Pathology 2 Exam 2 - endocrine/blood Flashcards | Knowt (2024)

• cells that secrete hormones directly into the blood

• Hormones modify functions of target cells

• synthesized and stored in granules

• TRH, ADH, ACTH, TSH, PTH

• not stored

• mineralocorticoids, cotisol, steroids, sex steroids

• T3, T4, catecholamine

• issue is is the endocrine organ itself

  • often neoplastic for hyperfunction

• Immune-mediated injury: hypothyroid

• Failure of development: dwarfism

• Genetic hormone synthesis defect: genetic defect

• a lesion in other organ secretes an excess of trophic hormone

• a destructive lesion in one organ such as pituitary, interferes with trophic hormone release

• Most are peptides

• Humoral hypercalcemia of malignancy

  • secretion of PTHrP by cancer

  • T cell lymphoma

  • Apocrine anal sac adenocarcinomas

• insulin resistance

• common in ruminants

• can cause prolonged gestation

• Genetic –failure of development (aplasia) of the adenohypophysis

• Toxic plants - Veratrum californicum in sheep

• Increased degradation

  • Induction of liver enzymes

  • phenobarbital

• Decreased degradation

  • Persistent elevated blood hormone levels

  • hyperestrogenism with cirrhosis

• Posterior lobe of pituitary

  • Hormones: Oxytocin, ADH

• Pituitary section

• Influenced by releasing hormones from the hypothalamus

  • Pars Distalis (Anterior Lobe): ACTH, TSH, FSH, LH, LTH, GH

  • Pars Intermedia (Posterior Lobe): ACTH in dogs

  • Pars Tuberalis: Capillaries

• Pituitary Cyst from failure of Rathke’s pouch differentiation

  • Low GH, TSH, prolactin, and gonadotropins. ACTH

• Autosomal recessive

• Slower growth rate: normal until 2 months old

• retention of puppy coat

• bilateral symmetrical alopecia

• Derived from corticotroph cells in pars distalis or pars intermedia

• Causes cortisol excess

  • canine hyperadrenocorticism (Cushing’s)

• Pot-bellied appearance, hepatomegaly, muscle atrophy, fat redistribution

• PU/PD

  • Bostons, Boxers, Dachshunds

• Common in horses, common in older horses

  • females>males

  • Large and compressive

• Causes Pituitary Pars Intermedia Dysfunction PPID

• Produces POMC-derived peptides

• PU/PD, laminitis, increased appetite, weakness, somnolence, hyperhidrosis, hyperglycemia, glucosuria, hirsutism.

• rare

• Growth hormone-secreting acidophils

• Can cause acromegaly (overgrowth of CT, bone, and viscera) insulin-resistant diabetes mellitus, Jay Leno chin: cats

• Hypophyseal Form

  • Inadequate ADH due to destruction of Neurohypophysis

• Nephrogenic Form

  • Target cell defect

• PU/PD, hypo-osmotic urine,

• Functional ACTH-producing pituitary adenoma

• Functional adrenal cortical adenoma or carcinoma: most common

• Idiopathic hyperplasia: dogs

  • Calcinosis Cutis (calcification)

• Chronic corticosteroid use or excessive cortisol

• Neutrophilia without a left shift, high glucose, high alkaline phosphate, low urine spec gravity

• Delayed wound healing, frequent infections, increased appetite, pendulous abdomen, bilateral alopecia

• Multiple discrete nodules of any of the 3 cortical zones

• Older animals

• bilateral: both glands

• Bilateral, diffuse, uniform

• Response to excessive ACTH from functional pituitary adenoma

  • Hyperadrenocorticism (Cushing’s)

• Single, unilateral, well demarcated and differentiated

• Functional

• Older dogs

• Less common than adenomas

• Large and bilateral often functional

• Highly metastatic & invasive

• Low glucocorticoids and mineralocorticoids

• adrenal glands are mainly medulla

• K+ is retained and Na+ and Cl- are lost

• Idiopathic adrenocortical atrophy, immune-mediated destruction, stopping long-term steroid therapy, pituitary lesions

• Weight loss, gastroenteritis, low stress tolerance, shock

• Common in standard poodles

• Red masses

• Most common adrenal medulla neoplasm

• Composed of Epi or norEpi secreting cells.

• Small: stay localized in adrenal

• Large: metastasize into vena cava and aorta

• Functional: catecholamine overproduction

  • Tachycardia, edema, cardiac hypertrophy.

