From:
Pam Sessoms
Date: 2002-09-26 23:00:57 UTC
Subject: Mojo's histopath - was bleeding out and rt adrenal
To: ferrethealth@smartgroups.com
Message-ID: <Pine.A41.4.44+UNC.0209261859240.33492-100000@login4.isis.unc.edu>
Hey all,
Awhile back, I asked about the possibility of a ferret bleeding out from a
*smallish* diseased right adrenal gland; I had previously read of this
possibility with *really large* diseased right adrenals. We discovered
blood inside Mojo's abdomen during an ultrasound in July, but there was no
obvious cause for the bleeding. I said I'd report what was found when he
eventually died, as I didn't want further surgery on him.
Mojo was put to sleep around a month ago. Turns out, his right adrenal
probably didn't have anything to do with the blood. We don't really know
for sure where it actually came from, but there wasn't any sign of it
having come from the adrenal. Another thing was that there wasn't really
anything terribly remarkable in his abdomen that could be seen just
looking at it. His liver was covered in pale flecks, but we thought they
were very likely just the fat that often acculates there in sick ferrets
who are losing weight. But as Dr. Williams often says, "gross posts are
not enough" and so tissues were sent off for histopath.
The histopath report is below. He had lymphoma in several organs,
including lung, and we had didn't know it until this report came through!
He wasn't full of masses, his peripheral nodes weren't big, never had
elevated lymphocytes on bloodwork...
Mojo's main ongoing long-term complaint (besides the standard insluinoma
and adrenal) was a strange noise from his throat/chest. It sounded like a
loud, musical "hiccup." That noise that some people can make by plunking
a thumb against their cheek and making that "ploink" sound is almost
exactly it. He never had a "regular" cough, never had obvious trouble
breathing, never breathed too fast. Just that strange musical noise,
usually while sleeping, until the last few weeks of his life, when it was
more frequent and also happened when awake. He had a tracheal wash awhile
back but it did not come back neoplastic, only inflammatory. But it looks
like the lympho was in a lung and that was probably the cause all along...
Here is the report (typos are mine, all mine):
------------------------
This ferret had the left adrenal removed several years ago. The ferret
had signs of a right adrenal mass that was responsive to hormones.
Insulinomas were removed twice and blood glucose was well controlled. The
animal has had chronic coughing for several years. A transtracheal
aspirate 6 months ago showed chronic inflammation with no etiology and
there was poor response to antibiotics and steroids. Hemoabdomen of
unknown cause was diagnosed on 7/2. Several masses were seen around the
right adrenal at ultrasound. The animal has been weak, not eating, and
losing weight and was euthanized. At necropsy, there was a hard white
right adrneal. The liver was mottled with multifocal white to tan
nodules. A 4 to 5 mm green nodule was present. The left cranial lung
lobe was dark and wet with multiple small nodules throughout.
The spleen has a fairly discrete nodule consisting of elements of red and
white pulp and hematopoietic tissue. This displaces adjacent parenchymal
elements peripherally. The liver has extensive infiltrates of a
monomorphic population of lymphocytes. These infiltrates extensively fill
portal areas and extend through the limiting plate forming large
coalescing masses that sometimes efface multiple adjacent lobules. The
infiltrates extend along sinusoids in smaller numbers. The cells have
hyperchromatic moderately pleomorphic nuclei, sometimes with slightly
prominent nucleoli and indistinct cytoplasmic margins and are identifed as
neoplastic lymphocytes. The lung has similar nodular collections of these
neoplastic lymphocytes occurring as mass like lesions primarily oriented
around bronchovascular bundles and bronchi. Similar lymphocytic
infiltrates occur around the pancreatic duct. Focally, dense similar
infiltrates occur within the kidney widely separating tubules and
glomeruli. The mesenteric lymph node is effaced by neoplastic lymphocytes
that fill cortical and medullary sinuses and extend into surrounding
adipose tissue. The adrenal has large masses of large vacuolated and
disorganized cortical epithelial cells effacing the normal architecture of
the adrenal cortex. Interspersed amongst these cells and extending along
the capsular margin and into pericapsular adipose tissue are neoplastic
lymphocytes. The heart is largely within normal limits.
Diagnosis:
Malignant lymphoma, widely disseminated, liver, lung, kidney, lymph node,
adrenal. Adrenocortical adenoma.
Comment: Strange clinical signs of this ferret are attributed to
neoplastic infiltrates that occur in many organs. The most severely
involved organ is the liver. It appears that this ferret also had an
adrenal tumor that was secondarily infiltrated by neoplastic lymphocytes.
-----------------------------
Anyway, just sharing the final outcome...
-Pam S.
End of ferrethealth Digest
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