Canine and Feline Liver Cytology

Carlo Masserdotti, DVM, Dipl ECVCP, Spec Bioch Clin IAT, Consultant, Anatomic and Clinical Pathology, IDEXX Laboratories, Brescia, Italy.

1 Before the analysis. Rules for interpretation of hepatic cytology

1.1   The rules for cytological diagnosis of hepatic diseases

1.1.1        Rule 1

1.1.2        Rule 2

1.1.3        Rule 3

1.1.4        Rule 4

1.1.5        Rule 5

1.1.6        Rule 6

1.1.7        Rule 7

 

1.2   Diagnostic approach to liver disease

1.2.1        Clinical and anamnestic signs

1.2.2        Hematochemical investigations

1.2.2.1 Pathological bases of liver damage

1.2.2.2 Diagnosis of liver damage

1.2.2.3 Useful enzymes for the recognition of damage to the hepatocyte and cholangiocyte

1.2.2.4 Liver failure diagnosis

1.2.2.5 Parameters of liver failure

1.2.3    Ultrasonographic investigation

1.2.4    Cytological and histopathological investigation

1.2.4.1 Sample collection

1.2.4.2 Cytological approach to hepatic diseases

 

1.3   To rimember

 

2 Normal Histology and Cytology of the liver

2.1 Normal liver histology

2.2 Normal cytology of the liver

2.2.1 Hepatocytes

2.2.2 Kupffer cells

2.2.3 Stellate cells

2.2.4 Cholangiocytes (biliary cells)

2.2.6 Hepatic mast cells

2.2.7 Hematopoietic cells

2.2.8 Mesothelial cells

 

2.3 To rimember

 

3 Non-specific and reversible hepatocellular damage

3.1 Accumulation of water

3.2 Accumulation of glycogen

3.3 Accumulation of lipids

3.4 Accumulation of bilirubin and bile salts

3.5 Hyperplasia of stellate cells

3.6 Regenerative changes

3.7 To rimember

 

4 Intra and extra-cytoplasmic pathological accumulation

4.1 Pathological intracytoplasmic accumulation

4.1.1. Lipofuscin

4.1.2 Copper

4.1.3 Iron and hemosiderin

4.1.4 Protein droplets

4.1.5 Cytoplasmic granular eosinophilic material

4.1.6. Hepatic lysosomal storage disorders

 

4.2 Pathological extracytoplasmic accumulations

4.2.1 Bile

4.2.2 Amyloid

 

4.3 To remember

 

5 Irreversible hepatocellular damage

5.1 Necrosis

5.2 Apoptosis

5.3 To remember

 

6 Inflammation

6.1 Presence of neutrophilic granulocyte

6.2 Presence of eosinophilic granulocytes

6.3 Presence of lymphocytes and plasmacells

6.4 Presence of macrophages

6.5 Presence of mast cells

6.6 To remember

 

7 Nuclear inclusions

7.1 “Brick” inclusions

7.2 Glycogen pseudo-inclusions

7.3 Lead inclusions

7.4 Viral inclusions

7.5 To remember

 

8 Cytological features of liver fibrosis

8.1 Cytological features of liver fibrosis

8.2 To remember

 

9 Cytological Features of biliary diseases

9.1 General features of biliary diseases

9.2 Cytological features of some specific biliary diseases

9.2.1 Acute and chronic cholestasis

9.2.2 Acute cholangitis

9.2.3 Chronic cholangitis

9.2.4 Lymphocytic cholangitis

 

9.3 To rimember

 

10 Bile and gallbladder diseases

10.1 Bactibilia and septic cholecystitis

10.2 Epithelial hyperplasia

10.3 Gallbladder mucocele

10.4 Limy bile syndrome

10.5 Biliary sludge

10.6 Neoplastic diseases of gallbladder

10.7 Other gallbladder diseases

10.8 To remember

 

11 Ethiological agents

11.1 Virus

11.2 Bacteria

11.3 Protozoa

11.4 Fungi

11.5 Parasites

11.6 To remember

 

12 Neoplastic lesions of the hepatic parenchyma

12. 2 Nodular lesions of epithelial origins

12.2.1 Nodular hyperplasia

12.2.2 Hepatocellular adenoma

12.2.3 Hepatocellular carcinoma

12.2.4 Cholangioma

12.2.5 Cholangiocellular carcinoma

12.2.6 Other nodular lesions of biliary origins

12.2.7 Hepatic carcinoid

12.2.8 Hepatoblastoma

 

12.3 Nodular lesions of mesenchymal origin

12.3.1 Malignant mesenchymal neoplasms

 

12.4 Nodular lesions of hematopoietic origin

12.4.1. Myelolipoma

12.4.2. Large-cell hepatic lymphoma

12.4.3 Small cell lymphoma

12.4.4. LGL lymphoma

12.4.5 Epitheliotropic lymphoma

12.4.6 Other types of hepatic lymphoma

12.4.7. Malignant histiocytic neoplasms

12.4.8. Mast cell tumor

12.4.9 Hepatic splenosis

 

12.5 Liver metastasis

12.6 Criteria for the selection of sampling methods of liver nodular lesions

12.7 To remember