Nonlymphomatous hepatobiliary masses in cats: 41 cases (1972 to 1991)

Clinical impact of near-infrared fluorescence imaging with indocyanine green on surgical treatment for hepatic masses in dogs

BACKGROUND

Near-infrared fluorescence imaging using indocyanine green (ICG) is clinically applied to intraoperatively identify hepatic masses in humans. In addition, it is reported to be effective for assessing complete resection in human hepatocellular carcinoma (HCC). However, there is limited information on ICG fluorescence imaging for canine HCC, and its clinical usefulness is still unclear. Therefore, the purpose of this study was to evaluate the intraoperative identification and status of surgical margin for canine hepatic masses using near-infrared ICG fluorescence imaging. This clinical study included 104 dogs with hepatic masses. Between 12 and 24 h prior to surgery, ICG solution was injected intravenously at a dose of 0.5 mg/kg. The fluorescence intensity and pattern of each hepatic mass was investigated using an infrared camera before resection. After resection, the fluorescence intensity of the resection margin was also investigated. The resected masses were histopathologically diagnosed and compared using ICG fluorescence imaging.

RESULTS

One hundred and twenty-two masses obtained from 104 dogs included 76 HCCs, 16 hepatocellular adenomas, 12 focal nodular hyperplasias, and 18 other lesions. Of the 122 masses, 106 (94 partial, 9 whole, and 3 ring fluorescence patterns), 7, and 9 masses showed increased, the same, or decreased fluorescence compared to the normal liver tissue, respectively. The fluorescence intensity and pattern were not significantly related to the histopathological diagnosis. The sensitivity and specificity of the margin evaluation in the 47 dogs were 100% and 77.3%, respectively. The median survival times in cases of HCC with complete and incomplete resection were 914 and 254 days, respectively. The median survival time of patients with a complete resection was significantly longer than that of patients with a incomplete resection (p = 0.043).

CONCLUSION

ICG fluorescence imaging has potential clinical value for the identification and margin evaluation of canine hepatic masses. Although it is difficult to use fluorescence imaging for the differential diagnosis of liver tumours, it may be useful for assessing complete resection in cases of hepatic masses demonstrating increased fluorescence in dogs, and complete resection of HCC could have a survival benefit.

Severe pericardial effusion in a cat with peritoneopericardial diaphragmatic hernia and incarcerated hepatic sarcoma

Case summary

A 4-year-old female neutered domestic longhair cat was presented at a referral hospital for dyspnoea with a history of suspected pleural effusion. Thoracic ultrasonography demonstrated a large-volume pericardial effusion causing cardiac tamponade and a cystic mass within the pericardium. CT revealed a peritoneopericardial diaphragmatic hernia (PPDH) caused by a defect of the ventral diaphragm. Herniated contents consisted of the right lateral and caudate liver lobes, and an associated cystic hepatic mass. Ventral midline coeliotomy was performed for herniorrhaphy and partial pericardiectomy, together with lobectomy of the incarcerated liver mass. Histopathology and immunohistochemistry diagnosed a poorly differentiated hepatic sarcoma with inflammation and remodelling in the adjacent incarcerated liver parenchyma. The patient developed metastatic sarcoma 2 months after surgery and was euthanased as a result.

Relevance and novel information

Pericardial effusion causing cardiac tamponade is a previously unreported sequelae to PPDH in cats. Reports on the presence of malignancy in incarcerated liver are scarce and the location is not typical for a sarcoma in this species.

