C O N F E R E N C E 10 9 November 2016
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Joint Pathology Center Veterinary Pathology Services WEDNESDAY SLIDE CONFERENCE 2016-2017 C o n f e r e n c e 10 9 November 2016 CASE I: AzVDL 02-3362 (JPC 4019839). Cytologic Description: The preparation has large areas of dense cellularity. There are Signalment: Nine-year-old, female, numerous linear structures (nematode Siamese cross, (Felis catus). uterus) containing oval bioperculated ova are present within the dense areas. Well- History: The cat presented for chronic preserved and degenerate parasite ova are cystitis unresponsive to antibiotic therapy also scattered throughout the background. and dietary changes. Pneumocystogram The ova are approximately 60 microns in revealed a thickened uneven bladder wall length with a granular interior and a thick with a small lumen. The cat was referred to refractile shell. In the thinner areas of large an internal medicine service with the cellular densities, the nucleated cells are primary differential diagnosis of neoplasia. present in organized sheets with well- Ultrasound showed an irregular mass in the defined cytoplasmic borders. The cells have bladder wall at the trigone. A “traumatic round nuclei with mild anisokaryosis and a catheterization” of the bladder was scant to small amount of basophilic performed and cytologic preparations were cytoplasm. The background has a large submitted for evaluation. number of lysed and degenerate cells with fewer small clusters of intact epithelial cells Gross Pathology: None. showing the same morphology as those within the dense clusters. There are areas of Laboratory results: The CBC at monolayer adjacent to the dense clusters presentation to the specialty service was with a moderate number of neutrophils and within reference interval. The only eosinophils. Eosinophils, neutrophils, and abnormality in the chemistry profile was small lymphocytes are found throughout the hyperglycemia. The abnormalities in the background. Occasional small lymphocytes urinalysis included glucosuria, mild pyuria contain a few eosinophilic to azurophilic and large numbers of variably sized trans- granules. itional epithelial cells. 1 Table 1: Capillarid Species Name Location Host Eucoleus bouhmi frontal sinus fox, dog Eucoleus aerophilus bronchi dog, cat, fox Aonchotheca putorii stomach, intestine bear, hedgehog, raccoon, swine, bobcats, mustelids, cat Aonchotheca spp intestine ruminants Calodium hepaticum liver rodents, many occasional hosts including humans. Pearsonema plica urinary bladder dog, fox, wolf Pearsonema feliscati urinary bladder cat Contributor’s Cytologic Diagnosis: nematodes have been placed in several new Transitionalcell hyperplasia with mild genera based on location within the host, the suppurative and eosinophilic inflammation most accepted of which are Eucoleus (nasal and fragmented Pearsonema (Capillaria) sinus and bronchi), Aonchotheca (intestine) feliscati nematode and numerous bio- and Pearsonema (urinary bladder) (Table perculated eggs. 2)2. Pearsonema plica and P. feliscati, infect the domestic dog, fox, wolf, and cat. Contributor’s Comment: Urinary nema- In most cases, the nematode is loosely todiasis is caused by several genera and attached to the urinary bladder mucosa and, affects numerous species of domestic and less often, ureteral mucosa with mild wild animals (Table 1).2, 5,10 The nematode inflammation and edema evident on species found in the kidney, ureters or renal histologic examination of the affected vasculature are associated with clinical tissue.7,8 Clinical disease is uncommon but disease. The most spectacular of which is has been reported in the dog and fox and the giant kidney worm of dogs, Dio- rarely in the cat.7,8 The prevalence of these ctophyme renale, that eventually destroys parasites in the dog and cat is not known. and replaces the renal parenchyma. However, a prevalence of 76% and 59% has Nematodes of the genera Pearsonema been reported in two dog breeding kennels (Capillaria), on the other hand, are found in the United States.7 In this heavily within the urinary bladder and are often an parasitized population, hematuria, dysuria incidental finding with minimal clinical and pollakiuria were common findings in the disease evident.2,10 The capillarid dogs with confirmed infection. 