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Schreeg ME, Miller SA, Cullen JM. Choledochal cyst with secondary cholangitis, choledochitis, duodenal papillitis, and pancreatitis in a young domestic shorthair cat. J Vet Diagn Invest 2021; 33:782-787. [PMID: 34027760 DOI: 10.1177/10406387211017107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.
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Affiliation(s)
- Megan E Schreeg
- North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA.,The Ohio State University College of Veterinary Medicine, Columbus, OH, USA
| | | | - John M Cullen
- North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA.,Experimental Pathology Labs, Durham, NC, USA
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2
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Patania OM, Troan BV, Cullen JM. Ductal Plate Malformations in Captive Snakes. Vet Pathol 2021; 58:736-742. [PMID: 33938322 DOI: 10.1177/03009858211011941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ductal plate malformations are abnormalities in the liver that arise from inappropriate or incomplete remodeling of the embryologic ductal plate. Various types of ductal plate malformations are reported in the human and veterinary literature, most commonly affecting domestic mammalian species but also fish. We investigated the occurrence and described the histopathologic features of ductal plate malformations in captive snakes. Malformations were identified in 18 snakes: 10 colubrids, 6 vipers, and 2 boids. There was no sex predilection, and the mean age was 17 years. The majority of lesions were incidental with most snakes having one or more comorbidities, most commonly neoplasia or systemic inflammation, that resulted in natural death or euthanasia. Ductal plate malformations in all livers were broadly characterized by a well-demarcated nodule of irregular bile ducts embedded within a varying amount of fibrous stroma. Malformations were further categorized based on the amount of fibrous stroma and dilation of the bile ducts as von Meyenburg complexes, cystic liver disease, and/or an intermediate hybrid subtype representative of cysts arising within von Meyenburg complexes. Histochemical and immunohistochemical staining, including Gomori's trichome and pan-cytokeratin, respectively, were applied on select cases to confirm histologic features. Malignant transformation was not identified within this population.
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Affiliation(s)
| | - Brigid V Troan
- 6798North Carolina State University, Raleigh, NC, USA
- North Carolina Zoo, Asheboro, NC, USA
| | - John M Cullen
- 6798North Carolina State University, Raleigh, NC, USA
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3
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Kaniok H, Gonzalez‐Gasch E, Alloway E, Suarez‐Bonnet A. An unusual presentation of a hepatic ductal malformation in a Boxer dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Heidi Kaniok
- Surgery Department Southfields Veterinary Specialists Basildon Essex SS15 6TP United Kingdom
| | - Esteban Gonzalez‐Gasch
- Surgery Department Southfields Veterinary Specialists Basildon Essex SS15 6TP United Kingdom
| | - Elizabeth Alloway
- Histology Department VPG Histology Gloucester Road Bristol BS7 0BJ United Kingdom
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4
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Helgert ND, Sula MM. Caroli Syndrome in a 6-Year-Old Rottweiler Dog. J Comp Pathol 2018; 167:1-5. [PMID: 30898291 DOI: 10.1016/j.jcpa.2018.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/08/2018] [Accepted: 11/15/2018] [Indexed: 12/20/2022]
Abstract
A 6-year-old entire female rottweiler dog with a recent history of ascites and respiratory disease was submitted for necropsy examination. The dog had been diagnosed ultrasonographically with biliary cysts as a puppy. Grossly, the liver was smaller than expected with an irregular surface. Islands of hepatocytes were separated by bands of fibrosis and many bile ducts were markedly dilated. Histologically, extensive fibrosis extended beyond the limiting plate and into the surrounding hepatic parenchyma and was associated with abundant small bile ducts throughout. In conjunction with the detection of biliary cysts early in life, the gross and histological findings were consistent with a diagnosis of Caroli syndrome. In man, Caroli syndrome is frequently associated with renal and pancreatic cysts; a single renal cyst was identified in this case.
