A case of feline gastrointestinal eosinophilic sclerosing fibroplasia limited to the mesentery

An entire, female, mixed-breed cat of unknown age was presented with a 6-week history of lethargy, anorexia and vomiting. There was an increase in the number of white blood cells in the blood, including neutrophils and eosinophils; moderate anaemia; ascites; and possible mesenteric peritonitis. Exploratory laparotomy revealed firm, multifocal small nodules in the mesentery. As the nodules were surgically unresectable, they were biopsied. Histologically, the nodules were composed of thin trabeculae of dense collagen fibres mixed with plump fibroblasts and numerous eosinophils, consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia. Bacteria were not detected on histological examination of the nodules and cytology of the ascites. Remission of disease occurred following treatment with prednisolone and ciclosporin A for 22 days and antibiotics for 40 days. After remission, ciclosporin A was administered for 236 days and then discontinued. Eosinophilia also resolved after treatment with ciclosporin A. The cat is still alive and in good condition on day 689. This report describes what may be an atypical case of feline gastrointestinal eosinophilic sclerosing fibroplasia, lacking involvement of the gastrointestinal tract, and was apparently cured by treatment that involved ciclosporin A.     

Abortions in sheep caused by Salmonella Brandenburg: Pathological findings

CASE HISTORY: A 7-year-old cat developed sporadic vomiting, reduced appetite, and weight loss over the previous 3 months.

CLINICAL FINDINGS: Palpation revealed a large mid-abdominal mass and the cat had marked eosinophilia. The cat progressively lost weight over the next 7 weeks when euthanasia was performed.

PATHOLOGICAL FINDINGS: Necropsy revealed a 3?cm diameter firm white intramural mass in the colon and another in the pylorus. Mesenteric and cranial mediastinal lymph nodes were firm, pale, and enlarged. Histopathological examination revealed foci of necrosis surrounded by thick dense collagen trabeculae and predominantly eosinophilic inflammation within the intestine and lymph nodes. Marked eosinophilic infiltration of the liver was also present.

DIAGNOSIS: The lesions were consistent with gastrointestinal eosinophilic sclerosing fibroplasia (FGESF).

CLINICAL RELEVANCE: This is the first report of FGESF in a New Zealand cat and the first time lesions of FGESF have been observed in extra-abdominal tissues. Intestinal neoplasia can be clinically identical to FGESF and histopathology is required for differentiation. Evidence suggests that FGESF has a more favourable prognosis than intestinal neoplasia.     

Extreme eosinophilia with disseminated eosinophilic granulomatous disease in a horse

Extreme eosinophilia with disseminated eosinophilic granulomatous disease is described in a 4-year-old Arabian mare. Clinical signs included weight loss, coughing, jugular distention, and ventral edema. Cutaneous lesions were not observed. Eosinophilic inflammation was observed in cytologic specimens from the respiratory tract, body cavities, and lymph nodes. At necropsy, a 20-cm diameter intrathoracic mass was observed. Smaller nodules were present in the lymph nodes, liver, spleen, adrenal glands, pancreas, and skeletal muscle. Histologically, these masses and nodules were characterized by infiltrates of eosinophils, macrophages, and multinucleated giant cells, reactive fibroplasia; and multifocal eosinophilic coagula. Microscopically, mild eosinophilic infiltrates were observed in sections of stomach, small intestine, colon, and pleura; however, gross lesions were not observed in these tissues at necropsy. The etiology of the extreme eosinophilia and disseminated eosinophilic granulomatous disease in this horse was not determined.     