• Newborns due to birth trauma

• exhaustion/overexertion

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• stress response

• toxemia, septicemia

• Surrounding cells

• Thyroid endocrine cell.

• Cuboidal to columnar.

• Single layer around colloid-filled follicles.

• Regulated via Hypothalamic-pituitary-thyroid axis.

• Produce T3 and T4

• Thyroid C cell

• Produce calcitonin

  • Respond to reduce plasma [calcium]

  • Chronic hypercalcemia causes hyperplasia cells

• Not controlled by TSH

• Base of the tongue around developing glands

• Can migrate from caudally to diaphragm

• Dogs: near the ascending aorta

  • thyroid carcinoma is ddx for heart tumor

• From thyroglossal duct remnants.

• Small cysts or sinus tracts along necks midline

• contain watery secretions

• Nonneoplastic Enlargement due to follicular cell hyperplasia

• Diffuse: compensatory, TSH-induced response to hypothyroidism

• multinodular: in old cats, functional, independent, hyperthyroidism)

• High/low Iodine TH defects, goitrogens

• Fetal and neonatal periods: diffuse goiter

• grossly Diffusely enlarged and reddened goiter

• Increased vascularity, large follicles, decreased luminal diameter, follicular cell hypertrophy.

• Fetus – myxedema (edema & glycosaminoglycans) in dermis,

  less hair

• Compounds causing hyperplastic goiter

  • plants and drugs

• High/low iodine increases sensitivity

• involution stage Post-dietary iodine repletion in hyperplastic goiter

• Thyroid gland stays large

• Atrophic follicular cells due to low TSH

• Older dogs

• 90% cases are primary

  • Idiopathic follicular atrophy

  • Lymphocytic thyroiditis.

• Shrunken, pale thyroid gland.

• Parenchyma lost or replaced by fat

• Possible end-stage of autoimmune lymphocytic thyroiditis

• Autoimmune thyroid disease.

  • Infiltration by thyroid-reactive T lymphocytes.

  • Triggered by genetic and environmental factors.

• Old cats> dogs

• functional, leading to hyperthyroidism.

• Discrete tan to brown nodules, tissue compression

• Feel thyroid on PE

• Dogs

• Large and vascular

• Non functional

• from ectopic thyroid tissue with metastasis to lungs

• C-cell Adenoma

  • Equine thyroid tumor

  • incidental at necropsy

• C-cell Carcinoma:

  • Bulls and dogs

    • high-calcium diets

    • Increased vertebral bone density

  • metastasize to regional lymph nodes or lungs.

• paired glands near the thyroids

  • Dogs and Cats: Bilateral external and internal

• made of chief cells (PTH)

• Parathyroid Gland cells

• release PTH in response to low ionized calcium

  • activates osteoclasts to absorb ca

  • block reabsorption of phosphorus

• Low PTH release or poor PTH response

  • low calcemia and high phosphorus

• Risks: Mini schnauzers, thyroidectomy cats

• High PTH secretion

• Parathyroid adenomas, chief cell carcinoma: dogs

• High phosphorus and low calcium

  • low cholecalciferol, calcium deficiency

• More common

• diffuse and bilateral.

• Big head dx in horses

  • bone replaced with CT

• poor calcitriol synthesis

• low GFR, high phosphorus, low calcium in blood

• Causes high PTH leading to fibrous osteodystrophy

  • rubber jaw

• Hypofunction

  • Pancreatic Islet B Aplasia/Hypoplasia: puppies

  • Degeneration or Necrosis

  • Immune-Mediated Inflammation: islet cell destruction.

  • Chronic Pancreatitis: endocrine and exocrine tissue destruction

  • Insulin-Resistance: Cats

• Low immune response, UTI, cataracts, polyuria

• β-Cell (Insulin Secreting) Neoplasms

  • β-Cell Carcinoma common in right lobe of dogs

  • meets liver and lymph nodes

• Common in dogs and ferrets (benign in ferrets)

• Appearance: Solitary, yellow to red, round nodules, small

• Multiple small nodules

• gray to tan

• Old animals

• incidental

• primary adult hematopoietic site

• neonate to adult there is bone marrow contraction found in spaces of axial bone and proximal femur/humerus

