs that have reduced number of germ cells to organs partially converted to testes. Externally, the genitals are those of a female but they may have steer-like conformation. Male twins are largely unaffected, but may have decreased fertility
History:This is tissue from a 6 year old Holstein cow. The animal died of Hardware disease.
Describe the lesion(s).
The intercotyledonary chorion is multifocally thickened with delicate, shaggy tan-gray tissue (primitive villous placentation). Cotyledons vary markedly in size, with several cotyledons 20-30% larger than others. There are at time 3-5 cotyledons directly adjacent to each other. There are corresponding areas on the uterus where there is primitive caruncle formation in-between enlarged and irregular caruncles. Small firm pale nodules 1-2 mm in diameter are present on the internal surface of the amnion near the umbilical vessels.
History: This is tissue from a 6 year old Holstein cow. The animal died of Hardware disease.
Give a morphologic diagnosis.
Placenta.
- Chronic, multifocal adventitial placentation
- Chronic, multifocal Amniotic Plaques
Uterus: Chronic, multifocal adventitial caruncle formation
History: This is tissue from a 6 year old Holstein cow. The animal died of Hardware disease.
What is the significance of this change?
Adventitious placentation refers to the development of additional, often intercotyledonary placentation. This is a mechanism of compensation for an inadequate number of functional placentomes. The initiating cause may be poor nutrient transfer due to inflammation in other areas of a pregnant uterus/placenta (placentitis), or it may be a consequence of previous metritis where a large number of caruncles have been injured and healed by fibrosis. Compensation can consist of a great increase in the size of remaining caruncles, and corresponding cotyledons, during pregnancy, many of which may fuse, and/or by the development of a more primitive villous placentation between the cotyledons. The adventitious placentation develops first adjacent to the placentomes. The process may remain localized or involve virtually the entire intercotyledonary placenta. In the latter instance, pregnancy is insecure and may not proceed beyond midterm.
History: This is tissue from a 6 year old Holstein cow. The animal died of Hardware disease.
How can this change be caused iatrogenically ?
Aggressive manual removal of a retained placenta can injure or remove uterine caruncles, resulting in compensatory adventitial placentation.
History: These are tissues from a cow that recently aborted.
Describe the lesion(s).
Multifocally, the villi of entire cotyledons are fused by tan friable material and slightly cupped. The intercotyledonary areas (intercotyledonary chorion) are markedly thickened, opaque, granular and leather-like. Small cupped cotyledons are present immediately adjacent to larger cotyledons (adventitial placentation).
History: These are tissues from a cow that recently aborted.
Give a morphologic diagnosis.
Placenta: Severe chronic diffuse placentitis with adventitious placentation
History: These are tissues from a cow that recently aborted.
What agents are high on your differential list?
The thickened leathery areas are highly suggestive of a mycotic infection but bacterial infection would be another differential. Bovine mycotic placentitis in the US is most commonly caused by Aspergillus fumigatus, but other common fungal etiologies in cattle include the Zygomycetes (Absidia, Mucor, Rhizopus and Mortierella).
History: These are tissues from a cow that recently aborted.
If this proved to be a mycotic abortion, what additional fetal lesions might be observed?
Additional fetal lesions: the fetus may be small and emaciated, or there may be fetal mycotic dermatitis. Submit placenta (chorioallantois), as well as skin and lung if affected.
History: These are tissues from a cow that recently aborted.
What is the herd heath significance of a diagnosis of mycotic abortion?
There are no contagious fungal causes of bovine abortion. May want to evaluate feed (excessive mold) and ventilation to assess for excessive exposure to fungal spores.
History: Tissue from late gestation aborted lambs.
Describe the changes.
There are several, random and widely spaced, slightly raised, circular to target-shaped, white to tan foci in the liver, that measure approximately 0.5 -1.0 cm in diameter. Occasionally the center of the lesions is depressed or cavitated.
History: Tissue from late gestation aborted lambs.
An impression smear of these lesions reveals necrocellular debris and neutrophils. Give an appropriate morphologic diagnosis.
Liver: Moderate, acute, multifocal, necrosuppurative hepatitis
History: Tissue from late gestation aborted lambs.
What is the likely etiology?
Campylobacter sp abortion (C. fetus fetus, C. jejuni, possibly Flexispira rappini, Helicobacter)
History: Tissue from late gestation aborted lambs.