Gallbladder and Liver Lobe Torsion in a Young Cat Presented with Hemoabdomen

An 11 mo old domestic shorthair presented with acute lethargy. The cat was hypothermic and bradycardic and had pale pink mucous membranes, poor pulses, and a distended abdomen. Point-of-care ultrasound identified significant abdominal effusion, which was diagnosed to be a hemoabdomen. Bloodwork revealed hyperlactatemia, regenerative anemia, neutrophilia, hypoproteinemia, hypoalbuminemia, and increased alanine aminotransferase. The cat received an allotransfusion and a subsequent canine xenotransfusion and received further supportive therapy. After stabilization, abdominal ultrasonography diagnosed a gallbladder and liver lobe torsion with hemoabdomen. Exploratory laparotomy confirmed the torsion of the right medial and quadrate hepatic lobes together with the gallbladder. Cholecystectomy and lobectomy of the affected lobes were performed using a surgical stapler. The cat was discharged after 4 days. Histopathology confirmed hemorrhagic infarction of the liver lobes and gallbladder, consistent with the described torsion, and the hepatic pseudocyst. It also demonstrated a mucocele in the gallbladder. One month postoperatively, the cat had totally recovered. Hepatic lobe torsion without neoplasia is a rare disease in cats, with variable clinical signs. Gallbladder torsion is a hitherto unreported condition in cats. This is the first report of gallbladder and liver lobe torsion with secondary hemoabdomen in a cat, successfully treated by one-stage surgery.

Gallbladder adenoma in a domestic shorthair cat

A 13-year-old neutered female domestic shorthair rescue cat presented asymptomatically with raised hepatic enzymes following a routine pre-anaesthetic blood test. Cholangitis was suspected, and supportive treatment with 2 weeks of amoxicillin–clavulanic acid and 4 weeks of ursodeoxycholic acid and S-adenosylmethionine was trialled, with no improvement in biochemistry parameters. Clinicopathological investigations also revealed a markedly raised total bilirubin and abnormal bile acid stimulation test. Abdominal ultrasonography revealed pathological changes in the gallbladder, hepatomegaly with increased echogenicity and markedly thickened common bile duct walls. An exploratory laparotomy was performed revealing a grossly abnormal gallbladder with a small rupture at the dorsal fundus, which was managed via cholecystectomy. Pancreatic and hepatic biopsies were collected concurrently. Histopathology from the submitted samples revealed a gallbladder adenoma, chronic neutrophilic cholangitis and nodular hyperplasia of the pancreas. Culture of the gallbladder bile was negative but may be attributable to the initial treatment with antibiosis. At the time of writing, 5 months postoperatively, the cat had recovered well and remained asymptomatic and clinically healthy, but hepatic enzymes and bilirubin were only mildly reduced from the preoperative levels, despite the cat remaining clinically normal.

Hepatocyte ploidy in cats with and without hepatocellular carcinoma

BACKGROUND

Domestic cats rarely develop hepatocellular carcinoma. The reason for the low prevalence is unknown. Reductions in hepatocellular ploidy have been associated with hepatic carcinogenesis. Recent work in mice has shown that livers with more polyploid hepatocytes are protected against the development of hepatocellular carcinoma. Hepatocyte ploidy in the domestic cat has not been evaluated. We hypothesized that ploidy would be reduced in peri-tumoral and neoplastic hepatocytes compared to normal feline hepatocytes. Using integrated fluorescence microscopy, we quantified the spectra of ploidy in hepatocellular carcinoma and healthy control tissue from paraffin embedded tissue sections.

RESULTS

Feline hepatocytes are predominantly mononuclear and the number of nuclei per hepatocyte did not differ significantly between groups. Normal cats have a greater number of tetraploid hepatocytes than cats with hepatocellular carcinoma.

CONCLUSIONS

Total hepatocellular polyploidy in normal cat liver is consistent with values reported in humans, yet cellular ploidy (nuclei per cell) is greater in humans than in cats. Tetraploid cat hepatocytes are predominantly mononuclear.

The cytologic features of biliary diseases: A retrospective study

BACKGROUND

Histologic examination, together with clinical data and instrument support, contributes to the recognition of biliary diseases. Although quantitative and qualitative changes in hepatic and biliary cells can occur, descriptions of cytologic samples from the liver affected by cholangiopathies are rare.

OBJECTIVES

This study aimed to describe the quantitative and qualitative changes in cholangiocytes, hepatocytes, and inflammatory cells in cytologic samples from dogs and cats affected by histologically confirmed cholangiopathies.

METHODS

Cytologic samples from the liver with histologically confirmed cholangiopathies were reviewed and compared to describe the changes seen on cytology. The samples were obtained from the Archive of Clinica Veterinaria Sant'Antonio and the Laboratorio Veterinario Bresciano. Statistical analysis was not performed.