Hypereosinophilic paraneoplastic syndrome in a cat with intestinal T cell lymphosarcoma

A 10-year-old, neutered female, domestic shorthair cat was presented with a recent history of weight loss, polydipsia, diarrhoea and vomiting. On physical examination, intestinal thickening and mesenteric lymph node enlargement were apparent. Clinical investigations revealed peripheral blood eosinophilia, eosinophilic abdominal effusion and eosinophilic mesenteric lymphadenitis. There was a temporary response to treatment with glucocorticoids but signs progressed and the cat was euthanased. On histology, there was eosinophilic infiltration and fibroplasia of intestine and mesenteric lymph nodes. Large aggregates of neoplastic round cells in the intestine and lymph nodes were identified as T lymphocytes using immunohistochemistry. A diagnosis of intestinal T cell lymphosarcoma was made. This case demonstrates that hypereosinophilic paraneoplastic syndrome may occur in cats with lymphosarcoma. Eosinophil chemotaxis may be a response to the production of interleukin-5 by neoplastic lymphocytes.     

Three cases of canine gastrointestinal stromal tumors with multiple differentiations and c-kit-expression

Three canine gastrointestinal stromal tumors (GISTs) were examined. Histopathologically, the tumor mass in the jejunum (Case 1) consisted of the proliferation of epithelioid cells with abundant eosinophilic or vacuolated cytoplasm. Gangliocyte-like or multinucleated giant cells were scattered. The tumor cells exhibited neural natures mimicking human gastrointestinal autonomic nerve tumors, which were immunopositive for several neuronal markers. Another jejunal mass (Case 2) was composed by a solid proliferation of spindle-shaped cells, arranging in interlacing fascicles and occasional storiform pattern. The tumor seemed to be classified undifferentiated GISTs, that showed no apparent neural or muscular features by ultrastructural and immunohistochemical examinations. In the pyloric mass (Case 3), the spindle cells having eosinophilic processes and elongated nuclei were arranged in sheets. Immunohistochemically, the tumor cells showed muscular natures as regards alpha smooth muscle actin and desmin expression.     

Idiopathic Eosinophilic Masses of the Gastrointestinal Tract in Dogs

Background: Eosinophilic inflammation of the gastrointestinal tract of dogs occurs in numerous disorders, typically resulting in diffuse intestinal thickening. Rarely, eosinophilic masses have been reported.
Objective: Describe a series of dogs with 1 or more idiopathic eosinophilic gastrointestinal masses (IEGM) to better characterize the clinical features, treatment, and prognosis.
Animals: Seven dogs with 1 or more gastrointestinal masses composed primarily of eosinophilic infiltrates for which no underlying cause was found.
Methods: Retrospective case series.
Results: Rottweilers and purebred, large breed dogs predominated. Dogs were middle-aged and typically had chronic signs of upper or lower gastrointestinal disease. Decreased appetite, vomiting, and evidence of gastrointestinal hemorrhage were present in the majority of cases. An abdominal or rectal mass was frequently noted on physical examination. Common laboratory abnormalities included peripheral eosinophilia, mature neutrophilia, hypoproteinemia, and hypocholesterolemia. The masses were histologically composed of moderate to severe eosinophilic infiltrates, which were often transmural and accompanied by fibrosis. All dogs treated with surgery alone died of complications of their disease. Treatment with corticosteroids and ivermectin improved clinical signs, caused resolution of eosinophilic infiltrates, and prolonged survival in most dogs treated medically.
Conclusions and Clinical Importance: These findings suggest that the prognosis for dogs with IEGM may be good when recognized and managed appropriately. When surgery is performed, medical treatment should also be added.     

Eosinophilic papulocrustous dermatitis (miliary dermatitis) and eosinophilic inflammatory bowel disease in two cats

Two cats with chronic eosinophilic skin disease were investigated. The clinical investigation of the skin disease in one cat was limited and inflammatory bowel disease was diagnosed post mortem. A history of weight loss and a palpably thickened bowel in the second cat suggested concurrent gastrointestinal disease. Diagnosis of inflammatory bowel disease was confirmed on biopsy. Treatment with azathioprine and methylprednisolone acetate resolved the signs of gastrointestinal disease, the pruritus and 95% of the skin lesions. The concurrence of eosinophilic papulocrustous dermatitis and eosinophilic bowel disease raises the possibility of their being linked bv a common aetiology or pathophysiology.     

