PATHways - American College of Veterinary Pathologists

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V o l u m e 3 , I s s u e 2 P a g e 14 Case Report The case of the Milk-Spotted Liver, Continued…... And the answer is……………. Morphologic diagnoses: Liver: Severe chronic active cholecystitis and hepatitis with intralesional adult nematodes, marked bile duct hyperplasia and hypertrophy, and lymphatic dilatation Comments: Adults of the large roundworm, Ascaris suum, reside most commonly in the small intestine but may migrate aberrantly into the stomach or bile ducts. It’s important to note that this can occur post-mortem. The pathologist should be especially wary of this if single to small numbers of adults are seen within bile ducts. In this case, however, necropsy was performed within minutes of euthanasia, there were moderate numbers of adults within bile ducts, and severe lesions consistent with long-standing infection. In the life cycle of Ascaris suum, many eggs are produced (up to 250,000/day). They can develop to the infective stage (containing the L3 larva) in 2-3 weeks in warm conditions. For the most part, eggs are resistant to chemical agents, but low humidity, heat, or direct sunlight are detrimental to survival. After ingestion of the larvated eggs, hatching occurs in the small intestine. Within two hours, numerous small submucosal hemorrhages may be seen in the wall of the duodenum and anterior jejunum as the larvae penetrate to the hepatic portal system. Larvae arrive in the liver where they molt to the L3. The L3 leave the liver and travel to the lungs via the bloodstream. They break out of the capillaries into the alveoli where they molt; the L4 migrate up the bronchioles, bronchi, and trachea to the pharynx. The L4 are swallowed and swept to the small intestine where they grow rapidly and molt to the L5. Patency occurs at 35-60 days. The severe hepatic changes noted in this case may have contributed to clinical debilitation. Histologically, this pig also had severe bronchopneumonia (Pasteurella multocida and Mycoplasma hyorhinis), a mild lymphoplasmacytic perivascular encephalitis (nonspecific, but suggestive of sepsis), a lymphoplasmacytic interstitial nephritis, and lymphoid depletion (PCV-2). Immunohistochemistry for Leptospira spp. was negative. As such, the interstitial nephritis may have been associated with PCV-2. Intracytoplasmic botryoid inclusions were not noted in lymph node or kidney. Qualitative fecal revealed many Balantidium coli cysts and few Ascaris suum eggs. References available on page 15.
V o l u m e 3 , I s s u e 2 References for Case Report References: 1. M.B. Chitwood and J.R. Lichtenfels, Identification of parasitic Metazoa in tissue sections, Exper. Parasitol. 32 (1972), p. 472. 2. Gardiner, CH, Poynton SL. An Atlas of Metazoan Parasites in Animal Tissues. Washington DC: Armed Forces Institute of Pathology, 1999, pp. 19-21. 3. Leman A. D. et al. Diseases of Swine. (Ames, Iowa: Iowa State University Press, 1986.) 4. Merck & Company. Merck Veterinary Manual, 9 th ed. (Whitehouse Station, NJ: Merck & Co., Inc. with Merial Limited, 2006.) A m e r i c a n C o l l e g e o f V e t e r i n a r y P a t h o l o g i s t s 2810 Crossroads Drive Suite 3800 Madison, Wisconsin 53718 Phone: 608-443-2466 Fax: 608-442-2474 Email: membership@acvp.org S o c i e t y o f T o x i c o l o g i c P a t h o l o g y 1821 Michael Faraday Drive Suite 300 Reston, VA 20190 Phone: 703-438-7508 Fax: 703-438-3113 Email: stp@toxpath.org Newsletter Committee Members Feel free to contact committee members with questions or for advice ACVP Recruiting Committee Student Chapter Subcommittee Newsletter Group: Krista La Perle* (la-perle.1@osu.edu) Stephanie Corn* (stephanie-corn@idexx.com) Kaori Sakamoto (kaoris@uga.edu) Brett Saladino (brett.saladino@covance.com) * Contributed to this newsletter STP Career Development and Outreach Committee Student Interactions Subcommittee Newsletter Group: Sarah Tannehill-Gregg* (stannehi@amgen.com) Jim Proctor (jprocto2@its.jnj.com) Jessica Hoane* (jessica.hoane@crl.com) Molly Boyle* (mboyle@ils-inc.coml) Gaurav Tyagi (gaurav.tyagi@roche.com) Check out the ACVP Student Chapters group on Facebook! http://www.facebook.com/#!/group.php?gid=1238795976443 10 This is a great site for student chapters to: � Exchange ideas about meeting topics � Get ideas for fundraising � Look for housing for externships � Find roommates for meetings http://www.roflzoo.com/cat-the-vet.html http://www.phombo.com http://christchurch.yatbo.com/petsanimals-a-dogs-puppies-a-a3317232560-a-English-bulldog-pupp P a g e 15
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PATHways - American College of Veterinary Pathologists

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