From:
Lisa Shortley
Date: 2001-11-20 18:29:00 UTC
Subject: Noobie biopsy results - need help interpreting.
Hi there,
I posted a few days ago about my ferret Noobie passing away
suddenly. Dr Williams told me to wait until I received the
biopsy report from his necropsy before trying to figure out
what happened. We received the pathology report back and
while rather lengthy, Im still at a loss. Can someone please
help interpret this or give me some sort of idea about what
possibilities remain?
As a short background, Noobie was a stray who came to live
with me in November, 2000. He wasnt eating and was extremely
lethargic. His poops were liquid, if anything. I took him to
a specialist for exam and he recommended surgery for a
suspected blockage. Noobie was found to have a very enlarged
mezonteric lymph node, his stomach wall was inflamed and
severely thickened, and his liver looked odd, his small
intestine had something wrong as did his bowel. The vet
biopsied all this and his results came back as severe
Inflammatory Bowel Disease. I questioned about Helicobactor,
but was told that this would have showed up in the biopsy
report. He was begun on a regimen of Imuran and Pred and
bland diet. After about 5 months, he began to improve
drastically. He had his adrenal surgery 8/11 and all of his
prior problems were found cured . Because he had no clinical
symptoms of intestinal problems, and had been weaned off his
meds, he didnt want to biopsy things since clinically, he was
doing so well and everything looked good.
After reading this report, I realize that I have one ferret
who was diagnosed with IBD via biopsies and while eating okay,
remains thin. I have another who was diagnosed with
hepatitis. My ferret Nala died suddenly in July after her
stomach hemmoraged. Lymphosarcoma was found to be the cause&
But Im starting to feel like perhaps there could be a trend
here, perhaps? Is there a chance that this could have been
treatable? What about contagious?
Here is the biopsy:
Microscopic Description:
The specimen consists of necropsy sections of stomach, liver,
and lymph node. The gallbladder is not identified and the wet
tissue will be resectioned. The tissues are from a neutered
male, 5 year old ferret with a history of jaundice and a high
bilirubin with normal liver values.
The stomach has intense inflammation in the lamina propria
which extends into the submucosa and muscularis. Areas of
ulceration are present which have neutrophilic infiltrates.
Diffuse severe infiltrates of lymphocytes and plasma cells are
present throughout the lamina propria and are admixed with a
few neutrophils. Well developed lymphoid nodules are present
along the muscularis mucosae and in the submucosa. Many of
these nodules have germinal centers. Inflammation extends to
the serosal surface and represents neutrophils, histiocytes,
lymphocytes, and plasma cells.
The liver has mild to moderat periportal inflammation
representing lymphocytes, plasma cells, and neutrophils.
Occasional bile ducts have neutrophilic infiltrates. Bile
ducts are mildly hyperplastic and some ducts are dilated.
Moderate cholestasis is present withint he ducts. Mild
telangiectasia is also noted.
The architecture of the lymph node appears to be intact but
the slide has marked sectioning artifact which affects
interpretation. A few germinal centers are recognized and
show normal peripheral maturation. Mild hemorrhage is present
in the sinuses.
Pathological Diagnosis:
Multifocal ulcerative gastritis, stomach
Severe lymphoplasmacytic gastritis, stomach
Moderate chronic active serositis, stomach
Mild to moderate chronic active cholangiohepatitis, liver
Moderate intraductular cholestasis with mild bilaiary
hyperplasia and patchy biliary ectasia, liver.
Mild telangiectasia, liver
Reactive lymph node.
Mild to moderate chronic active cholangiohepatitis with
nodular lymphoid hyperplasia and hemorrhage, gallbladder.
Comment:
Gastric morphology is consistent with Helicobacter infection
although no organisms are seen. The presence of multiple
ulcers has also been associated with Helicobacter infection.
Inflammation extends into the muscularis and is present on the
serosal surface of the stomach suggesting the possibility of a
perforated ulcer which is not present in the examined
sections.
No evidence of biliary neoplasia is seen in the liver.
Changes are consistent with a biliary obstructive and
inflammatory process possibly secondary to the gastric
inflammation. Helicobacter infection in mice is a documented
cause of chronic cholangiohepatitis. The presence of
neutrophils could indicate bacterial infection. The lymph
node appears to be reactive but deeper sectioning is in
progress for better morphology and the result will be noted in
a supplemental report. The result of wet tissue resectining
for the gallbladder will also be noted in a supplemental
report.
Supplemental Report:
The gallbladder contains a mild to moderate inflammatory
infiltrate in the submucosa. Neutrophils, histiocytes,
lymphocytes, and plasma cells are identified. One lymphoid
nodule is present within the submucosa and moderate hemorrhage
is noted in the lumen. No microorganisms are seen. Deeper
sectioning of the lymph node confirms the diagnosis of a
reactive node.
Thank you all so much for tolerating such a long email. I am
eagerly awaiting any sort of ideas or interpretations. I have
8 other ferrets here.
Lisa Shortley