RESULTS

A total of 196 cytologic samples retrieved from the database fit the selection criteria, 88 from dogs, and 108 from cats. A total of eight categories of cholangiopathies have been identified and described, while histology is often required to achieve a definitive diagnosis, six categories of cholangiopathy in dogs and seven in cats provide cytologic information.

CONCLUSIONS

Cytologic examination, together with clinical and ultrasonographic data, can be useful for identifying hepatic abnormalities in acute and chronic cholestasis, chronic cholangitis, feline lymphoplasmacytic cholangitis, and cholangiocellular neoplasms.

Primary hepatic neoplasms in cattle

ABSTRACT: Primary hepatic neoplasms are mostly detected in cattle as incidental findings in slaughterhouses or diagnosed at the necropsy, wherein it may be related to the cause of death. A proper characterization of primary hepatic neoplasms is essential to provide an accurate diagnosis, especially at the slaughter lines, in order to reduce erroneous condemnations. This work aimed to characterize the gross, histological, and immunohistochemical features of primary liver neoplasms detected in slaughtered cattle in Southern Brazil. Nineteen primary hepatic neoplasms were identified. Grossly, these lesions were classified according to their distribution, as focal, multifocal, or diffuse. Histologically, the shape and arrangement of the cells, as well as possible malignant features were evaluated. Immunohistochemistry (IHC) was also performed for biliary epithelium (anti-CK7) and hepatocytes (anti-Hep Par-1) markers. Hepatocellular carcinoma (84.2%) was the most frequently detected hepatic neoplasm, followed by cholangiocarcinoma (15.8%), and these were only identified in adult cows. Hepatocellular carcinomas occurred as solitary masses or multifocal nodules, which on the cut surface were often green. Cholangiocarcinomas occurred as multifocal nodules, occasionally showing an umbilicated appearance. Histologically, hepatocellular carcinomas had mostly trabecular and solid patterns, while cholangiocarcinomas presented mostly a solid arrangement. Upon IHC, all hepatocellular carcinomas were immunolabeled for anti-Hep Par-1, ranging from mild (25%), moderate (31.2%) to marked (43.7%), while immunolabeling for anti-CK7 was detected only in one case of cholangiocarcinoma.

Retrospective study of the relative frequency of feline hepatobiliary disease in New Zealand based on 10 years of hepatic biopsy samples

Aims

To retrospectively determine the relative frequency of feline hepatobiliary diseases from biopsy specimens submitted to a single laboratory across a 10-year period and to establish whether age, sex or breed associations exist.

Methods

Histopathological data from 154 liver biopsies of New Zealand cats sampled between 2008 and 2018 were analysed. The samples were allocated to primary, secondary and tertiary disease categories using criteria established by the World Small Animal Veterinary Association. Breed associations were derived using ORs and 95% CIs. Gender and age associations were also evaluated.

Results

The most frequently diagnosed hepatobiliary diseases were lymphocytic cholangitis (20 per cent), hepatitis (16.9 per cent), reversible hepatocellular injury (16.4 per cent), neutrophilic cholangitis (9.7 per cent), haematopoietic neoplasia (9.7 per cent), hepatocellular neoplasia (5.6 per cent) and cholangiocellular neoplasia (4.1 per cent). Burmese cats were found to be at significantly increased risk of both biliary and parenchymal diseases and Birman cats to be at significantly increased risk of parenchymal disease. Domestic longhair cats were at significantly increased risk of hepatobiliary neoplasia. Birman cats were at significantly increased risk of hepatitis while domestic shorthair cats were at significantly decreased risk of neutrophilic cholangitis, reversible hepatocellular injury and hepatitis.

Conclusions

This study is the first retrospective examination of the relative frequency of hepatobiliary disease in biopsy specimens from New Zealand cats. Some breeds were associated with specific histopathology.

Feline abdominal ultrasonography: what's normal? what's abnormal? The liver

PRACTICAL RELEVANCE

Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the liver can be key in the diagnosis of diseases such as hepatic lipidosis and hepatic neoplasia.