Severe lymphocytic-plasmacytic and atrophic gastritis, as well as, predominantly eosinophilic, severe enteritis, in a 19-month-old Labrador retriever

A 19-month-old, male, Labrador retriever was presented with a history of chronic vomiting. Blood analysis and abdominal ultrasononography could not rule out the possibility of gastrointestinal inflammation. Histologic examination of endoscopic gastrointestinal biopsies confirmed severe lymphocytic-plasmacytic and atrophic gastritis, as well as, predominantly eosinophilic, severe enteritis.     

Accumulation of Sapogenin Conjugates and Histological Changes in the Liver and Kidneys of Lambs Suffering from Alveld,a Hepatogenous Photosensitization Disease of Sheep Grazing Narthecium ossifragum

Sixteen lambs exhibiting hepatogenous photosensitization (alveld) after grazing pasture containing Narthecium ossifragum and seven nonphotosensitized lambs grazing the same pastures were studied. All the alveld-affected lambs revealed liver damage dominated by single cell necrosis, portal fibroplasia and bile duct proliferation. Crystalloid clefts were demonstrated in the bile ducts of two and in the hepatocytes and Kupffer cells of nine photosensitized lambs. Plasma bilirubin concentration was severely increased in ten of the cases of alveld whereas the activity of aspartate aminotransferase was moderately to severely increased in seven cases. The activity of glutamate dehydrogenase was moderately elevated in one of the photosensitized lambs. The main histopathological findings in the kidneys from the alveld-affected lambs were dilated tubules, often with eosinophilic material in the tubular lumina. Regenerative changes were seen in a large proportion of the renal sections. Elevated plasma concentrations of urea and creatinine, and the renal histopathological changes, suggested that the photosensitized lambs had been through a phase of renal injury. Analysis of the free and conjugated sapogenin content in liver tissue and bile was performed by gas chromatography–mass spectrometry. There were significantly higher concentrations of conjugated episapogenins in both the liver and bile in the alveld-affected lambs than in the nonphotosensitized lambs.     

Pulmonary and hepatic eosinophilic granulomas and epistaxis in a horse suggestive of multi‐systemic eosinophilic epitheliotropic disease

Multi‐systemic eosinophilic epitheliotropic disease (MEED) is a relatively uncommon disease characterised by eosinophilic infiltration of more than one organ system, with the skin and gastrointestinal tract most commonly affected. This case report describes a gelding that presented for weight loss, increased respiratory rate and effort and chronic intermittent epistaxis. During post mortem examination diffuse eosinophilic granulomatous lesions were identified in the lung and liver, leading to a diagnosis of MEED. Veno‐occlusive pulmonary remodelling was also discovered, believed to be the cause of the chronic epistaxis and a result of the pulmonary fibrosis and eosinophilic granulomas.     

Eosinophilic enteritis in a specific-pathogen-free cat

Moderate to severe, chronic, segmental eosinophilic enteritis was diagnosed histopathologically in a 2-year-old, specific-pathogen-free cat. Peripheral eosinophilia was not observed, although eosinophilic infiltrates were found in mesenteric lymph nodes. Typical gastrointestinal signs characteristic of this disease (diarrhea, vomiting, and anorexia) were not seen; only weight loss was observed. Treatment was not instituted. Previously reported cases of feline eosinophilic enteritis have been associated with several domestic breeds having a diversity of backgrounds. The cat of this report had a known genealogy and disease-free history, was reared under barrier conditions, and was fed a restricted diet. The cause of the disease in this cat was not determined.     

Enteric pythiosis in a horse

Enteric pythiosis was diagnosed in a 2-year-old Quarter Horse gelding. The horse had signs of colic, which appeared to be alleviated by administration of mineral oil and analgesics, but only temporarily. Intestinal distention developed after initial examination. At surgery, a thick stenotic area was observed in the middle portion of the jejunum. The thick intestine and associated mesentery contained multiple firm nodules of gritty caseous material. Histopathologic findings included sclerosing eosinophilic granulomatous enteritis and peritonitis. Although the lesion resembled a response to migrating parasites and lacked hyphae in initial sections, the gross appearance of the lesion prompted the acquisition of additional sections to detect the etiologic agent.     

