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Granulomatous Disease

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Doctorate Pathology Mapa Mental sobre Granulomatous Disease, criado por melian.yates em 23-10-2013.
melian.yates
Mapa Mental por melian.yates, atualizado more than 1 year ago
melian.yates
Criado por melian.yates aproximadamente 11 anos atrás
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Resumo de Recurso

Granulomatous Disease
  1. Classifications
    1. With/ Without Granulomas
      1. All Granulomas are part of Granulomatous inflammation
        1. Not all granulomatous inflammatory lesions have granulomas
          1. Granuloma = Focal/ multifocal
            1. Granulomatous = Thickened/ Turgid
        2. Cells Present
          1. 1) Granulomatous
            1. Macrophages
              1. Multinucleated giant cells (Macrophages), Lymphocytes, Fibroblasts
            2. 2) Eosinophilic Granulomatous
              1. Macrophages + Eosinophils
                1. Cats & horses
                  1. Ex. Feline Eosinophilic granuloma complex
                2. 3) Pyogranulomatous
                  1. Macrophages + Neutrophils
                    1. Ex. Actinobacillus ligieresii, Actinomyces bovis
                3. Aetiology
                  1. Bacteria
                    1. Actinobacillus lignieresii
                      1. Actinomyces bovis
                      2. Live in Macrophages:
                        1. Mycobacteria
                          1. M. tuberculosis complex
                            1. M. boivs
                              1. Cattle, other animals
                                1. Spread by coughing & sneezing
                                  1. Survive in respiratory tract macrophages
                                  2. < 10% of infected animals develop clinical disease
                                    1. Zoonotic
                                      1. Pathology
                                        1. Gross
                                          1. Well circumscribed, often encapsulated, pale yellow to white foci, often with Caseous Necrosis &/or mineralization
                                            1. Most often respiratory tract lymph nodes are affected
                                              1. Can have lesion in lungs
                                                1. Can have systemic disease
                                                  1. Granulomas all over body
                                                2. Histologically
                                                  1. Central area of Caseous Necrosis
                                                    1. Classical Granulomas
                                                      1. Acid fast bacteria w/in internal macrophages & giant cells
                                              2. (Cats) M. lepraemurium
                                                1. Cutaneous nodular lesions
                                                  1. Refractory to normal Abx
                                                    1. Granulomatous dermatitis with Acid fast organisms
                                                  2. M. avium complex (MAC)
                                                    1. M. a paratuberculosis
                                                      1. Johne's disease
                                                        1. Cattle, sheep, goats, deer
                                                          1. Animals infected when young
                                                            1. Contaminated feces
                                                              1. Bacteria lives in macrophages for years: subclinical
                                                                1. Causes diarrhaoea & weight loss when older
                                                            2. Pathology
                                                              1. Grossly
                                                                1. Thickened & corrugated small intestine
                                                                  1. Can be yellow in Sheep
                                                                    1. Terminal ileum is most often affected
                                                                      1. Iliocecal junction
                                                                    2. Enlarged mesenteric lymph nodes
                                                                    3. Histologically (Sheep)
                                                                      1. Multibacillary
                                                                        1. Macrophages & Giant cells
                                                                          1. Many Intracellular acid fast bacteria
                                                                          2. Paucibacillary
                                                                            1. Lymphocytes & Plasma cells w/ Macrophages
                                                                              1. Very few acid fast bacteria
                                                                                1. Rare in Cattle
                                                                                2. Both types have the same clinical signs, gross lesions & outcome
                                                                          3. M.a. avium
                                                                            1. Avian mycobacteriosis
                                                                              1. Granulomas in liver, intestines & other organs
                                                                            2. Pathogenesis
                                                                              1. Intracellular survival aided by specialized cell wall
                                                                                1. Stop the lysosome from fusing
                                                                                  1. Capsular polysaccharide, complex free lipids
                                                                                    1. Mycolic Acids
                                                                                      1. Arabinogalactan
                                                                                        1. Peptidoglycan
                                                                              2. Rhodoccocus
                                                                                1. Brucella
                                                                                  1. Salmonella
                                                                                2. Stop phagolysosome fusing
                                                                                  1. Inhibit lysosome enzymes
                                                                                    1. Capsule resistant to lysosomal enzymes
                                                                              3. Parasites
                                                                                1. Lungworm
                                                                                  1. Cat: Aelurostrongylus abstrusus
                                                                                    1. Sheep: Muellerius capillaris
                                                                                      1. Cattle: Dictyocaulus Viviparus
                                                                                        1. Dog: Angiostrongylus vasorum
                                                                                      2. Fungi
                                                                                        1. Aspergillus sp.
                                                                                          1. Opportunistic
                                                                                            1. Immunocompromised animals
                                                                                              1. Viral infection of gut
                                                                                                1. Antibiotic therapy
                                                                                            2. Granulomas & Pyogranulomas
                                                                                            3. Systemic Mycoses
                                                                                              1. Coccidioides immitis
                                                                                                1. Inhalation
                                                                                                  1. Granulomas & Pyogranulomatous
                                                                                            4. Foreign Material
                                                                                              1. Most foreign material will induce a granulomatous response
                                                                                                1. Difficult/ Impossible for Macrophages to breakdown foreign material
                                                                                                  1. Suture Material
                                                                                                    1. Silica
                                                                                                      1. Hair shafts ( Furunculosis)
                                                                                                        1. Sperm granuloma
                                                                                                2. Viruses
                                                                                                  1. Only 2 Viruses
                                                                                                    1. FIPV (Feline Infectious Peritonitis Virus)
                                                                                                      1. Coronavirus
                                                                                                        1. Feline infectious peritonitis (FIP)
