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Fernández-Gallego A, Del-Pozo J, Boag A, Maxwell S, Pérez-Acino J. Xanthogranulomatous Pituitary Adenoma in a Dog with Typical Hyperadrenocorticism. J Comp Pathol 2020; 180:115-121. [PMID: 33222868 DOI: 10.1016/j.jcpa.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/16/2020] [Accepted: 09/11/2020] [Indexed: 11/16/2022]
Abstract
Xanthogranuloma of the sellar region has been reported in both humans and animals. The lesion is rare, and its aetiology and pathogenesis are not fully understood. The association of sellar xanthogranuloma with an adenoma, known as xanthogranulomatous pituitary adenoma (XPA), is an extremely rare condition in humans and is usually associated with anterior pituitary insufficiencies, headache, vomiting and visual deficits. We present the first report of XPA in an animal. A 7-year-old male neutered Labrador Retriever was presented for investigation of progressive lethargy, vomiting and hyporexia, having been previously diagnosed with chronic kidney disease, pituitary-dependent hyperadrenocorticism and hypoparathyroidism. The dog was euthanized due to lack of response to medical treatment and post-mortem examination revealed XPA. Although rare, xanthogranulomatous lesions should be considered in patients with pituitary disease.
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Affiliation(s)
- Ana Fernández-Gallego
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK.
| | - Jorge Del-Pozo
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Alisdair Boag
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Scott Maxwell
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Jorge Pérez-Acino
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
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Presence of CD3 + and CD79a + Lymphocytes in the Pituitary Gland of Dogs at Post-mortem Examination. J Comp Pathol 2020; 176:116-121. [PMID: 32359623 DOI: 10.1016/j.jcpa.2020.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 11/22/2022]
Abstract
Hypophysitis has been reported occasionally in dogs, with most cases resembling primary lymphocytic hypophysitis in man. Although it is generally assumed that lymphocytes are not present normally in the canine pituitary gland, few studies have investigated this hypothesis. However, lymphocytes are recognized in the pituitary gland of people and horses without signs of pituitary disease. It is unknown to what degree lymphocyte infiltration of the pituitary gland might occur as an incidental finding in dogs. The aim of the present study was to investigate the presence and distribution of lymphocytes in the pituitary gland of dogs without clinical suspicion of pituitary disease. Twenty dogs were subjected to routine necropsy examination. Formalin-fixed and paraffin wax-embedded sections of pituitary were stained with haematoxylin and eosin (HE) or subjected to immunohistochemistry (IHC) using primary antibodies specific for the T-cell marker CD3 and the B-cell marker CD79a. The number of CD3+ and CD79a+ cells per area unit (CPA) was determined for different pituitary regions. Two dogs had extensive neoplastic lesions in the pituitary gland and were excluded from analysis. In the remaining 18 dogs, occasional scattered CD3+ cells were found in the pituitary gland. There was a significant difference in CD3+ CPA between pituitary regions (P = 0.001). The highest CD3+ CPA was found in the pars tuberalis (median 41.3 cells/mm2, interquartile range 20.9-50.5 cells/mm2). In six of the 18 dogs (33%), CD79a+ cells were detected in small number (median total cell number 0 cells/section, interquartile range 0-1.0 cells/section). This study shows that T cell, and fewer B cells, may be found in the pituitary gland of dogs without clinical suspicion of pituitary disease. Regional difference in T-cell density, with the highest CD3+ CPA in the pars tuberalis, may imply regional immunoregulatory functions in the canine pituitary gland.
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Ji K, Zhang L, Wang L, Wang W. Xanthogranuloma of the sellar region diagnosed by frozen section. Open Med (Wars) 2017; 11:426-428. [PMID: 28352831 PMCID: PMC5329863 DOI: 10.1515/med-2016-0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/12/2016] [Indexed: 12/01/2022] Open
Abstract
Xanthogranuloma (XG) of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis.
