Ok ya'll I need help in understanding this I was aware of three liver nodules that were found by A & M in Dec 2007 during her ultrasound Looks like there were more. I got a creepy sad feeling reading this as my girl was being dissected! How I miss her. I have asked Dr B to send me the discharge summary as to what tests were performed The Dr's are scratching their head as the Snap CPL was positive for pancreatitis and the necropsy shows that she didn't have Too many big words for me Can someone explain?
NECROPSY REQUEST
CLINICAL DIAGNOSIS:
None.
HISTORY:
Long-term history of Cushing’s disease, diabetes mellitus, hypothyroidism, and pancreatitis. Recently diagnosed w/ iatrogenic
Addison’s disease. Presented 10/20/08 for vomiting, anorexia, and pain.
Received supportive care while hospitalized. The patient demonstrated neurological signs in the hospital (anxiety, circling,
pacing). Owners elected humane euthanasia.
*Specific questions related to Pebbles’ case:*
1. R/O neurological disease - macroadenoma, thrombotic, inflammation.
2. Is there evidence of pancreatitis?
3. State of endocrine glands.
CLINICAL QUESTIONS:
HOLD FOR PRIVATE CREMATION - LIVE OAKS.
NECROPSY GROSS REPORT
ANIMAL IDENTIFICATION:
A 24.14 kg (53 lb.), 10-year-old, spayed female, black and white, Siberian Husky, in good body condition is presented for
necropsy on October 23, 2008.
POSTMORTEM ANALYSIS AND DIAGNOSIS:
The cause of death is euthanasia. Presumably the clinical history is explained by a functional pituitary gland adenoma noted.
Changes described in pancreas, liver, gallbladder and costochondral junctions, are common age-related findings in dogs. No
evidence of pancreatitis is observed. The fracture of the medial coronoid processes is an incidental finding. Histopathology of
selected tissues is pending.
GROSS DIAGNOSIS:
Pituitary gland adenoma with thalamic compression.
SYSTEM FINDINGS:
INTEGUMENTARY AND SPECIAL SENSES: Shaved areas include a 7cm and a 5cm circumferential band proximal to the right
and left elbow, respectively. The hair coat over the lateral aspect of the thorax and abdomen has diffuse patchy alopecia
(endocrine alopecia).
RESPIRATORY: A 1 x 2.5cm, well demarcated white area, is on the pleural surface of the middle lobe of the right lung and
does not extend into the underlying parenchyma (focal pleural fibrosis).
URINARY (Right kidney: 58g; left kidney: 62g): Three, slightly depressed, irregularly marginated areas ranging from 3 x 2mm
to 4 x 7mm are scattered on the surface of the cortex of the left kidney (scarring retraction).
LIVER AND PANCREAS (Liver: 1.4kg): White, moderately firm nodules, 1 to 2mm diameter, are scattered throughout the
pancreatic parenchyma (multiple adenomas/nodular hyperplasia). The liver is mildly enlarged with a mild enhancement of the
lobular pattern (hepatocellular vacuolar degeneration, presumed). A 3cm diameter, tan, raised, moderately firm nodule is on
the visceral aspect of the distal portion of the left lateral liver lobe. On cut surface, the nodule blends into and resembles
the liver parenchyma (hepatoma/nodular hyperplasia). Similar nodules, approximately 0.6cm diameter, are scattered
throughout the liver parenchyma. The mucosal surface of the gallbladder has three, 2 to 3mm diameter, multinodular,
exophytic proliferations (cystic mucoid biliary hyperplasia).
DIGESTIVE: A moderate amount of tan, roughened, gritty plaque covers the upper and lower premolar and molar teeth and
the related gingiva is diffusely reddened (dental tartar with mild periodontal disease).
ENDOCRINE: Bilaterally, the adrenal glands have increased cortex to medulla ratio, approximately 3:1 (bilateral adrenal
cortical hyperplasia).
MUSCULOSKELETAL: The cartilage portion at the costochondral junctions contains a tan gritty core (mineralization of the
costochondral junction). Bilaterally, the medial coronoid process of the ulna is separated from the articular surface forming
two fragments (6 x 8 x 3mm -left elbow and 4 x 5 x 2mm right elbow) (bilateral, medial coronoid process fractures). The
borders of the proximal articular surfaces of the radius and ulna are mildly roughened and the articular cartilage of the medial
condyle of the humerus is slightly eroded (bilateral degenerative joint disease secondary to fracture of the medial coronoid
processes).
