From:
"Ulrike"
Date: 2009-01-08 21:08:35 UTC
Subject: [ferrethealth] Piper- Lymphoma (Lymphosarcoma), immunoblastic-polymorphous type
To: "FHL" <ferrethealth@yahoogroups.com>
I wrote about Piper the "gravely ill ferret" (
http://ferrethealth.org/archive/FHL6986 ) and wanted to update it. The
histopathology report came back saying she had Lymphoma (Lymphosarcoma),
immunoblastic-polymorphous type. Before I recap, could this have been
caused by her going through an old sooty oil boiler/ furnace pipe? She
escaped from our garden 13 or 14 months before she died and came back
covered in soot, we only later found out that she managed to get out of the
garden and must have gone through the old boiler pipe that was at the front
of the house... Of course I washed her straight away when she came back in
but maybe she ingested some or absorbed some toxin through her skin? She
never acted sick by the way. I'm just wondering now whether the cancer
could be genetic or may have been caused by the soot in some way.
To recap her illness, Monday evening (01/12/08) she acted like she was in
pain. By Wednesday she was put on Buprenorphine, had a dexamethasone and
Baytril shot and had blood taken for a blood test. Friday she had an x-ray
taken which showed oedema, and coupled with bad blood test results and the
way she had deteriorated, she was put to sleep.
Her post mortem pictures, blood test results, and histopathology report are
on this page:
http://www.ferretlove.co.uk/piperpm.htm
but I'll copy them at the end of this post, too.
Ulrike
**************************************************************************************
[Moderator's Reminder to people in the U.S.:
Remember that the U.S. uses a different measurement
system than most countries and that Uli is in the UK
so do not assume that the numbers mean the same things
as they would for testing here.]
Piper's blood test results
Haematology
RBC 9.85 x10^12/L (7.5-11.9)
Hb 17.2 g/dl (12-20.8)
HCT 56.2 % (36-68)
MCV 57 fl (42.4-88.4)
MCH 17.5 pg (15-20)
MCHC 30.6 g/dl (26.2-38.6)
Platelets 258 x10^9/L (180-800)
WBC 2.49 x10^9/L (3.5-7) *** LOW ***
Neutrophils 70 % 1.74 x10^9/L (1.9-5.9)
Lymphocytes 30% 0.75 x10^9/L (1.7-2.9) *** LOW ***
Monocytes 0% 0.00 x10^9/L
Eosinophils 0% 0.00 x10^9/L (0-0.35)
Basophils 0% 0.00 x10^9/L
Blood film examination: 2 fresh blood smears and a film made from the
submitted EDTA were examined. Red cells appear normocytic and normochromic.
Moderate lymphopaenia with no abnormal cells seen. All other leucocytes
appear of normal morphology. Platelet count and morphology appear normal
with occasional platelet clumps in the tail of the EDTA smear.
Biochemistry
Total protein 41 g/L (53-72) *** LOW ***
Albumin 18 g/L (33-44) *** LOW ***
Globulin 23 g/L
Albumin Globulin ratio 0.8
Sodium 137 mmol/l
Potassium 6.2 mmol/l
Total calcium 1.25 mmol/l (2-2.95) *** LOW***
Phosphate 3.2 mmol/l (1.3-2.9) *** HIGH ***
Urea 25.5 mmol/l (3.6-16) *** HIGH ***
Creatinine 67 umol/l (35-80)
Alk Phos 37 U/L (30-120)
ALT 161 U/L
Bile Acids 19.3 umol/l
Glucose 7.9 mmol/l (3.4-7.4) *** HIGH ***
Clinical comments:
Hypoproteinaemic and hypoalbuminaemic.
May(?) reflect malnutrition/ failure to absorb/ failure to process protein
(liver) or(?) excess loss (gut/ kidney).
Hypocalcaemia may be due to malabsorption or just reflect the
hypoproteinaemia.
The(?) urea is very high. In the absence of a high creatinine, this could be
pre-renal (I would check cardiac function but should also consider gut
disease or(?) a generalised catabolic state) but it is high enough not to
rule out renal failure.
(The ? are by words that were somewhat cut off on the copy of the report.)
**************************************************************************************
Piper's histopathlogy report
Diagnosis
Lymphoma (Lymphosarcoma)
Prognosis
Not Applicable
Post-mortem tissues from a ferret: multiple samples received; heart
evaluated grossly and 23 sections of various tissues including heart
evaluated histologically.