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Affiliation(s)
- Kun Ji
- Department of Pathophysiology, Shenyang Medical College, Shenyang 110034, Liaoning, China
| | - Liyan Zhang
- Department of Pathophysiology, Shenyang Medical College, Shenyang 110034, Liaoning, China
| | - Liwei Wang
- Department of health Sciences Research, Mayo Clinic College of Medicine, Rochester 55901, Minnesota, United States of America
| | - Wei Wang
- Departments of Neurosurgery, The Second Clinical Medical School of Inner Mongolia University for the Nationalities (Inner Mongolia General Forestry Hospital), Yakeshi 022150, Inner Mongolia, China
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Rzechorzek NM, Liuti T, Stalin C, Marioni-Henry K. Restored vision in a young dog following corticosteroid treatment of presumptive hypophysitis. BMC Vet Res 2017; 13:63. [PMID: 28241874 PMCID: PMC5330113 DOI: 10.1186/s12917-017-0983-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Hypophysitis is an umbrella term for a group of disorders involving inflammation of the pituitary gland. A rare occurrence in humans, hypophysitis can produce a range of clinical signs including (but not limited to) visual deficits and diabetes insipidus. Only five cases of canine hypophysitis exist in the literature, all presenting in mature dogs with no visual deficits and a grave outcome. This case report describes the clinical and advanced imaging features of blindness-inducing presumptive hypophysitis in a dog, which rapidly resolved with medical management. Case presentation A 1-year-and-seven-month-old neutered male Standard Poodle presented with subacute blindness, ataxia, and polyuria/polydipsia (PUPD). Magnetic resonance imaging (MRI) detected a contrast-enhancing pituitary mass with perilesional oedema compromising the optic chiasm. Suspecting neoplasia, anti-inflammatory corticosteroid was commenced prior to radiation therapy planning. Complete resolution of neurological and visual deficits occurred within 12 days of starting steroid treatment. Repeated advanced imaging indicated macroscopic resolution of the lesion. An extended thyroid panel with insulin-like growth factor-1 analysis supported a diagnosis of hypophysitis. Resolution of PUPD was achieved with tapering courses of prednisolone and desmopressin; the dog has since been clinically normal for 14 months and treatment-free for 11 months. Conclusions To the authors’ knowledge, this is the first instance in which a canine pituitary mass has demonstrated long-term resolution with palliative medical treatment alone, alongside reversal of associated blindness and presumptive diabetes insipidus. We suspect this lesion to be a form of hypophysitis, which should be included among differential diagnoses for pituitary masses, and for subacute blindness in dogs. Where possible, we advocate biopsy-confirmation of hypophysitis prior to timely intervention with anti-inflammatory treatment.
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Affiliation(s)
- Nina Marie Rzechorzek
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK. .,Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK.
| | - Tiziana Liuti
- Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK
| | - Catherine Stalin
- The Neurology Service, Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, Garscube Campus, Bearsden Road, Glasgow, G61 1QH, UK
| | - Katia Marioni-Henry
- Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Midlothian, EH25 9RG, UK
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Grau-Roma L, Peckham R, Paton J, Stahel A, de Brot S. Occurrence of primary lymphocytic hypophysitis in two horses and presence of scattered T-lymphocytes in the normal equine pituitary gland. J Vet Diagn Invest 2016; 29:115-121. [DOI: 10.1177/1040638716676292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The postmortem examination of a 14-y-old Appaloosa gelding with clinically diagnosed pituitary pars intermedia dysfunction showed a unique finding of moderate multifocal lymphocytic hypophysitis (LH). The pituitary glands of 24 horses submitted for postmortem examination were examined grossly and examined histologically for the presence of lymphocytes. Of these 23 horses, 1 additional case suffered from moderate LH. The 2 cases with LH tested negative for Equid herpesvirus 1 and 4 by polymerase chain reaction and immunohistochemistry (IHC), and no viral particles were observed by electron microscopy in 1 case examined. The cause of LH remains unknown, but based on the T-lymphocytic nature of the inflammation and the human literature, an immune-mediated origin is hypothesized. In addition, the review of 24 cases revealed that 10 horses had few and small multifocal lymphocytic infiltrates within the pituitary gland; the remaining 12 horses showed no evident lymphocytes when examined by hematoxylin and eosin. IHC for CD3 showed the presence of a small number of individual T-lymphocytes scattered through the gland in all examined horses, which appears therefore to be a normal feature of the pituitary gland in horses.
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Affiliation(s)
- Llorenç Grau-Roma
- School of Veterinary Medicine and Sciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK (Grau-Roma, de Brot)
- University College Dublin, Equine Veterinary Hospital, University College Dublin Campus, Belfield, Dublin, Ireland (Peckham)
- Scarsdale Equine Veterinary Practice, Derby, UK (Paton)
- Institute of Virology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland (Stahel)
| | - Robert Peckham
- School of Veterinary Medicine and Sciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK (Grau-Roma, de Brot)
- University College Dublin, Equine Veterinary Hospital, University College Dublin Campus, Belfield, Dublin, Ireland (Peckham)
- Scarsdale Equine Veterinary Practice, Derby, UK (Paton)
- Institute of Virology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland (Stahel)
| | - Jacqui Paton
- School of Veterinary Medicine and Sciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK (Grau-Roma, de Brot)
- University College Dublin, Equine Veterinary Hospital, University College Dublin Campus, Belfield, Dublin, Ireland (Peckham)
- Scarsdale Equine Veterinary Practice, Derby, UK (Paton)
- Institute of Virology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland (Stahel)
| | - Anina Stahel
- School of Veterinary Medicine and Sciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK (Grau-Roma, de Brot)
- University College Dublin, Equine Veterinary Hospital, University College Dublin Campus, Belfield, Dublin, Ireland (Peckham)
- Scarsdale Equine Veterinary Practice, Derby, UK (Paton)
- Institute of Virology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland (Stahel)
| | - Simone de Brot
- School of Veterinary Medicine and Sciences, University of Nottingham, Sutton Bonington Campus, Loughborough, UK (Grau-Roma, de Brot)
- University College Dublin, Equine Veterinary Hospital, University College Dublin Campus, Belfield, Dublin, Ireland (Peckham)
- Scarsdale Equine Veterinary Practice, Derby, UK (Paton)
- Institute of Virology, University of Zurich, Vetsuisse Faculty, Zurich, Switzerland (Stahel)
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Alleaume C, Mrini ME, Laloy E, Marchal J, Aujard F, Chahory S. Scleral and corneal xanthomatous inflammation in a gray mouse lemur (Microcebus murinus). Vet Ophthalmol 2016; 20:177-180. [PMID: 27030164 DOI: 10.1111/vop.12374] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bilateral multifocal corneal opacity was detected in a 4.5-year-old male captive gray mouse lemur (Microcebus murinus) without other clinical ocular changes. Histopathological examination revealed a severe diffuse granulomatous scleritis and focal keratitis with intralesional cholesterol, consistent with xanthomatous inflammation. This is the first report of xanthomatous inflammation in a gray mouse lemur. This condition may be the result of systemic factors (lipid metabolism disorders) and/or local predisposing factors such as hemorrhage or inflammation. The pathogenesis in this case could not be fully determined. Further studies on lemurs are required for a better understanding of their lipid metabolism, as well as for diagnosing and evaluating the incidence of xanthomatous inflammation in these species.