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Affiliation(s)
- N D Helgert
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, Tennessee, USA.
| | - M M Sula
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, Tennessee, USA
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Molín J, Asín J, Vitoria A, Sanz A, Gimeno M, Romero A, Sánchez J, Pinczowski P, Vázquez FJ, Rodellar C, Luján L. Congenital Hepatic Fibrosis in a Purebred Spanish Horse Foal: Pathology and Genetic Studies on PKHD1 Gene Mutations. Vet Pathol 2018; 55:457-461. [PMID: 29402207 DOI: 10.1177/0300985817754122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 1-month-old Purebred Spanish Horse (PSH) foal presented with progressive hepatic failure culminating in death. Hepatic lesions were consistent with congenital hepatic fibrosis (CHF). Genetic studies in the PKHD1 gene in the affected foal revealed that it was heterozygous for the 2 previously described single-nucleotide polymorphisms (SNPs) linked to CHF in Swiss Franches-Montagnes (SFM) horses. In addition, 2 novel mutations were detected, the foal being homozygous for one of them and heterozygous for the other. Genetic studies in a healthy PSH population ( n = 35) showed a 3-fold higher genotypic frequency for PKHD1 SNP g.49,630,834G>A and a 5-fold higher genotypic frequency for PKHD1 SNP g.49,597,760A>T compared with those reported for SFM horses. SNPs in the PKHD1 gene in CHF-affected SFM horses might not fully explain the CHF observed in the PSH. Other mutations in the PKHD1 gene could play a more important role in the PSH.
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Affiliation(s)
- Jéssica Molín
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Javier Asín
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Arantzazu Vitoria
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Arianne Sanz
- 2 Department of Anatomy, Embryology and Genetics, University of Zaragoza, Zaragoza, Spain
| | - Marina Gimeno
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Antonio Romero
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Javier Sánchez
- 2 Department of Anatomy, Embryology and Genetics, University of Zaragoza, Zaragoza, Spain
| | - Pedro Pinczowski
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Francisco J Vázquez
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Clementina Rodellar
- 2 Department of Anatomy, Embryology and Genetics, University of Zaragoza, Zaragoza, Spain
| | - Lluís Luján
- 1 Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
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Guerra JM, Daniel AGT, Cardoso NC, Grandi F, Queiroga F, Cogliati B. Congenital hepatic fibrosis and polycystic kidney disease not linked to C >A mutation in exon 29 of PKD1 in a Persian cat. JFMS Open Rep 2015; 1:2055116915619191. [PMID: 28491400 PMCID: PMC5362006 DOI: 10.1177/2055116915619191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 01/23/2023] Open
Abstract
CASE SUMMARY We describe the case of a 1-year-old male Persian cat diagnosed with congenital hepatic fibrosis (CHF) associated with renal polycystic disease and, for the first time, we have shown that there was no C >A mutation in exon 29 of PKD1 (polycystic kidney disease 1). The cat presented with a history of chronic weight loss, anorexia, vomiting, depression and lethargy, with profuse salivation and ascites on clinical examination. A mild elevation in liver-associated plasma enzymes suggested a hepatic disease. Owing to the cat's deteriorating condition, it was euthanized. During necropsy, the liver was found to be enlarged, firm and reddish, and the kidney had multiple small cortical cysts. Immunohistochemistry revealed that bile duct cells and epithelial cells of renal cysts showed positive immunoreactivity to keratin 19. Collagen fibers surrounding bile ducts within portal areas demonstrated reactivity to type IV collagen antibody, confirming the congenital nature of the process. A diagnosis of ductal plate malformation consistent with CHF associated with polycystic kidney in a young Persian cat was made. Interestingly, genetic testing revealed a wild-type sequence at position 3284 in exon 29 of PKD1. RELEVANCE AND NOVEL INFORMATION The absence of the classic genetic mutation associated with the particular clinical presentation supports the hypothesis of a distinct etiopathogenesis among fibropolycystic diseases in domestic cats. Moreover, congenital hepatic fibrosis is a rare but important differential diagnosis for young Persian cats and their crosses with clinical signs of chronic end-stage liver disease.
