JPC SYSTEMIC PATHOLOGY

RESPIRATORY SYSTEM

September 2017

P-F04

 

Signalment (JPC # 1804208):  Pacific white-sided dolphin (Lagenorhynchus obliquidens)

HISTORY:  Unknown

HISTOPATHOLOGIC DESCRIPTION:  Lung:  Diffusely, bronchial, bronchiolar, and alveolar lumina and occasionally alveolar septa are filled or expanded by numerous extracellular and intrahistiocytic, spherical, 8-20 um diameter yeast that have a pale, amphophilic center, a thin, refractile wall, are surrounded by a clear, 5 um wide, non-staining capsule, and occasionally exhibit narrow based budding.   Approximately 20% of alveolar, bronchiolar, and bronchial lumina are filled with an exudate composed of numerous macrophages, viable and degenerate neutrophils, fewer lymphocytes and plasma cells, occasional multinucleated giant cell macrophages, and variable amounts of hemorrhage, fibrin, and edema. Alveolar septa are often expanded up to 3-5 times normal by macrophages, lymphocytes, plasma cells and few neutrophils and eosinophils, as well as hemorrhage, fibrin, edema, and congestion.  There is multifocal necrosis of alveolar septa, bronchioles, and bronchi, characterized by loss of cellular architecture and replacement by eosinophilic cellular and karyorrhectic debris.  Rarely, bronchial and bronchiolar epithelium is attenuated.  

Mucicarmine stain:  Diffusely, there is bright red staining of yeast capsules (carminophilia), and yeast occasionally exhibit narrow based budding.

MORPHOLOGIC DIAGNOSIS:  Lung:  Pneumonia, pyogranulomatous, diffuse, marked, with numerous carminophilic yeast, etiology consistent with Cryptococcus neoformans, Pacific white-sided dolphin (Lagenorhynchus obliquidens), cetacean.

ETIOLOGIC DIAGNOSIS:  Pulmonary cryptococcosis

CAUSE:   Cryptococcus neoformans 

SYNONYM:  European Blastomycosis

GENERAL DISCUSSION:

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ADDITIONAL DIAGNOSTIC TESTS: 

DIFFERENTIAL DIAGNOSIS:

COMPARATIVE PATHOLOGY:

 

Organism

Cryptococcus neoformans

Histoplasma capsulatum var. capsulatum

Coccidioides immitis

Blastomyces dermatiditis

Tissue response

Histiocytic; may be minimal

Histiocytic

Pyogranulomatous

Pyogranulomatous

Diameter (µm)

2-10

2-6

5-100

8-25

Location

Extracellular, rarely intracellular

Intracellular

Intra- or Extracellular

Intra- or Extracellular

Cell wall thickness

Thin

Thin

Thick

Thick

Number of nuclei

Single

Single

None

Multiple

Budding and attachment

Single bud; narrow-based

Single bud; narrow-based

None

Single-bud; broad-based

Capsule

Mucicarmine-positive

None

None

None

Endospores

None

None

Yes

None

Dimorphic

Yes

Yes

Yes

Yes

Common species affected

Cats

Dogs, cats

Many species

Dogs

Common sites affected

Lung, CNS

Lung, disseminated

Lung

Lung, skin, disseminated

Modified from Migaki G, Hubbard GB, Butler TM. Histoplasma capsulatum var. duboisii Infection, Baboon. In: Jones TC, Mohr U, Hunt RD, eds. Nonhuman Primates II: Monographs on Pathology of Laboratory Animals.  New York, NY:Springer-Verlag;1993:21

REFERENCES:

  1. Burek K. Cryptococcosis. In: Williams ES, Barker IK, eds., Infectious Diseases of Wild Mammals, 3rd ed. Ames, IA: Iowa State University Press; 2001:520-522.
  2. Calle PP, Joslin JO. New world and old world monkeys. In: Miller ER, Fowler ME eds. Fowler’s Zoo and Wild Animal Medicine. Vol 8. St. Louis, MO: Elsevier; 2015:319-329.
  3. Caswell JL, Williams KJ. Respiratory system. In: Maxie MG, ed., Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. Vol. 2. 6th ed., New York, NY: Elsevier Limited; 2016:582-583.
  4. Helke KL, Denver MC, Bronson E, Mankowski JL. Disseminated cryptococcosis in a guenon (Cercopithecus ascanius). Vet Pathol. 2006; 43:75.
  5. Jones TC, Hunt RD, King NW. Veterinary Pathology. 6th ed. Baltimore, MD: Williams & Wilkins; 1997:516-517.
  6. Lopez A, Martinson A. Respiratory system, Mediastinum and Pleurae. In: Zachary JF, ed. Pathologic Basis of Veterinary Disease. St. Louis, MO: Elsevier; 2017:524, 547, 550-551.
  7. Malik R, Krockenberger M, O’Brien CR, et al. Cryptococcosis. In: Greene CE ed. Infectious Diseases of the Dog and Cat. 3rd ed. St. Louis, MO: Elsevier Inc.; 2006:584-598.
  8. Martinez-Nevado E, et al. Atypical presentation of Cryptococcus neoformans in koala (Phascolarctos cinereus): A magnetic resonance imaging and computed tomography study. J Zoo Wildl Med. 2017; 48(1):250-254.
  9. McAdam AJ, Sharpe AH. Infectious diseases. In: Kumar V, Abbas AK, Fausto N, eds. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2015:384.
  10. Mcleland S, Duncan C, Spraker T, Wheeler E, Lockhart SR, Gulland F. Cryptococcus albidus infection in a California sea lion (Zalophus californianus). J Wildl Dis. 2012; 48(4):1030-1034.
  11. Miller WG, Padhye AA, Van Bonn W, Jensen E, Brandt ME, Ridgway SH. Cryptococcosis in a bottlenose dolphin (Tursiops truncates) caused by Cryptococcus neoformans var. gattii. J Clin Micro. 2002; 40:721-724.
  12. Osterholzer JJ, Surana R, Milam JE, et al. Cryptococcal urease promotes the accumulation of immature dendritic cells and a non-protective T2 immune response within the lung. Am J Pathol. 2009; 174:932-943.
  13. Rommel S, Lowenstine L. Gross and microscopic anatomy. In: Dierauf LA, Gulland FMD, eds. CRC Handbook of Marine Mammal Medicine. 2nd ed. Washington, D.C.: CRC Press; 2001:144.
  14. Trivedi SR, Sykes JE, Cannon MS. Clinical features and epidemiology of cryptococcosis in cats and dogs in California: 93 cases (1988–2010). J AmVet Med Assoc. 2011;239(3):357-369.
  15. Seixas F, Martins ML, Pinto ML, et al. A case of pulmonary cryptococcosis in a free-living toad (Bufo bufo). J Wildl Dis. 2008;44:460-463.
  16. Szymczak WA, Sellers RS, Pirofski LA. IL-23 dampens the allergic response to Cryptococcus neoformans through IL-17-independent and -dependent mechanisms.

    Am J Pathol. 2012;180(4):1547-1559.


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