CLINICAL CHALLENGES

Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. When assessing the liver via ultrasound, a diffuse alteration in liver echogenicity may be difficult to detect unless the change is marked and, although comparisons can be made with the spleen and kidneys, this relies on these organs being normal.

EQUIPMENT

Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience.

AIM

This review, the first in an occasional series on feline abdominal ultrasonography, discusses ultrasonographic examination of the normal and diseased liver, with focus on the liver parenchyma. It is aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Ultrasound-guided sampling of the liver is also covered. Future articles will discuss the biliary tree and hepatic vascular anomalies.

EVIDENCE BASE

Information provided in this article is drawn from the published literature and the author's own clinical experience.

Caecocolic intussusception associated with a caecal polyp and concurrent hepatocellular carcinoma in a cat

CASE SUMMARY

A 17-year-old female neutered domestic shorthair cat presented for several days of reduced faecal volume and a rectal prolapse. Physical examination revealed a 2 cm rectal prolapse, hepatomegaly and a low body condition score of 3/9. Haematology and biochemistry revealed a mild non-regenerative anaemia (haematocrit 24.5%; reference interval [RI] 30.3-52.3%), a mild mature neutrophilia (16.21 × 10⁹/l; RI 1.48-10.29 × 10⁹/l) and a mild increase in alanine aminotransferase activity (222 IU/l; RI 12-130 IU/l). Abdominal radiographs identified hepatomegaly. The rectal prolapse was reduced under general anaesthesia. Abdominal ultrasound identified a caecocolic intussusception and a large hepatic mass. Thoracic radiographs were unremarkable. Hepatic fine-needle aspirate cytology revealed well-differentiated hepatocytes. A typhlectomy was performed and the quadrate liver lobe, with mass, was resected. Gross examination of the caecum identified a focal polyp; histopathology showed moderate plasmacytic-lymphocytic typhlitis and reactive mucosal-associated lymphoid tissue. The hepatic mass was diagnosed as a well-differentiated hepatocellular carcinoma. Six weeks postoperatively the cat had gained 0.5 kg, had an improved body condition score of 5/9 and resolution of clinical signs. The cat died acutely 1 year later from an unknown cause.

RELEVANCE AND NOVEL INFORMATION

Caecocolic intussusception is rare in cats and uncommon in dogs. This is the third report in a cat and the first associated with a caecal polyp. As reported in dogs, the outcome following surgery was good. Hepatocellular carcinoma is a rarely reported feline neoplasm, which may have a good prognosis with surgical resection.

Diagnostic Imaging of the Hepatobiliary System: An Update

Recent advances in diagnostic imaging of the hepatobiliary system include MRI, computed tomography (CT), contrast-enhanced ultrasound, and ultrasound elastography. With the advent of multislice CT scanners, sedated examinations in veterinary patients are feasible, increasing the utility of this imaging modality. CT and MRI provide additional information for dogs and cats with hepatobiliary diseases due to lack of superimposition of structures, operator dependence, and through intravenous contrast administration. Advanced ultrasound methods can offer complementary information to standard ultrasound imaging. These newer imaging modalities assist clinicians by aiding diagnosis, prognostication, and surgical planning.

Hepatobiliary Neoplasia

Older companion animals may be uncommonly affected with hepatobiliary neoplasia. If clinical signs are shown they are often nonspecific. Animals may have increased liver enzyme activities detected on serum biochemistry. Ultrasound imaging can help to characterize liver lesions and guide sampling with fine needle aspiration. Treatment for massive liver tumor morphology involves liver lobectomy. Prognosis depends on the tumor morphology, type, and stage, but can be good for cats and dogs with massive hepatocellular tumors, with animals experiencing prolonged survival and low recurrence rates.