Primary mesenteric root osteosarcoma in a dog

Abstract: A 10‐year‐old spayed female Boxer‐mix was presented with a history of several weeks of soft stools, straining to defecate, inappetance, and lethargy and several days of hematochezia, melena, and dyschezia. Physical examination findings included mild tachycardia and tense cranial abdomen. CBC results indicated moderate mature neutrophilia. Ultrasonographic examination of the abdomen revealed a large mass with complex echogenicity in the cranial abdomen, likely associated with the intestines. Cytologic examination of a fine‐needle aspirate revealed a population of round, stellate, and spindle‐shaped cells arranged individually and in aggregates with occasional cells embedded in an eosinophilic extracellular matrix. The cytologic interpretation was malignant mesenchymal neoplasm with osteosarcoma being the primary differential. Surgical exploration of the abdomen revealed a 10‐cm‐diameter mass located at the intestinal mesenteric root. The mass occluded blood flow to portions of the gastrointestinal tract. The dog was euthanized due to the nonresectable nature of the tumor. Histopathologic examination revealed an expansile poorly demarcated mesenchymal neoplasm composed predominantly of spindloid and pyriform cells, occasionally embedded in a matrix compatible with osteoid. The diagnosis was extraskeletal osteosarcoma of the intestinal mesenteric root, only rarely reported in dogs.     

Chronic eosinophilic dermatitis: a manifestation of a multisystemic, eosinophilic, epitheliotropic disease in five horses

A generalized, chronic, progressive, exfoliative dermatitis in five horses is described. Histologically, the lesion is characterized by a superficial and deep perivascular dermatitis which is eosinophil-rich with a marked lymphocytic and plasmacytic component, accompanied by marked acanthosis and hyperkeratosis. More severe cases progress to a lichenoid pattern with the same cellular composition with focal eosinophilic spongiosis and eosinophilic subcorneal pustules. Clinically, the disease is associated with chronic, severe weight loss and is fulminating. The skin lesions are accompanied by lymphoplasmacytic and eosinophilic infiltrates and formation of eosinophilic granulomas in other epithelial organs, most noticeably the pancreas, in which a chronic, fibrosing pancreatitis develops. Other epithelial organs involved to various degrees are salivary glands, the gastrointestinal system, including the oral cavity and esophagus, biliary epithelium and bronchial epithelium. The etiology of this disease is unknown.     

Visceral mast cell tumour with eosinophilia and eosinophilic peritoneal and pleural effusions in a cat

Summary A cat with weight loss, pyrexia and recurrent lethargy and depression was found to have pleural and peritoneal eosinophilic effusions, peripheral eosinophilia, eosinophilic lymphadenitis and a massively enlarged mesenteric lymph node. Visceral mast cell neoplasia was diagnosed after histopathological examination of a biopsy of the mass. Palliative chemotherapy was attempted unsuccessfully and the cat was euthanased.     

Comparison of clinical history and dermatologic findings in 29 dogs with severe eosinophilic dermatitis: a retrospective analysis

The medical records and histopathological sections of 29 dogs diagnosed with a unique eosinophilic dermatitis resembling Wells' syndrome were reviewed in an attempt to elucidate the pathogenesis of this syndrome. The medical records were reviewed for information on dermatological lesion appearance, systemic signs in other organ systems, clinical analyte abnormalities, and drug therapy. Histological sections of dogs with moderate to severe eosinophilic dermatitis without folliculitis and furunculosis were reviewed and evaluated for the presence of collagen flame figures. Three categories of patients were found. Category 1 consisted of 17 dogs treated for vomiting and/or diarrhoea (often haematochezia or haematemesis) prior (mean: 4.6 days) to the onset of skin lesions. Fourteen category 1 dogs had erythematous lesions (macules, papules or plaques) that were most pronounced on the abdomen. Sixteen of the 17 dogs received multiple classes of drugs, and 59% were hypoalbuminemic. Category 2 consisted of five dogs that had skin lesions and gastrointestinal signs at presentation and four of these dogs were hypoalbuminemic. Category 3 included seven dogs without enteric illness. A positive drug score was found in six category 1 dogs and one each from categories 2 and 3. Eighteen cases had eosinophilic dermatitis without flame figures, seven cases had early flame figures and four had well-developed flame figures. These changes did not correlate with the categories of clinical presentation. More than 50% of the dogs developed eosinophilic dermatitis following treatment for severe gastrointestinal disease. The authors propose that this represents a unique syndrome that may have causal drug association.     