2 are elongate and approximately 60 microns in length and 27 microns in width. They have bipolar plugs (bioperculate), a thick shell with “globular” ridges enclosing a single cell.10 The literature does not provide morphologic or biological Urinary bladder, cat. Several large aggregates of protein encase tangential sections of adult characteristics other nematodes. (green arrows.) (Wrights, 16X) than the host to distinguish P. plica In the cat, the disease is rarely reported in and P. feliscati. The cat is included in host the United States;6 however, in Australia, an species for both P. feliscati and P. plica in incidence of greater than 30% was found in Georgis’ Parasitology for Veterinarians 8 with no mention of differential one survey study. No evidence of clinical 2 cystitis was seen in the infected cats. On characteristics. The capillarid in this case is histological examination of the urinary given as P. feliscati based on host. bladder in the infected cats, the nematodes were superficially embedded in the mucosa with no breaching of the basal layer or basement membrane. A moderate JPC Cytologic Interpretation: Presence of inflammatory infiltrate that included eosino- Peasonema spp nematode fragments and phils was seen in association with the ova, mild transitional cell dysplasia, and low embedded parasite. The lifecycle for P. grade eosinophilic and neutrophilic feliscati is not determined.2,6 It is assumed inflammation, Siamese cross, Felis catus. to be similar to P. plica which is thought to be through the earthworm as an intermediate Conference Comment: The contributor host or a transport host such as a bird. Adult provides a compelling cytologic specimen worms are 2.5 to 5 cm in length. The ova and outstanding review of capillarid Table 2: Urinary Nematodes Name Host Dioctophyme renale dog, mink Pearsonema plica, P. feliscati dog, fox, wolf, cat Stephanurus dentatus swine Trichosomoides crassicauda rats Crassicauda boopis whales 3 Urinary bladder, cat. Tangential sections of the adult female parasites contina numerous 25x50um eggs within the uterus. (Wrights, 124X). nematodes affecting a wide variety of large numbers of eggs were found in all veterinary species. As mentioned by the bladders containing five or more adults.9 In contributor, the Capillaria genera have been this case, the mild to moderate eosinophilic reclassified based on the location of the and neutrophilic inflammation may be adult parasite in the host; however, the secondary to a high parasite burden. genus name Capillaria is still widely used in the veterinary literature. In both dogs and cats, Peasonema plica has been reported in the urinary bladder and Typically, infection with Pearsonema ureter submucosa and is typically associated feliscati is of little pathologic significance to with mild subclinical inflammation and the cat and is usually considered an edema.1,7 There is a higher prevalence of the incidental finding. Most studies show no parasite in wild red foxes (Vulpes vulpes) in relationship between the presence of adult many European countries and it is associated capillarids in the bladder and significant with an increased pathogenicity. This can cystitis.8,9 Histologically, Pearsonema result in severe cystitis, pollakiuria, dysuria feliscati resides in the superficial epithelium and hematuria in this species.1,3 In this case, of the urinary bladder and does not penetrate both Pearsonema plica and Pearsonema the basement membrane.5 However, if the feliscati have been implicated in urinary ureters become occluded with adult bladder infection in cats, conference nematodes, cats may display the clinical participants could not distinguish between signs of post-renal obstruction. The highest two cytologically. reported number of adult worms present from a single urinary bladder was 25 and 4 nematode can be more difficult to appreciate than on histologic tissue section. However, the presence of the highly characteristic ova confirms the presence of a urinary capillarid nematode. Participants also noted vacuolation, binucleation, anisokaryosis, and prominent nucleoli within the reactive sloughed urothelium. Transitional epithelial cells are among the most pleomorphic cells in the body and can demonstrate marked reactive change in response to a variety of insults. For this reason, the conference moderator Urinary bladder, cat. Eggs are 25x50um, brown, with a bioperculated (arrows) brown refractile shell and reminded participants that care must be granular contents. (Wrights, 830X) taken prior to over-interpreting reactive urothelium as malignancy. Conference participants readily identified numerous bioperculate eggs free within the Contributing Institution: sample and inside the reproductive tract of Arizona Veterinary Diagnostic Laboratory adult nematode fragments. Pearsonema spp 2831 N. Freeway are a subclassification of aphasmid Tucson, AZ 85705 nematodes of the family Trichuridae. http://cals.arizona.edu/vdl/ Histologically, aphasmid nematodes are characterized by thin eosinophilic cuticle, References: reduced polymyarian- coelomyarian musculature, two hypodermal 1. Basso W, Spanhauer Z, Arnold D, bacillary bands, a stichosome esophagus, Deplazes P. Capillaria plica (syn. 4 a spiny sheath and oval bioperculate eggs. Pearsonema plica)