                                                                                                          1. Lives in macrophages
                                                                                                            1. Vasculitis
                                                                                                              1. Wet & Dry forms of disease
                                                                                                                1. Wet
                                                                                                                  1. Abdominal distension
                                                                                                                    1. Dyspnea due to thoracic effusion
                                                                                                                  2. Dry
                                                                                                                    1. Most often involves the eyes & CNS
                                                                                                                      1. Areas of inflammation on Retina
                                                                                                                      2. Kidney, Liver, lymph nodes
                                                                                                                    2. Infected Macrophages accumulate around small blood vessels
                                                                                                                      1. Deposition of immune complexes & Activation of Complement
                                                                                                                        1. Macrophages release proinflammatory cytokines which promote leakage of blood vessels
                                                                                                                          1. Damage to Blood vessels
                                                                                                                    3. FECV => FIPV
                                                                                                                      1. Clinical Signs
                                                                                                                        1. Malaise, fluctating fever, inappetance, weight loss
                                                                                                                      2. Closely related to FECV - Harmless
                                                                                                                    4. PCV-2 ( Porcine circovirus 2)
                                                                                                                      1. Circovirus
                                                                                                                        1. PCVAD (PCV -2 Associated Disease)
                                                                                                                          1. Systemic Disease
                                                                                                                            1. PMWS (Post weaning multisystemic wasting syndrome)
                                                                                                                            2. Respiratory, Enteric, Reproductive Disease
                                                                                                                              1. Porcine Dermatitis and Nephropathy Syndrome (PDNS)
                                                                                                                              2. Not all infected pigs develop disease
                                                                                                                                1. Granulomatous Inflammation
                                                                                                                                  1. Lymph nodes
                                                                                                                                    1. Lungs
                                                                                                                                      1. Intestines
                                                                                                                                        1. Liver
                                                                                                                                          1. Other tissues
                                                                                                                                      2. Granulomatous lymphadenitis
                                                                                                                              3. Toxins
                                                                                                                                1. Hairy Vetch (Vicia villosa) - Legume
                                                                                                                                  1. Causes necrosis & granulomatous inflammation in many organs (Heart, Kidney, Liver)
                                                                                                                                2. Idiopathic
                                                                                                                                  1. GME (Granulomatous meningoencephalomyelitis of Dogs)
                                                                                                                                    1. Histiocytic ulcerative colitis
                                                                                                                                      1. Dogs: Sebaceous adenitis
                                                                                                                                        1. Feline eosinophilic granuloma complex
                                                                                                                                          1. Consists of 3 diseases
                                                                                                                                            1. Feline Eosinophilic Granuloma
                                                                                                                                              1. More common in young cats
                                                                                                                                                1. Nodular or linear lesions on skin, footpad, mucotaneous junctions & oral cavity
                                                                                                                                                  1. Raised, pink, alopecic
                                                                                                                                                    1. Histology: Eosinophils & Macrophages
                                                                                                                                                2. Eosinophilic plaque
                                                                                                                                                  1. Raised, red, alopecic to ulcerated, flat topped plaques on the skin
                                                                                                                                                    1. VERY Pruritic
                                                                                                                                                      1. Eosinophils, Lymphocytes & Macrophages
                                                                                                                                                  2. Indolent Ulcer
                                                                                                                                                    1. Ulcerated lesion on upper lip adjacent to the philtrum
                                                                                                                                                      1. Pain & pruritis are rare
                                                                                                                                                        1. Unilateral or Bilateral
                                                                                                                                                          1. Histologically: Eosinophils, Neutrophils, Mast cells & Macrophages
                                                                                                                                            2. Young to middle aged small dog breeds
                                                                                                                                              1. Causes neurological disease
                                                                                                                                                1. Can affect spinal cord, brain meninges
                                                                                                                                              2. Gross Lesions
                                                                                                                                                1. Few (maybe some discoloration)
                                                                                                                                                2. Histologically
                                                                                                                                                  1. Inflammation & Necrosis of the white matter
                                                                                                                                                    1. Macrophages, Lymphocytes, Plasma cells

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