• divided into yellow and red

• Dynamically active

1. mesonephric

2. liver

3. bone marrow

• hematopoietic tissues mixed with trabecular bone and adipose tissue

• Vascular

• Appears grossly red

• bone marrow contracts into the proximal diaphysis of the femur and humerus

• replaced with adipose tissue within the trabecular bone

• juvenile dog – marrow spaces diffusely red

• adult dog – proximal diaphysis is red

• stimulated by chronic inflam or anemia

• increase red and decrease yellow marrow

  • normal in cats

• form extramedullary hematopoiesis in tissues

  • spleen, liver, and lymph nodes

  • Wont cross by BBB

• Proximal humerus and femur

• Sternum

• Need a CBC and history to interpret: within 24 hours

• Do not package cytology with formalin or cold packs

• Cytology: smears or aspirates, often a touch prep, slight squash, or smear from the core bone biopsy

• examination of

  • architectural changes

  • myelofibrosis

  • mature myeloid cells

  • neoplasias

• examination of

  • myeloproliferative disorders

  • myelodysplasias

  • immune-mediated diseases

  • immature and mature myeloid cell lines

  • infectious organisms

  • leukemias

• bone marrow atrophy

• developed normally than decreased in size

• Direct injury reduces hematopoietic cells

• Hypoplasia

• fibrosis replacing the hematopoietic tissue

• results in cytopenias and decreased myeloid production

  • detected on CBC

• chronic inflam, infectious dx, immune-mediated dx, toxicities

• increase production or one or multiple cell lines

• response to extramedullary tissue injury

• increased BM production

• EX: hemorrhage, premature destruction of erythrocytes

  (hemolysis), inflammation within the tissues

• Caused by marrow-directed injury or disturbances

  • not cancer

• abnormal hematopoietic cell development

• NOT the same as myelodysplastic syndromes (MDS): neoplasia

• failure of a hematopoietic cell to develop

• caused by toxins

  • chemo agent 5-fluorouracil

• deficiency of all types of blood cells

• Bone marrow inflammation!

• Often seen with IMHA - dogs & cats

• Granulomatous type

  • systemic fungal infections or mycobacteriosis

• Acute/neutrophilic type

  • bacterial infections and immune mediated

• Histologic: shows infiltrates, fibrin, edema, necrosis

• seen in medullary component, stromal cells, and stroma

• can cause cytopenias in severe cases

• If patient survives than can make a complete recovery of hematopoiesis or may undergo scar formation

• DIC, sepsis, infection, medullary and extramedullary neoplasia

  • leukemia

• displacement of hematopoietic tissue by fibrosis, neoplasia, or granulomas

• can cause non-regenerative anemia and cytopenias

• fibrosis in the bone marrow

• can cause non-regenerative anemia and cytopenias

• causes hyperviscosity of the blood: cats

  • erythematous mucous membranes

• Acute myeloid leukemia AML with lymphocyte differentiation

• Myeloproliferative neoplasm

• Acute myeloid leukemia

• > 20% blast cells in blood or bone marrow

• Cytosis of mature cells in blood

• hypercellular bone marrow

• <5% of blasts cells

• Nonregenerative cytopenia

• dysplasia

• Small to moderate increase 5-20% of blast cells

• CHRONIC : has fibrin

• Serious atrophy of fat

• Gelatinous transformation of fat within the marrow

• due to starvation / malnutrition or chronic disease

• most common leukemia in dogs

  • middle aged to older dogs: small to medium sized cells

• ~70% are T-cell type, arise in the splenic red pulp with minimal BM involvement

• ~30% are B-cell, arise in bone marrow

  • associated with a monoclonal gammopathy and gradual myelophthisis

• Better long-term survival: more then a year

• Primary type is extremely rare: domestic species

• commonly caused by metastatic spread of mast cell tumors in dogs

• Rare in cats

  • release of mast cells from visceral sites (usually splenic) or

    cutaneous mast cell tumors

• Plasma cell tumor: either arising in the BM, or extramedullary plasma cell tumors - oral/skin (EMP)

  • most common in dogs

• rare to find circulating in the blood

• Needs 2 or 3 of the following:

