| Training case 1 (EJVP Vol 3 No 3; page 153)
Histopathology Case
Tissue from a 3-months-old Sprague-Dawley rat (TB0145-M31)
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QUESTIONS
A: Histopatholgical description
B: Morphologic diagnosis
C: Aetiologic diagnosis
D: Comments
ANSWERS
A: Histopatholgical description
Section of liver with a normal architecture, enlarged portal tracts of increased cellularity and multifocal areas of coagulative and suppurative necrosis.
The portal areas are enlarged due to oedema and marked proliferation, and show biliary hyperplasia. In the lumen of the bile ducts, within the epithelium and often also immediately surrounding the bile ducts a minor to severe infiltration of neutrophils is seen; in case of severe intraluminal accumulation of neutrophils there is occasional destruction of epithelium. At some places with severe infiltration of neutrophils in the lumen of the bile duct, groups of long slender bacteria can be recognised. The inflammatory reaction of the stroma consists mainly of neutrophils and small numbers of eosinophils; also oval or spindle shaped fibroblasts (activated stromal cells) and a solitary lymphocyte and plasma cell are present. Multifocally the inflammatory infiltrate spills over into the surrounding parenchyma often with some necrosis and with destruction of the limiting plate.
In the liver parenchyma there are many foci of coagulative necrosis, suppurative inflammation (microabscesses) or with a mixed appearance, which frequently are closely associated with the portal areas. Moreover, the parenchyma shows leucocytosis of the sinusoids and randomly distributed isolated necrotic liver cells and small groups of neutrophils.
Additional findings are present in the portal veins consisting of swelling of the endothelium, sticking and exocytosis of neutrophils to and through the endothelium respectively and focal thrombosis.
B: Morphologic diagnosis
1 Suppurative cholangitis, multifocal, coalescing, subacute, moderate
2 Necrotising and suppurative hepatitis, periportal, multifocal, acute, moderate
3 Biliary hyperplasia, diffuse, subacute, moderate
C: Aetiologic diagnosis
Ascending bacterial cholangitis
D: Comments
In this case, the ascending bacterial cholangitis was caused by extrahepatic biliary obstruction (indicative features: biliary hyperplasia, multifocal hepatic necrosis).
Ascending bacterial cholangitis alone is rarely seen as a spontaneous lesion in rats of this age.
Other Questions
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