NERVOUS (Brain: 88g): A tan, multinodular, mottled dark red/yellow, approximately 1.5 x 0.8 cm extension from the pituitary
from the sella turcica with a slightly right lateral orientation (pituitary gland adenoma). The overlying brain parenchyma
appears slightly depressed (brain atrophy secondary to the compressive neoplasm).
CARDIOVASCULAR (Heart: 164g; left ventricular free wall 1.5 cm wide; right ventricular free wall 0.5 cm wide), HEMIC AND
LYMPHATIC (Spleen 94g), GENITAL: No significant lesions observed.
NECROPSY HISTOPATHOLOGY REPORT
MICROSCOPIC LESIONS:
Pituitary gland: Adenoma of the pars intermedia with acute, massive coagulative necrosis (ischemia presumed).
Brain (thalamic region overlying the pituitary tumor): Moderate, subacute, locally extensive necrosis with multifocal
hemorrhage and focal lymphohistiocytic encephalitis.
Adrenal gland: Moderate, diffuse hyperplasia of the zona fasciculata and reticularis.
Thyroid gland: Endocytotic activity is not apparent.
Kidney: Moderate, chronic, multifocal to locally extensive, lymphoplasmacytic interstitial nephritis with interstitial and
glomerular fibrosis and mild tubular necrosis.
Liver, parathyroids: No significant lesion observed.
INTERPRETIVE DIAGNOSIS:
Pituitary gland adenoma.
INTERPRETIVE SUMMARY:
Histopathology confirms the gross diagnosis of pituitary gland adenoma with thalamic compression. Bilateral adrenal
hyperplasia is associated with the pituitary neoplasm. The compression necrosis of the thalamic region overlying the pituitary
tumor that could eventually explain the neurologic signs. No microscopic evidence of pancreatitis is observed in the sections
examined. The thyroid gland does not show appreciable endocytotic activity suggesting a decreased functionality of the
gland. Support for this should be sought by laboratory measurement of thyroid hormones. Parathyroids are unremarkable.
COMMENTS:
The Pathology data on the VMIS may be used freely, within the Texas A&M Veterinary Medical Teaching Hospital and College
of Veterinary Medicine, for clinical or academic/research purposes. Dissemination of this information to external parties, by
means of publications, grants, and seminars, for example, is prohibited without prior approval of the Pathologist of Record.
NECROPSY REQUEST
CLINICAL DIAGNOSIS:
None.
HISTORY:
Long-term history of Cushing’s disease, diabetes mellitus, hypothyroidism, and pancreatitis. Recently diagnosed w/ iatrogenic
Addison’s disease. Presented 10/20/08 for vomiting, anorexia, and pain.
Received supportive care while hospitalized. The patient demonstrated neurological signs in the hospital (anxiety, circling,
pacing). Owners elected humane euthanasia.
*Specific questions related to Pebbles’ case:*
1. R/O neurological disease - macroadenoma, thrombotic, inflammation.
2. Is there evidence of pancreatitis?
3. State of endocrine glands.
CLINICAL QUESTIONS:
HOLD FOR PRIVATE CREMATION - LIVE OAKS.
NECROPSY GROSS REPORT
ANIMAL IDENTIFICATION:
A 24.14 kg (53 lb.), 10-year-old, spayed female, black and white, Siberian Husky, in good body condition is presented for
necropsy on October 23, 2008.
POSTMORTEM ANALYSIS AND DIAGNOSIS:
The cause of death is euthanasia. Presumably the clinical history is explained by a functional pituitary gland adenoma noted.
Changes described in pancreas, liver, gallbladder and costochondral junctions, are common age-related findings in dogs. No
evidence of pancreatitis is observed. The fracture of the medial coronoid processes is an incidental finding. Histopathology of
selected tissues is pending.
GROSS DIAGNOSIS:
Pituitary gland adenoma with thalamic compression.
SYSTEM FINDINGS:
INTEGUMENTARY AND SPECIAL SENSES: Shaved areas include a 7cm and a 5cm circumferential band proximal to the right
and left elbow, respectively. The hair coat over the lateral aspect of the thorax and abdomen has diffuse patchy alopecia
(endocrine alopecia).
RESPIRATORY: A 1 x 2.5cm, well demarcated white area, is on the pleural surface of the middle lobe of the right lung and
does not extend into the underlying parenchyma (focal pleural fibrosis).
