JPC SYSTEMIC PATHOLOGY
DIGESTIVE SYSTEM
September 2018
D-M07

SIGNALMENT (JPC #2372961):  Cat

HISTORY:  Found dead without any clinical signs with the exception of weight loss.

HISTOPATHOLOGIC DESCRIPTION:  Liver:  Diffusely and markedly expanding and bridging portal areas are high numbers of lymphocytes, fewer plasma cells, rare neutrophils and macrophagesthat separate and surround bile ducts and occasionally extend across the limiting plate and into adjacent sinusoids, where they separate and surround individual necrotic hepatocytes (piecemeal necrosis).  There is varying degrees of fibrosis within portal areas and it occasionally forms a thick band between portal areas and the limiting plate.  Adjacent hepatocytes are often pale, swollen, and vacuolated (degenerate), and rarely are individualized with bright eosinophilic cytoplasm and pyknotic nuclei (necrosis).  Bile duct epithelium is often pale with vacuolated cytoplasm and/or shrunken (degeneration) and there is distortion of bile ductule shape, associated with the surrounding lymphocytes.  Rarely within areas of inflammation there are nodules of lipid and pigment laden macrophages (lipogranulomas). Diffusely, there are increased numbers small bile ducts (biliary ductular reaction).  Centrilobular hepatocytes (lipofuscin) and Kupffer cells (hemosiderin or bile) often contain moderate amounts of granular to globular yellow-brown pigment. The margin of the liver has an undulant, rounded, lobular appearance.  The capsule is diffusely and markedly expanded by moderate amounts of clear space, with dilated portal lymphatics, (edema) and few previously described inflammatory cells.

MORPHOLOGIC DIAGNOSIS:  Liver:  Hepatitis, portal and bridging, lymphocytic, chronic, diffuse, severe, with biliary hyperplasia and fibrosis, breed unspecified, feline.

CONDITION:  Lymphocytic portal hepatitis

SYNONYMS:  Lymphocytic cholangitis; nonsuppurative cholangitis / cholangiohepatitis

GENERAL DISCUSSION:

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ADDITIONAL DIAGNOSTIC TESTS:

DIFFERENTIAL DIAGNOSES:

COMPARATIVE PATHOLOGY:

REFERENCES:

  1. Brown DL, Van Wettere AJ, Cullen JM. Hepatobiliary system and exocrine pancreas. In: Zachary JF, McGavin MD, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier; 2017:462.
  2. Crook EK, Carpenter NA. Acute lymphocytic cholangitis and liver failure in an Amur tiger (Panthera tigris altaica). J Zoo Wildl Med. 2014; 45(1):143-147.
  3. Cullen JM, Stalker MJ. Liver and biliary system. In: Maxie MG, ed. Jubb, Kennedy and Palmer’s Pathology of Domestic Animals. Vol 2. 6th ed. Philadelphia, PA: Elsevier; 2016:308.
  4. Harvey AM, Gruffydd-Jones TJ. Feline inflammatory liver disease. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat. Vol 2. 7th ed. Philadelphia, PA: Saunders; 2010:1643-8.
  5. van den Ingh TSGAM, Cullen JM, Twedt DC, Van Winkel T, Desmet VJ, Rothuizen J. Morphological classification of billiary disorders of the canine and feline liver. In: WSAVA Liver Standardization Group, eds. WSAVA Standards for Clinical and Histological Diagnosis of Canine and Feline Liver Diseases. Philadelphia, PA: Saunders; 2006:68-69.
  6. Warren A, Center S, McDonough S, et al. Hybridization in Cats With Lymphocytic Cholangitis/Cholangiohepatitis Histopathologic Features, Immunophenotyping, Clonality, and Eubacterial Fluorescence In Situ. Vet Pathol. 2011;48:627.


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