Hepatic fibrosarcoma incarcerated in a peritoneopericardial diaphragmatic hernia in a cat

Case summary

A 14-year-old, female neutered domestic shorthair presented for dyspnoea. Thoracic ultrasonography and radiography showed that a heterogeneous mass was present within the pericardial sac, and the mass continued caudally with the mesenteric fat. On CT, the outline of the diaphragm was not continuous and there was an obvious defect with diaphragmatic thickening present at the mid-level of the liver. A pleural effusion and a small-volume pericardial effusion were also present. A ventral midline coeliotomy and median sternotomy revealed a 5 × 6 × 7 cm firm, irregular, tan-coloured soft tissue mass within the pericardial sac attached to both the diaphragmatic defect and liver. The mass was carefully dissected away from the heart and the diaphragmatic defect was repaired with primary closure. Postoperatively, the cat had a persistent pneumothorax that required continuous pleural suction for 41 h. The cat died 44 h postoperatively. Histopathology and immunohistochemistry confirmed the mass to be a hepatic fibrosarcoma incarcerated in a peritoneopericardial diaphragmatic hernia (PPDH).

Relevance and novel information

This is the first reported case of metaplastic transformation of liver into a sarcoma in a cat with PPDH. In addition, hepatic fibrosarcoma is a rarely reported location for fibrosarcoma in this species.

Left lateral liver lobe torsion in a cat with moderate pectus excavatum

A 6-year-old neutered female domestic shorthair cat weighing 3.1 kg was referred to the clinic owing to a 2 day history of anorexia. On physical examination, a pectus excavatum (PE) was apparent, and a cranial abdominal mass was palpated. Serum biochemical analysis showed severely elevated liver enzymes. On radiography, the PE was graded as moderate, and a 5 × 3 cm soft tissue density mass was detected in the cranial abdomen. Using duplex ultrasonography, the mass was identified as an enlarged liver lobe with vascular thrombosis. The diagnosis of liver lobe torsion (LLT) was confirmed surgically, and the affected left lateral lobe was resected. On follow-up, performed 1 and 6 months postoperatively, no further abnormalities were found on clinical examination or serum biochemical analysis. At follow-up examination, the PE did not appear to cause any additional clinical signs, indicating that treatment of moderate PE in older animals is not obligatory. This is the first reported case of LLT with concurrent PE, and the second feline case of LLT treated surgically. Animals with anatomical malformation of the diaphragm caused by PE may be at higher risk of developing LLT. Early diagnosis and surgical intervention of LLT can produce a good clinical outcome without further repercussions.

Clinical Characteristics of Hepatocellular Carcinoma in 19 cats from a Single Institution (1980-2013)

Clinical features of feline hepatocellular carcinoma (HCA) have been poorly characterized. In this retrospective study, we describe the signalment, clinical features, clinicopathologic parameters, imaging characteristics, hepatic mass size and lobe distribution, concurrent disorders, and survival in 19 cats with HCA. HCA is a rare neoplasm in elderly cats often associated with weight loss, hyporexia, and increased hepatic transaminase activities. Concurrent disorders (e.g., hyperthyroidism, inflammatory bowel disease, cholangiohepatitis, copper-associated hepatopathy) often confounded interpretation of clinical and clinicopathologic findings; 42% of HCA were incidentally identified. Although an abdominal mass was palpated in only 21% of cats, many cats had masses identified on ultrasonographic imaging with 47% having lesions >4 cm. Tumors were nearly equally distributed between right and left liver lobes, and two cats had HCA in multiple liver lobes. Median survival of eight cats diagnosed antemortem was 1.7 (0.6 to 6.5) yr. Median survival of six cats undergoing HCA surgical resection was 2.4 (1.0 to 6.5) yr with two cats still alive at time of manuscript submission. Following surgical resection, one cat treated with carboplatin survived 4 yr. Two cats with HCA diagnosed antemortem without surgical resection survived for 0.6 and 1 yr.

Chronic liver lobe torsion in a cat

A 13 yr old castrated male blue British shorthair with a 3 mo history of vomiting was diagnosed with a left lateral liver lobe mass following abdominal ultrasonography. At the time of celiotomy, liver lobe torsion (LLT) of the left lateral lobe was also present. Histopathologic evaluation of the liver mass and associated lobe revealed extensive necrosis secondary to chronic torsion. This is the second reported case of LLT in a cat. Both cases were associated with liver masses. The cat presented in this case remained clinically normal 8 mo postoperatively following lobectomy of the affected lobe.