  • Increased plasma cells in the BM

  • Monoclonal gammopathy: hyperglobulinemia

  • Radiographic evidence of osteolysis

  • Light chain proteinuria: antibody in urine

• metastasize to the spleen, liver, lymph nodes, and kidneys

• bone marrow and blood cells

• lymph nodes, spleen, thymus, and lymphocytes

• Red pulp: hematopoiesis, storage, macrophage blood filtration

• White pulp: lymphoid component

  • No lymphatic vessels

  • Vulnerable to BB pathogens

• send out the whole spleen

• masses are mostly necrotic hemorrhage

  • aka, useless

• Oozes, dark red, soft and friable

• Sinuses are dilated filled with blood

• Increased distance between white pulp

• Trabeculae are thinned

• Disturbances in systemic and portal circulation

  • Rare in animals with heart failure (liver is more affected)

• Acute secondary hemolytic anemias

• barbiturates

• splenic volvulus: dogs and pigs

  • deep chested breeds

  • twisted spleen

• infections

  • Anthrax

  • African Swine Fever

• enlarged spleens

• Dark red, firmer, "meaty", white spots, does not ooze

• Diffuse cellular infiltrates increase spleen size

• Diffuse while pulp lymphoid hyperplasia – some cause of chronic antigenic stimulation

• White material on capsule (fibrous deposition)

• Diffuse extramedullary hematopoiesis

• Lymphoma, Mastocytosis(cats), Histiocytosis

• Pale, "waxy" feel, firm, slightly rubbery, does not ooze

• Amyloidosis

• limited to germinal centers and spare the red pulp

  • Sago spleen (looks like sago seeds)

• stain a light pink with Congo Red and green when polarized

• Common senile change in dogs, old bulls

• benign

• tan, light to dark red, and hemorrhagic or bloody masses

• nodules compress vasculature causing necrosis and hemorrhage

• Complex type: contains lymphoid, EMH, and stromal proliferation

• Lymphoid type: white pulp

• Hematopoietic type: red pulp

  • localized excessive extramedullary hematopoiesis

• Most common primary splenic tumor in dogs

• One large vascularized mass

• send whole spleen to histopathology

• Can metastasize to the omentum

• Not common

• Macrophages are highly efficient at removing invaders

• hematogenous infections

• Rhodococcus equi: equine

  • chronic suppurative bronchopneumonia with abscesses

• Trueperella pyogenes: cattle

  • Pneumonia with septicemia multiple abscesses, endocarditis, polyarthritis, pleuritis, reproductive infections

• common in enlarged spleens

• commonly seen in the supracapsular red pulp due to poor perfusion and decreased venous return

• acute are hard to ID

• Chronic are pale grey well demarcated, extend from capsule to the parenchyma, wedge shaped, scaring

• Classical Swine Fever

• Normal spleen: Level of trauma

• Pathological rupture: minimal to mild trauma

• acute: drained of blood

• can heal in fragments forming multiple spleens

• Benign

• Degenerative process seen in older dogs

• Yellow, brown, gritty spots on margins

• Deposits of bilirubin, hemosiderin, and calcium in the CT of the splenic capsule and trabeculae

• Does not effect function of spleen

• Small Lymph nodes

  • Senile change (common in cats, dogs, primates)

  • outflow Obstruction of efferent lymphatics

  • increased sinus pressure

  • Surgery, prolonged recumbency

  • Radiation

  • High doses of prednisone or chemotherapy

  • Cachexia (old goats and sheep)

• Very common

• Lymphoid hyperplasia

• Local or generalized(more serious)

• Chronic antigenic stimulation

• Retention of lymph node architecture

• Salmonellosis, classical swine fever, African swine fever

• Hemorrhage draining to regional nodes

• Slightly red or hemorrhage

• Diseases with vascular damage from toxins or vasculitis

  • Salmonellosis, classical swine fever, African swine fever

• Common in bacterial septicemia

  • Salmonella spp.

  • Streptococcus equi (strangles), Streptococcus porcinus (jowl abscess in pigs)

  • Brucella spp., Truperella pyogenes, Francisella tularensis, Yersinia pestis

  • Toxoplasmosis

• High order bacteria (Mycobacterial)

  • Systemic fungal disease ( Blastomyces dermatitidis)

  • Foreign material

  • Rhodococcus equi:

    • Neonatal foals

    • Pulmonary, digestive, lymph nodes lesions

• Corynebacterium pseudotuberculosis

• problem in sheep and goats

• Carcinoma

• Melanoma

• Mast cell tumors

• Sarcomas (spread hematogenously to liver /lungs before lymph)

• Capsule

• Only T lymphocytes

• No follicular structure

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