JPC SYSTEMIC PATHOLOGY

RESPIRATORY SYSTEM

September 2017

P-M08 (NP)

 

Signalment (D95-9535A):  A horse

HISTORY:  This horse had epistaxis; rhinoscopy revealed a mass in the left nostril and, a large reddish brown mass that appeared to compress the nasopharyngeal area was seen in the right nostril.

HISTOPATHOLOGIC DESCRIPTION:  Respiratory epithelium and submucosa:  The submucosa is expanded and mucosa is elevated by a polypoid mass composed of numerous macrophages and multinucleated giant cells (both foreign-body and Langhan"s type), moderate numbers of lymphocytes and plasma cells, admixed with hemorrhage, fibrin, and ectatic lymphatics (edema), and multifocal increased numbers of small to medium caliber vessels (neovascularization).  Many giant cells and macrophages contain abundant golden-yellow granular pigment (hemosiderin/hemotoidin) and there are large, extracellular globular aggregates of yellow hematoidin pigment (ceroid sequins). There are multifocal small aggregates of deeply basophilic, finely granular pigment (mineralization). There is a focally extensive area (5 x 0.5 mm) within the submucosa composed of thin trabeculae of woven bone oriented perpendicular to the mucosal surface (periosteal proliferation of a turbinate) surrounded by numerous osteoblasts and separated by loose fibrous connective tissue.  Multifocally, the overlying respiratory epithelium is ulcerated or mildly thickened (hyperplasia). 

MORPHOLOGIC DIAGNOSIS:  Nasal mucosa:  Polyp, fibrovascular, with hemorrhage, hemosiderosis, hematoidin (‘ceroid sequins’) and granulomatous inflammation (ethmoid hematoma), breed not specified, equine.

CONDITION:  Ethmoid hematoma

SYNONYMS:  Progressive hematoma; progressive ethmoid hematoma (PEH); hemorrhagic nasal polyp

GENERAL DISCUSSION: 

PATHOGENESIS: 

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS: 

TYPICAL LIGHT MICROSCOPIC FINDINGS: 

DIFFERENTIAL DIAGNOSIS:

Diseases that can cause blood-stained nasal discharge:

COMPARATIVE PATHOLOGY: 

REFERENCES: 

  1. Caswell JL, Williams KJ. Respiratory system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. Vol 2. 6th ed. Philadelphia, PA: Elsevier; 2016:477.
  2. Lopez A, Martinson SA. Respiratory system. In: McGavin MD, Zachary JF, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Mosby; 2016:495-496.
  3. Pascoe JR. Ethmoid hematoma. In: Smith BP, ed. Large Animal Internal Medicine. 5th ed. St. Louis, MO: Mosby; 2015:561-562.
  4. Wilson DW. Tumors of the respiratory tract. In: Meuten DJ, ed. Tumors in Domestic Animals. 5th ed. Ames, IA: Iowa State Press; 2017:474.


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