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Affiliation(s)
- Charline Alleaume
- Ecole Nationale Vétérinaire d'Alfort, Unité d'Histologie Embryologie et Anatomie pathologique, Université Paris-Est, Maisons-Alfort, F-94704, France
| | - Meryem El Mrini
- Ecole Nationale Vétérinaire d'Alfort, Unité d'Histologie Embryologie et Anatomie pathologique, Université Paris-Est, Maisons-Alfort, F-94704, France
| | - Eve Laloy
- Ecole Nationale Vétérinaire d'Alfort, Unité d'Histologie Embryologie et Anatomie pathologique, Université Paris-Est, Maisons-Alfort, F-94704, France
| | - Julia Marchal
- Centre National de la Recherche Scientifique, Muséum National d'Histoire Naturelle, Mécanismes Adaptatifs et Evolution, Brunoy, F-91800, France
| | - Fabienne Aujard
- Centre National de la Recherche Scientifique, Muséum National d'Histoire Naturelle, Mécanismes Adaptatifs et Evolution, Brunoy, F-91800, France
| | - Sabine Chahory
- Ecole Nationale Vétérinaire d'Alfort, UP Ophtalmologie, Université Paris-Est, Maisons-Alfort, F-94704, France
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Chawla P, Cook L, Himmell L, Zekas L, Oglesbee M. Coextensive Meningioma and Cholesterol Granuloma in the Forebrain of a Cat. J Vet Intern Med 2015; 29:1638-42. [PMID: 26289395 PMCID: PMC4852139 DOI: 10.1111/jvim.13601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 12/01/2022] Open
Affiliation(s)
- P Chawla
- Southern California Veterinary Specialty Hospital, Irvine, CA
| | - L Cook
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - L Himmell
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH
| | - L Zekas
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | - M Oglesbee
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH
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Gao F, Narayanan J, Joneikis C, Fish BL, Szabo A, Moulder JE, Molthen RC, Jacobs ER, Rao RN, Medhora M. Enalapril mitigates focal alveolar lesions, a histological marker of late pulmonary injury by radiation to the lung. Radiat Res 2013; 179:465-74. [PMID: 23480564 DOI: 10.1667/rr3127.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The goal of our study was to identify a histological marker for testing countermeasures for mitigation of late radiation injury to the lung. Pulmonary fibrosis is currently the best described "late effect" in survivors of acute radiation pneumonitis. However, robust fibrosis does not develop in some rodent strains for years after a single dose of radiation to the whole thorax. We observed radiation-associated focal alveolar lesions that were rich in giant cells and macrophages containing cholesterol clefts in the lungs of irradiated WAG/RijCmcr rats. These lesions were first observed after pneumonitis, around 21 weeks after receiving a radiation dose of 13 Gy to the thorax but not until 71 weeks in unirradiated rats. The number of cholesterol clefts increased with time after irradiation through 64 weeks of observation, and at 30 weeks after 13 Gy, cholesterol clefts were associated with several indices of deterioration in lung function. The number of cholesterol clefts in irradiated lung sections were reduced by the angiotensin converting enzyme (ACE) inhibitor enalapril (25-42 mg/m²/day) from 18.7 ± 4.2/lung section to 6.8 ± 2.4 (P = 0.029), 5.2 ± 1.9 (P = 0.0051) and 6.7 ± 1.9 (P = 0.029) when the drug was started at 1 week, 5 or 15 weeks after irradiation, respectively, and continued. Similar lesions have been previously observed in the lungs of one strain of irradiated mice and in patients following radiotherapy. We propose that alveolar lesions with cholesterol clefts may be used as a histological marker of the severity of radiation lung injury and to study its mitigation in WAG/RijCmcr rats.
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Affiliation(s)
- Feng Gao
- Departments of Radiation Oncology, Marquette University, Milwaukee, Wisconsin, USA
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