Carcinosarcoma of the biliary system in a cat

A 12-year-old, mixed-breed domestic cat was diagnosed with a multicystic hepatic mass via ultrasonographic examination and computer tomography scan. The tumor associated with the left medial liver lobe, and connected by a thin stalk to the hilar region, was surgically removed. The mass was firm, encapsulated, mottled white to red black, multinodular, and cystic. Histologic diagnosis was carcinosarcoma supported by positive immunohistochemistry for cytokeratins and vimentin of atypical neoplastic cell populations. On the basis of morphology, the origin was considered to be in the biliary tract. Biliary carcinosarcoma is a rare neoplasm that occurs in people. The epidemiology and risk factors have not yet been determined, and the prognosis is poor except for cases in which curative resection is performed.

Mechanisms, causes, investigation and management of vomiting disorders in cats: a literature review

Vomiting is a common presenting complaint in feline practice. This article differs from previous reviews in that it is an evidence-based review of the mechanisms, causes, investigation and management of vomiting in the domestic cat. Published evidence was reviewed, and then used to make recommendations for clinical assessment, diagnosis, antiemetic drug treatment, dietary management and monitoring of cats presenting with vomiting. The strength of the evidence on which recommendations are made (and areas where evidence is lacking for cats) has been highlighted throughout.

Immunohistochemical Characterization of a Hepatic Neuroendocrine Carcinoma in a Cat

A hepatic mass was identified in a 5-year-old, female mixed-breed cat that died spontaneously after a clinical history of progressive emaciation, ptyalism, and persistent coryza. At necropsy, a 7-cm-diameter, yellow-brown, firm, multilobulated tumor was identified in the liver. Microscopically, the mass consisted of neoplastic cells arranged in small, closely packed nests within a thin fibrovascular stroma. These cells were of medium sized and polygonal, with fine argyrophilic cytoplasmic granules. Nuclei were predominantly round with finely stippled chromatin and indistinct nucleoli. Mitotic figures were numerous. Immunohistochemically, most of the neoplastic cells were immunoreactive for chromogranin A, neuron-specific enolase (NSE), and cytokeratin AE1/AE3 and weakly labeled for synaptophysin. The tumor was negative for glial fibrillary acidic protein (GFAP), vimentin, and cytokeratins 5, 6, 8, and 17. Vascular emboli and intrahepatic micrometastasis were also identified with chromogranin A. All these features were consistent with a hepatic neuroendocrine carcinoma and emphasized the importance of using a panel of antibodies to diagnose such rare tumors.

Paraneoplastic alopecia associated with hepatocellular carcinoma in a cat

A 15-year-old spayed female domestic shorthair cat presented with alopecia associated with hepatocellular carcinoma. Clinical signs, which had commenced 6 months previously, included loss of appetite, loss of weight, and depression. As reported by the owner, the cat developed alopecia a week before referral. The hair loss was localized to the ventral aspect of the thorax and abdomen, medial aspect of front and hind limbs, and ventral aspect of the tail, and was associated with histological features consistent with paraneoplastic alopecia. At necropsy, multiple hepatic nodules were observed, and subsequent histopathological investigation showed cords and sheets of hepatocyte-like neoplastic cells positive for the hepatocyte marker (Hep Par 1), thereby demonstrating the hepatocellular origin of the tumour, which was diagnosed as a hepatocellular carcinoma. This is the first report of feline paraneoplastic alopecia associated with hepatocellular carcinoma confirmed by the Hep Par 1 marker.

Mucinous Cholangiocarcinoma in a Cat

Mucinous cholangiocarcinoma was diagnosed in a 14-year-old, castrated male, domestic shorthaired cat with marked peritoneal effusion. Cytological confirmation of malignancy by fluid analysis and fine-needle, ultrasound-guided aspiration of the liver was followed by histological examination of tissue samples obtained at surgery and necropsy. No observed response followed chemotherapy with doxorubicin and carboplatin. Electron microscopy and immunohistochemistry helped to further characterize this unusual tumor.