GROSS FINDINGS.
Heart. Evaluation of the formalin-fixed heart revealed a focal tan
thickening of the base of the left ventricular free wall. The ratio of the
ventricular septal diameter to the diameter of the right ventricular free
wall was approximately 2.75 : 1.
HISTOLOGICAL FINDINGS.
Tissues generally show moderate autolysis, which has hindered interpretation
of some tissues.
Heart. Extensively in the wall of the left ventricle near the
atrioventricular junction, extensively in the papillary muscles, and to a
lesser extent in the right ventricular free wall and elsewhere in the
myocardium, myocardiocytes are disrupted by an interstitial infiltrate of
round cells. These vary somewhat in size but tend to have scanty cytoplasm,
large oval nuclei and prominent nucleoli. In a few areas where the cells are
better preserved, mitotic figures are recognizable at approximately 3 per
400x field. Intervening myocardiocytes are sometimes hypereosinophilic with
condensed nuclei and are surrounded by minor haemorrhage (necrosis; possibly
infarcts). Rarely, rafts of similar round cells are present in the lumens of
myocardial blood vessels.
Lung. Around most interstitial blood vessels and around airways, there are
nodular clusters and sheets of round cells similar to those in the heart.
These frequently and extensively infiltrate bronchial epithelium
(epitheliotropism). In the alveoli, similar cells are present and are
sometimes intermingled with bizarre multinucleate giant cells. There is
generalized moderate oedema.
Mediastinal Lymph Node. Adjacent to the lung, a node is overrun by similar
round cells. There are zones of necrosis, along with some infiltration by
spindle cells. Dense rafts of similar round cells plug lymphatic vessels in
adjacent adipose tissue.
Unspecified Lymph Nodes. Lesions are similar to those in the mediastinal
node, described above.
Spleen. Focally extensively, similar round cells expand the red pulp.
Adjacent to these are zones of necrosis and haemorrhage (infarction).
Elsewhere, there is prominent extramedullary haematopoiesis.
Stomach and Small Intestine. No lesions are recognized.
Pancreas. Round cells similar to those described above from the presumed
pancreatic lymph node spill out into adjacent adipose tissue and locally
infiltrate the pancreatic interstitium. Otherwise no lesions are visible.
Liver. Multifocally and apparently randomly, clusters of similar round cells
disrupt and replace hepatic parenchyma. There is moderate, generalized
congestion.
Kidney. Occasionally, radiating wedges of fibrocollagenous connective tissue
with clusters of small mononuclear leucocytes including some recognizable
plasma cells extend from the medulla to the cortex. Entrapped glomeruli are
sometimes sclerotic and entrapped tubules sometimes contain proteinaceous
casts. Elsewhere, renal tubular epithelial cells contain brown pigment
(possibly bile).
Adrenal Glands. Both glands are largely replaced by similar round cells,
with remnant islands of cortical and medullary tissue. Some zones of
necrosis, haemorrhage and fibrosis are also present.
Vulva. In the dermis / lamina propria, there are dense nodular aggregates of
round cells similar to those described above. There is mild congestion.
DIAGNOSIS:
Lymphoma, immunoblastic-polymorphous type
COMMENTS:
This ferret had malignant lymphoma (lymphosarcoma), which had infiltrated
most organs, including the heart and the vulva. Lymphoma is the cause of
death.
Lymphoma is a fairly common malignancy in ferrets. This neoplasm takes
several different forms in this species, and the immunoblastic-polymorphous
variant is relatively uncommon. All of the systemic forms behave similarly
though, and for the most part result in rapid metastasis and death. It is
common for clinical signs to arise suddenly, as in this case. Any temporal
link to clinical treatment or to the history of dental surgery is
coincidental. Lymphoma in ferrets carries a poor prognosis and is rarely
responsive to chemotherapy. Earlier diagnosis would almost certainty not
have changed the outcome.
This ferret also had mild to moderate, chronic interstitial nephritis, a
common lesion in middle-aged ferrets. There is some evidence of renal
protein loss, which might account for some of your clinical test results.
Nevertheless, this lesion does not appear severe enough to have led to renal
failure and is not the primary cause of illness or death.
------------------------------------
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