Intestinal T-cell lymphoma with severe hypereosinophilic syndrome in a cat

A Japanese domestic long-hair cat of about 8 years of age was presented with vomiting and hematochezia and was found to have significant hypereosinophilia. Bone marrow aspiration revealed moderate increases of eosinophilic lineages. Histopathological examination revealed mild eosinophilic and epitheliotropic T-lymphocytic infiltrations in the duodenum. Although the cat remained asymptomatic with only prednisolone administration, the cat presented with hematemesis, weight loss, and severe anorexia 512 days after the initial presentation. Subsequently, gastrointestinal perforation developed, and the cat died on Day 536. Histopathological examination of autopsy specimens revealed mixed cellular infiltration including eosinophils and neoplastic lymphocytes in the intestinal lymph nodes, intestine, liver, spleen, and pancreas. Immunohistochemical examination supports a diagnosis of intestinal T-cell lymphoma with severe hypereosinophilic syndrome.     

Two cases of severe iron-deficiency anaemia due to inflammatory bowel disease in the dog

Two dogs were referred for investigation of lethargy and anaemia. Preliminary examinations by the referring veterinary surgeons had revealed severe anaemia, which was poorly regenerative. In one case, the anaemia was microcytic and, in the other, it was hypochromic. These findings were suggestive of chronic blood loss anaemia. Neither dog had external signs of gastrointestinal disease, although one had vomited on a single occasion during the two weeks preceding referral. Although both dogs were producing grossly normal faeces, further investigations detected faecal occult blood. Multiple full thickness gastrointestinal biopsies were taken at laparotomy. These showed segmental eosinophilic enteritis of the duodenum and proximal jejunum in one case, and marked chronic lymphocytic gastritis in the other. Both cases illustrate the fact that severe systemic disease can result from gastrointestinal pathology in the absence of clinical signs of gastrointestinal disease.     

Cytologic, histologic, and immunohistochemical features of lingual liposarcoma in a dog

A 9-year-old female spayed mixed-breed dog was presented to the referring veterinarian with a history of decreased appetite and difficulty with prehension and swallowing because of a firm oval mass in the tongue. On cytologic evaluation of a fine-needle aspirate of the mass there were numerous round to polygonal cells organized individually or in loose clusters with rare branching capillaries. The cells had eosinophilic granular cytoplasm, round to oval nuclei, and occasionally indistinct borders. The cytologic diagnosis was granular cell tumor (GCT) of the tongue. Impression smears of a biopsy sample of the lingual mass contained similar eosinophilic granular cells with variable numbers of clear vacuoles in the background, numerous perivascular arrangements, and occasional lipoblasts, suggestive of liposarcoma. On histologic examination the tumor was composed of numerous lipocytes with rare foci of round eosinophilic granular cells without evidence of vacuolation; occasionally, atypical mitotic figures were seen. Immunohistochemically, the cells were uniformly negative for periodic acid-Schiff and did not express smooth muscle actin, desmin, or cytokeratin but were immunoreactive for vimentin and S100. A diagnosis of well-differentiated liposarcoma was made on the basis of morphologic and immunohistochemical results. Eosinophilic granular cells may be a component of well-differentiated liposarcoma and are not limited to GCT. Liposarcoma should be considered in the differential diagnoses of lingual tumors in the dog when cytological evaluation reveals eosinophilic granular cells consistent with GCT.