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Affiliation(s)
- Juliana Mariotti Guerra
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil.,Pathology Center, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | | | - Natalia Cavalca Cardoso
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Fabrizio Grandi
- Department of Pathology, Botucatu Medical School, Univ. Estadual Paulista, UNESP, Botucatu, Brazil
| | - Felisbina Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Center for Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Bruno Cogliati
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
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Drögemüller M, Jagannathan V, Welle MM, Graubner C, Straub R, Gerber V, Burger D, Signer-Hasler H, Poncet PA, Klopfenstein S, von Niederhäusern R, Tetens J, Thaller G, Rieder S, Drögemüller C, Leeb T. Congenital hepatic fibrosis in the Franches-Montagnes horse is associated with the polycystic kidney and hepatic disease 1 (PKHD1) gene. PLoS One 2014; 9:e110125. [PMID: 25295861 PMCID: PMC4190318 DOI: 10.1371/journal.pone.0110125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/15/2014] [Indexed: 12/20/2022] Open
Abstract
Congenital hepatic fibrosis has been described as a lethal disease with monogenic autosomal recessive inheritance in the Swiss Franches-Montagnes horse breed. We performed a genome-wide association study with 5 cases and 12 controls and detected an association on chromosome 20. Subsequent homozygosity mapping defined a critical interval of 952 kb harboring 10 annotated genes and loci including the polycystic kidney and hepatic disease 1 (autosomal recessive) gene (PKHD1). PKHD1 represents an excellent functional candidate as variants in this gene were identified in human patients with autosomal recessive polycystic kidney and hepatic disease (ARPKD) as well as several mouse and rat mutants. Whereas most pathogenic PKHD1 variants lead to polycystic defects in kidney and liver, a small subset of the human ARPKD patients have only liver symptoms, similar to our horses with congenital hepatic fibrosis. The PKHD1 gene is one of the largest genes in the genome with multiple alternative transcripts that have not yet been fully characterized. We sequenced the genomes of an affected foal and 46 control horses to establish a comprehensive list of variants in the critical interval. We identified two missense variants in the PKHD1 gene which were strongly, but not perfectly associated with congenital hepatic fibrosis. We speculate that reduced penetrance and/or potential epistatic interactions with hypothetical modifier genes may explain the imperfect association of the detected PKHD1 variants. Our data thus indicate that horses with congenital hepatic fibrosis represent an interesting large animal model for the liver-restricted subtype of human ARPKD.
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Affiliation(s)
- Michaela Drögemüller
- Institute of Genetics, University of Bern, Bern, Switzerland
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
| | - Vidhya Jagannathan
- Institute of Genetics, University of Bern, Bern, Switzerland
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
| | - Monika M. Welle
- Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - Claudia Graubner
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Reto Straub
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Vinzenz Gerber
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Dominik Burger
- Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Heidi Signer-Hasler
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
- Bern University of Applied Sciences HAFL, Zollikofen, Switzerland
| | | | | | - Ruedi von Niederhäusern
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
- Agroscope, Swiss National Stud Farm, Avenches, Switzerland
| | - Jens Tetens
- Institute of Animal Breeding and Husbandry, Christian-Albrechts-University, Kiel, Germany
| | - Georg Thaller
- Institute of Animal Breeding and Husbandry, Christian-Albrechts-University, Kiel, Germany
| | - Stefan Rieder
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
- Agroscope, Swiss National Stud Farm, Avenches, Switzerland
| | - Cord Drögemüller
- Institute of Genetics, University of Bern, Bern, Switzerland
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
| | - Tosso Leeb
- Institute of Genetics, University of Bern, Bern, Switzerland
- Swiss Competence Center of Animal Breeding and Genetics, University of Bern, Bern University of Applied Sciences HAFL and Agroscope, Bern, Switzerland
- * E-mail:
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Brown DL, Van Winkle T, Cecere T, Rushton S, Brachelente C, Cullen JM. Congenital hepatic fibrosis in 5 dogs. Vet Pathol 2010; 47:102-7. [PMID: 20080489 DOI: 10.1177/0300985809353313] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Congenital hepatic fibrosis is a disorder of biliary system development histologically characterized by diffuse periportal to bridging fibrosis with numerous small often-irregular bile ducts and reduction in the number of portal vein branches. The condition results from abnormal development of the ductal plate, the embryonic precursor to the interlobular bile ducts. It has rarely been reported in veterinary species, and it has never been reported in dogs. This article describes 5 cases of a ductal plate malformation in dogs consistent with congenital hepatic fibrosis. On light microscopy, all 5 livers had severe bridging fibrosis with a marked increase in the number of small bile ducts, which often had irregular, dilated profiles reminiscent of the developing ductal plate. In addition, 80% (4 of 5) of cases lacked typical portal vein profiles. Cytokeratin 7 and proliferating cell nuclear antigen immunohistochemistry was performed on the 3 cases for which paraffin-embedded tissue was available. The bile duct profiles were strongly positive for cytokeratin 7 in all 3 cases, and they were negative for proliferating cell nuclear antigen or only had rare positive cells. All 5 dogs presented with clinical signs of portal hypertension. Congenital hepatic fibrosis should be considered in the differential diagnosis in young dogs that present with portal hypertension and lesions that may have been interpreted as bridging biliary hyperplasia or extrahepatic biliary obstruction.
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Affiliation(s)
- D L Brown
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University Raleigh, NC, USA.
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