Is this a contagious cause of abortion that might have the potential to cause multiple abortions?
Yes. Depending on flock immunity, this agent could cause an abortion storm.
History: Tissue from a 6 year old appaloosa mare that aborted during the third trimester of gestation.
Describe the changes.
Placenta (amnion): The placenta is extensively thickened, opaque, discolored grey to green, and less pliable. The surface is multifocally covered by circular to irregular foci of greenish friable material. These foci vary in size from 1-3 cm in diameter.
History: Tissue from a 6 year old appaloosa mare that aborted during the third trimester of gestation.
Give a morphologic diagnosis.
Placenta: chronic multifocal to extensive fibrinous placentitis.
History: Tissue from a 6 year old appaloosa mare that aborted during the third trimester of gestation.
What are likely causes for the described lesions?
Given the history of abortion and lesions, an infectious etiology should be considered. Placentitis in the equine is most commonly associated with bacterial or fungal infection. Had the lesions been localized to the region of the cervical star (not possible to determine in this case as only amnion was available), the agent likely would have entered via the relaxed cervix.
History: Tissue from a 6 year old appaloosa mare that aborted during the third trimester of gestation.
Why is important to recover the entire placenta and lay it out in the shape of an “F” and assess the lesion pattern.
If the lesions appear to radiate out from the cervical star (base of the “F”) then the mechanism of abortion was likely ascending infection from the cervix. Additionally, it is vauable to know whether the entire placenta has been expelled. If portions have not been expelled, the mare may develop metritis.
History: Placenta from a ewe that has aborted.
Describe the changes.
Cotlyedons have multifocal random white foci approximately 1 mm in diameter scattered throughout the colyledonary villi. These foci are hard and gritty when palpated (mineralization). Intercoltyledonary placenta is generally normal (smooth, thin, can see through) but is discolored grey to brown in color (autolysis)
History: Placenta from a ewe that has aborted.
Provide a Morphologic diagnosis:
Placenta: Chronic, multifocal cotyledonary (necrosis &) mineralization
History: Placenta from a ewe that has aborted.
What is the most likely causative agent?
Toxoplasma gondii
History: Placenta from a ewe that has aborted.
What is the likely source of infection??
Cats (kittens most likely)
History: Placenta from a ewe that has aborted.
What additional fetal tissue should be submitted for diagnostics?
Brain
History: Tissue from a 7 year old female rabbit with a history of weight loss followed by death. This doe has not had bunnies in several years
Describe the lesion(s).
One uterine horn has a portion tied off with string that is markedly dilated, thin-walled and contains abundant fluid.The adjacent portion of this uterine horn is dilated, thin-walled, and the mucosal surface is not covered by an exudate.Within both uterine horns and in the uterine body are multifocal 1.5 – 3 cm in diameter, firm, tan, somewhat friable masses firmly attached to the uterine mucosa.
History: Tissue from a 7 year old female rabbit with a history of weight loss followed by death. This doe has not had bunnies in several years
Give a morphologic diagnosis.
Uterus: Chronic, multifocal uterine masses with marked fluid distension of the uterus
History: Tissue from a 7 year old female rabbit with a history of weight loss followed by death. This doe has not had bunnies in several years
What is your most likely diagnosis?
uterine carcinoma / adenocarcinoma; which in this case had disseminated throughout the uterus (intra-uterine implantation metastasis) with associated mucometra/hydrometra
History: Tissue from a 7 year old female rabbit with a history of weight loss followed by death. This doe has not had bunnies in several years
Is it common for rabbits to develop uterine masses and propose a mechanism for multiple intrauterine masses?
This is common in rabbits. (uterine adenocarcinoma occurs in up to 60% of females >3). There are multiple uterine masses as a result of implantation metastasis within a tubular structure.
History: Placenta from a small ruminant that aborted.
Describe the lesion(s).
The intercotyledonary placenta is brown in color, thickened, granular, opaque and less pliable.The colyledons are slightly cupped and the cotyledonary villy are extensively fused by the presence of an exudate.Immediately adjacent to affected cotyledons are smaller cotyledonary structures.
History: Placenta from a small ruminant that aborted.
Give a morphologic diagnosis.
Placenta: Severe chronic diffuse placentitis with adventitious placentation
History: Placenta from a small ruminant that aborted.
What are important differentials for this lesion in the following species:
Sheep: Campylobacter, Chlamydia
Goats: Chlamydia, Coxiella
