Interpretation of liver biopsies

Percutaneous Ultrasound-guided Cholecystocentesis and Bile Analysis for the Detection of Platynosomum spp.-Induced Cholangitis in Cats

Background

Examination of bile could be useful to diagnose Platynosomum spp.‐induced cholangitis in cats. Obtaining bile via percutaneous ultrasound‐guided cholecystocentesis (PUC) is possible but raises safety concerns in cats with severe cholecystitis.

Objectives

The objectives of this study were to investigate the use of PUC to collect bile samples from cats with known platynosomosis and to determine if bile analysis could be a diagnostic test.

Animals

Twenty‐seven free‐roaming cats positive for Platynosomum spp. eggs via fecal examination.

Methods

In this prospective study, fecal egg counts were performed by double centrifugation with Sheather's solution. Bile was collected using PUC from anesthetized cats. Egg counts in bile were performed with a stereoscope. Euthanasia and postmortem examination were performed immediately after PUC.

Results

All cats had ultrasound (US) evidence of cholangitis or cholecystitis. Thirty‐nine PUCs were performed with 14 cats having 2 PUCs 12 or 24 days apart. Postmortem examinations showed no overt gallbladder damage or leakage but fresh blood was noted in the gallbladder lumen of 3 cats. Median Platynosomum spp. egg counts were higher in bile (1450 eggs/mL; IQR, 400; 5138 eggs/mL) as compared to feces (46 eggs/mL; IQR, 10; 107 eggs/mL) (P < .001).

Conclusion and Clinical Importance

Bile egg count analysis is an alternative method with higher egg counts as compared to fecal egg count analysis for the diagnosis of platynosomosis. Obtaining bile via US guidance is technically feasible and safe in cats with cholangitis/cholecystitis. Cholecystocentesis and bile analysis are especially relevant for those cats with chronic cholangitis/cholecystitis and negative fecal egg counts for Platynosomum.

Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990–2000)

OBJECTIVE

To evaluate the accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats.

DESIGN

Retrospective study.

ANIMALS

56 dogs and 41 cats.

PROCEDURE

Medical records of dogs and cats evaluated from 1990 to 2000 by use of cytologic and histopathologic examination of the liver were reviewed. Histologic and cytologic diagnoses were categorized as vacuolar hepatopathy, inflammation, neoplasia, cirrhosis, primary cholestasis, shunt, normal, and other.

RESULTS

Overall agreement between the histopathologic diagnosis and cytologic diagnosis was found in 17 of the 56 (30.3%) canine cases and 21 of the 41 (51.2%) feline cases. Vacuolar hepatopathy was the category with the highest percentage of agreement. Vacuolar hepatopathy was identified via cytologic examination in 7 of 11 and 15 of 18 dogs and cats, respectively, in which histopathologic examination revealed that it was the predominant disease process. However, it was also the category that was most commonly misdiagnosed via cytologic examination. Inflammatory disease was accurately identified cytologically in 5 of 20 and 3 of 11 dogs and cats, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Acknowledging the limitations of cytology and the extent of discrepancies between cytologic and histopathologic findings in dogs and cats will help clinicians make better decisions in diagnosing liver disease.

Biopsia hepática em cães: relação entre qualidade da amostra e grau de conclusão do diagnóstico

O presente estudo objetivou analisar a qualidade do diagnóstico de biopsias colhidas com agulhas tipo aspirativa e cortante, comparando-as ao exame histológico post-mortem do fígado de cães portadores de afecções hepáticas. Foram utilizados 60 cães, sem distinção de sexo, raça ou idade. As biopsias foram procedidas com agulhas tipo Menghini<FONT FACE=Symbol>Ò</FONT> (de natureza aspirativa) e agulhas tipo Tru-Cut<FONT FACE=Symbol>Ò</FONT> (de natureza cortante). As biopsias foram colhidas utilizando-se a técnica percutânea transabdominal. O diagnóstico referente à agulha tipo Tru-Cut<FONT FACE=Symbol>Ò</FONT> não diferiu do diagnóstico referente à agulha tipo Menghini<FONT FACE=Symbol>Ò</FONT>. O referente à agulha tipo Tru-Cut<FONT FACE=Symbol>Ò</FONT> foi o que apresentou maior índice de concordância, 88,3% de acertos. A agulha tipo Tru-Cut<FONT FACE=Symbol>Ò</FONT> apresentou excelentes resultados independente da natureza das lesões, enquanto que a agulha tipo Menghini<FONT FACE=Symbol>Ò</FONT> falhou nos casos de fibrose.

Comparison of liver cytology and biopsy diagnoses in dogs and cats: 56 cases

The results of liver cytology and corresponding biopsy specimens submitted to the Pathology Department at Angell Memorial Animal Hospital during 1998 were retrospectively reviewed to objectively assess the diagnostic value of liver cytology. A "corresponding" biopsy was defined as a biopsy specimen obtained within 1 day of the cytology specimen. Fifty-six cases were reviewed, including 25 from dogs and 31 from cats. Results were in complete agreement in 34 cases, in partial agreement in 11 cases, and in disagreement in 11 cases. Agreement occurred most often in cases of fatty change (10 cases) and neoplasia (7 cases of lymphoma and 3 cases of epithelial tumor). Disagreement was most common in cases of hepatitis (6 cases) in which inflammation was not seen in cytologic specimens. Other causes for disagreement included fibrosis (2 cases), and 1 case each of amyloidosis, hemangiosarcoma, and lymphoma. Three cytologic specimens were considered suggestive of hepatitis because of leukocytosis in the background, although clinicians were advised to compare cytologic observation to CBC results. Cytologic evaluation of the liver was useful for determining disease processes, especially when disease distribution was diffuse.

The influence of stomach volume on the liver topography in cats

The aim of this study has been to describe the effect of varying degrees of fullness of the stomach on liver topography in cats by means of the sectional anatomy of the abdominal cavity. Twenty-four adult healthy cats of both sexes and of different ages were used. The cats were divided into two groups. The first group had empty stomachs and the second group had filled stomachs. Eight cats were dissected. The remaining cats were frozen at - 20 degrees C, eight of these were then sectioned paramedially and the other eight were sectioned transversely. In the dissection and sections, it was observed that the liver shifted considerably to the right and craniodorsally in cats with full stomachs. In this article, the topographical anatomy of the liver according to varying stomach volumes is described in a manner that is useful to veterinary surgeons and clinicians. The sectional findings obtained from the paramedial and transverse sections provide information for computed tomography and magnetic resonance imaging.

Cell-mediated immune responses to liver membrane protein in canine chronic hepatitis

Peripheral blood mononuclear cells from dogs with chronic inflammatory liver disease and dogs with noninflammatory liver diseases were evaluated for proliferative responses to pokeweed mitogen and canine liver membrane protein. Dogs with chronic hepatitis were selected based on histopathological evidence of periportal lymphocytic infiltrates with or without neutrophilic infiltrates, fibrosis and necrosis. Incorporation of tritiated thymidine was assessed 72 hours after addition of liver membrane protein or pokeweed mitogen. Peripheral blood mononuclear cell proliferation in response to liver membrane protein was significantly higher in chronic hepatitis dogs compared to control dogs. Eight of 12 dogs with chronic hepatitis and 2 of 7 dogs with noninflammatory liver disease had proliferative responses to liver membrane protein greater than 2 standard deviations above the mean of the control group. These data support the hypothesis that immune-mediated processes are involved in canine chronic hepatitis, but did not determine whether this is a primary disorder or occurred secondary to liver destruction.