Hepatocellular carcinoma with secondary abscessation in a cat

A 16-year-old castrated male domestic shorthair cat was presented for investigation of weight loss, lethargy, inappetence and polydypsia. On serum biochemical analysis there was evidence of severe hepatocellular damage and cholestasis. Abdominal ultrasonographic examination revealed an irregular lesion of mixed echogenicity in a left hepatic lobe. It was compromised of a hypoechoic periphery surrounding an anechoic central area containing highly echogenic densities with distal acoustic shadowing suggestive of gas formation. On necropsy, the only gross abnormality was a solitary 5 cm x 3 cm x 3 cm multilobulated mass in the left lateral hepatic lobe, containing foul-smelling purulent fluid within a thick fibrous wall. Cytological examination of the fluid revealed numerous degenerate neutrophils and large numbers of Gram-positive spore-forming rods. The histopathological diagnosis was hepatocellular carcinoma with secondary abscessation. The bacterial morphology was consistent with Clostridia sp. Both hepatocellular carcinoma and focal hepatic abscessation are rare in cats. Hepatic abscesses should be included in the differential diagnosis of cats with non-specific signs, even in the absence of biochemical evidence of a hepatopathy.

Hepatobiliary neuroendocrine carcinoma in cats: a clinicopathologic, immunohistochemical, and ultrastructural study of 17 cases

Hepatobiliary neuroendocrine carcinoma was diagnosed in 17 cats in a period of 10 years. Seven tumors were of intrahepatic origin, one of which was a composite containing components of epithelial and neuroendocrine carcinoma. Nine tumors were of extrahepatic origin, and one tumor was located in the gall-bladder. The cats were adult and geriatric, and the male : female ratio varied according to tumor group. Hepatomegaly, anorexia, weight loss, and vomiting were the most common clinical signs observed in the cats with hepatic neuroendocrine carcinoma. The cats with extrahepatic neuroendocrine carcinoma showed these signs plus icterus (5/9) and high concentrations of hepatic enzymes. Histologically, the hepatic neuroendocrine carcinomas had two patterns, one with acinar structures separated by vascular stroma lined by cuboidal or columnar cells and the other solid with groups of anaplastic cells separated by vascular stroma. The composite tumor consisted of both bile duct carcinoma and neuroendocrine carcinoma. The extrahepatic neuroendocrine carcinomas and the gallbladder neuroendocrine carcinoma were characterized by solid sheets or groups of round to oval cells with vascular or fibrovascular stroma. Immunohistochemical examination of 10 of the neuroendocrine carcinomas revealed that all 10 stained with neuron-specific enolase; one bile duct carcinoma and the gallbladder carcinoma stained with chromogranin; four of five bile duct carcinomas and the gall bladder carcinoma stained with synaptophysin; and one bile duct carcinoma stained with gastrin. One cat with hepatic carcinoma had duodenal ulcer; in this cat, ultrastructural studies showed neurosecretory granules leading to the diagnosis of Zollinger-Ellison syndrome. In four cats in which necropsy was permitted, carcinomatosis (4/4), lymph nodes (4/4), lungs (2/4), and intestines (1/4) were the metastatic sites. Fourteen of the 17 cats were euthanatized during or immediately after surgery.

Hepatobiliary inflammation, neoplasia, and argyrophilic bacteria in a ferret colony

Hepatobiliary disease was diagnosed in eight of 34 genetically unrelated cohabitating pet ferrets (Mustela putorios furo) during a 7-year period. The eight ferrets ranged in age from 5 to 8 years and exhibited chronic cholangiohepatitis coupled with cellular proliferation ranging from hyperplasia to frank neoplasia. Spiral-shaped argyrophilic bacteria were demonstrated in livers of three ferrets, including two with carcinoma. Sequence analysis of a 400-base pair polymerase chain reaction product amplified from DNA derived from fecal bacteria from one ferret demonstrated 98% and 97% similarity to Helicobacter cholecystus and Helicobacter sp. strain 266-1 , respectively. The clustering of severe hepatic disease in these cohabitating ferroes suggests a possible infectious etiology. The role of Helicobacter species and other bacteria in hepatitis and/or neoplasia in ferrets requires further study.