URINARY (Right kidney: 58g; left kidney: 62g): Three, slightly depressed, irregularly marginated areas ranging from 3 x 2mm
to 4 x 7mm are scattered on the surface of the cortex of the left kidney (scarring retraction).
LIVER AND PANCREAS (Liver: 1.4kg): White, moderately firm nodules, 1 to 2mm diameter, are scattered throughout the
pancreatic parenchyma (multiple adenomas/nodular hyperplasia). The liver is mildly enlarged with a mild enhancement of the
lobular pattern (hepatocellular vacuolar degeneration, presumed). A 3cm diameter, tan, raised, moderately firm nodule is on
the visceral aspect of the distal portion of the left lateral liver lobe. On cut surface, the nodule blends into and resembles
the liver parenchyma (hepatoma/nodular hyperplasia). Similar nodules, approximately 0.6cm diameter, are scattered
throughout the liver parenchyma. The mucosal surface of the gallbladder has three, 2 to 3mm diameter, multinodular,
exophytic proliferations (cystic mucoid biliary hyperplasia).
DIGESTIVE: A moderate amount of tan, roughened, gritty plaque covers the upper and lower premolar and molar teeth and
the related gingiva is diffusely reddened (dental tartar with mild periodontal disease).
ENDOCRINE: Bilaterally, the adrenal glands have increased cortex to medulla ratio, approximately 3:1 (bilateral adrenal
cortical hyperplasia).
MUSCULOSKELETAL: The cartilage portion at the costochondral junctions contains a tan gritty core (mineralization of the
costochondral junction). Bilaterally, the medial coronoid process of the ulna is separated from the articular surface forming
two fragments (6 x 8 x 3mm -left elbow and 4 x 5 x 2mm right elbow) (bilateral, medial coronoid process fractures). The
borders of the proximal articular surfaces of the radius and ulna are mildly roughened and the articular cartilage of the medial
condyle of the humerus is slightly eroded (bilateral degenerative joint disease secondary to fracture of the medial coronoid
processes).
NERVOUS (Brain: 88g): A tan, multinodular, mottled dark red/yellow, approximately 1.5 x 0.8 cm extension from the pituitary
from the sella turcica with a slightly right lateral orientation (pituitary gland adenoma). The overlying brain parenchyma
appears slightly depressed (brain atrophy secondary to the compressive neoplasm).
CARDIOVASCULAR (Heart: 164g; left ventricular free wall 1.5 cm wide; right ventricular free wall 0.5 cm wide), HEMIC AND
LYMPHATIC (Spleen 94g), GENITAL: No significant lesions observed.
NECROPSY HISTOPATHOLOGY REPORT
MICROSCOPIC LESIONS:
Pituitary gland: Adenoma of the pars intermedia with acute, massive coagulative necrosis (ischemia presumed).
Brain (thalamic region overlying the pituitary tumor): Moderate, subacute, locally extensive necrosis with multifocal
hemorrhage and focal lymphohistiocytic encephalitis.
Adrenal gland: Moderate, diffuse hyperplasia of the zona fasciculata and reticularis.
Thyroid gland: Endocytotic activity is not apparent.
Kidney: Moderate, chronic, multifocal to locally extensive, lymphoplasmacytic interstitial nephritis with interstitial and
glomerular fibrosis and mild tubular necrosis.
Liver, parathyroids: No significant lesion observed.
INTERPRETIVE DIAGNOSIS:
Pituitary gland adenoma.
INTERPRETIVE SUMMARY:
Histopathology confirms the gross diagnosis of pituitary gland adenoma with thalamic compression. Bilateral adrenal
hyperplasia is associated with the pituitary neoplasm. The compression necrosis of the thalamic region overlying the pituitary
tumor that could eventually explain the neurologic signs. No microscopic evidence of pancreatitis is observed in the sections
examined. The thyroid gland does not show appreciable endocytotic activity suggesting a decreased functionality of the
gland. Support for this should be sought by laboratory measurement of thyroid hormones. Parathyroids are unremarkable.
COMMENTS:
The Pathology data on the VMIS may be used freely, within the Texas A&M Veterinary Medical Teaching Hospital and College
of Veterinary Medicine, for clinical or academic/research purposes. Dissemination of this information to external parties, by
means of publications, grants, and seminars, for example, is prohibited without prior approval of the Pathologist of Record.
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