Multifocal Nodules Research Articles

Imaging features of primary renal lymphoma.

Background Cases of primary renal lymphoma (PRL) are quite rare and are often mistaken for renal cell carcinoma. Purpose To determine the multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) characteristics of PRL. Materials and Methods Twenty-three patients with PRL were identified by CT and MRI, and their tumor characteristics were assessed. Results Tumors exhibited single or multifocal nodules (n = 19) and diffuse renal enlargement (n = 4). Twenty-two tumors exhibited an infiltrative appearance. There was no evidence of calcification in any of the cases. Twenty-one tumors displaced or wrapped around abdominal vessels rather than encasing them. Enlarged retroperitoneal nodes were observed in three cases. Neither extension into the venous system nor distant metastasis was found. Tumor enhancement was of low attenuation compared with that of normal renal cortex and medulla ( P < 0.05). PRL was isointense on T1-weighted imaging, slightly hypointense on T2-weighted imaging and hyperintense on diffusion-weighted imaging. Twenty-two patients exhibited biopsy-confirmed PRN. There were four, 12, and seven cases of low-grade, intermediate-grade, and high-grade tumors, respectively. Patient were followed up over 16 to 166 months. Six patients died within three years and five patients died within five years. Conclusion Infiltrative appearance and tumor displacement or extension around abdominal vessels rather than vessel encasement are common findings on CT or MRI imaging and may suggest a diagnosis of PRL.

PDGFRB gain-of-function mutations in sporadic infantile myofibromatosis.

Infantile myofibromatosis is one of the most prevalent soft tissue tumors of infancy and childhood. Multifocal nodules with visceral lesions are associated with a poor prognosis. A few familial cases have been linked to mutations in various genes including PDGFRB. In this study, we sequenced PDGFRB, which encodes a receptor tyrosine kinase, in 16 cases of myofibromatosis or solitary myofibroma. Mutations in the coding sequence of PDGFRB were identified in 6 out of 8 patients with the sporadic multicentric form of the disease and in 1 out of 8 patients with isolated myofibroma. Two patients had the same mutation in multiple separated lesions. By contrast, a third patient had three different PDGFRB mutations in the three nodules analyzed. Mutations were located in the transmembrane, juxtamembrane and kinase domains of the receptor. We showed that these mutations activated receptor signaling in the absence of ligand and transformed fibroblasts. In one case, a weakly-activating germline variant was associated with a stronger somatic mutation, suggesting a two-hit model for familial myofibromatosis. Furthermore, the mutant receptors were sensitive to the tyrosine kinase inhibitor imatinib, except D850V, which was inhibited by dasatinib and ponatinib, suggesting a targeted therapy for severe myofibromatosis. In conclusion, we identified gain-of-function PDGFRB mutations in the majority of multifocal infantile myofibromatosis cases, shedding light on the mechanism of disease development, which is reminiscent of multifocal venous malformations induced by TIE2 mutations. Our results provide a genetic test to facilitate diagnosis, and preclinical data for development of molecular therapies.

A pediatric case of primary cutaneous anaplastic large cell lymphoma: An unusual presentation

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare form of ALCL, usually seen in elderly patients which is clinically characterized by single or multifocal nodules that ulcerate, autoregressive, and recurrent. Extracutaneous dissemination may occur, especially to regional lymph nodes. In this report, we present an unusual case of an 8-year-old boy with a noduloulcerativelesion present on the upper back with axillary painful lymphadenopathy, initially mimicking as scrofuloderma which was later histopathologically and immunohistochemically diagnosed as CD30+ PCALCL.

Four Cases of Recurrent Parotid Pleomorphic Adenoma

We examined four patients who underwent reoperations for recurrent parotid pleomorphic adenoma in our department. All four patients had multi-focal recurrent nodules following one or three prior surgical procedures. The surgical procedures included a total parotidectomy in two patients and a superficial parotidectomy in two patients; an antegrade technique was used for two patients and a retrograde technique was used for the other two patients. There were two incidents of transient facial nerve palsy after the operations, but both patients recovered within six months. None of the patients experienced further recurrence after the reoperations. Retrograde nerve dissection is useful, and possibly essential, for the treatment of recurrent pleomorphic adenoma of the parotid gland. However, long-term follow up for these tumors is needed because of the high rate of recurrence for recurrent parotid pleomorphic adenoma.

Feline Respiratory Extramedullary Plasmacytoma with Lymph Node Metastasis and Intrahistiocytic Amyloid

A 14-year-old domestic longhaired cat presented with a 2-year history of nasal discharge and a recent onset of inappetence and submandibular lymphadenopathy. The cat was humanely destroyed after developing severe respiratory distress. Necropsy examination revealed thickened nasal turbinates and soft palate, and friable red–tan material within the frontal sinus, nasal cavity and nasopharynx. The lungs contained multifocal irregular friable tan nodules. Multiple lymph nodes were enlarged, friable and red–tan in colour. Histopathology revealed a mature type extramedullary plasmacytoma (EMP) within the frontal sinus, nasal cavity, soft palate, larynx, trachea, lungs and multiple lymph nodes. The lymph nodes and larynx also contained marked granulomatous inflammation with extensive intrahistiocytic (and lesser amounts of extracellular) lambda light chain amyloid, confirmed by electron microscopy and immunohistochemistry. Neoplastic cells expressed CD79a and MUM1. This is the first report of an infiltrative EMP of the feline respiratory tract with lymph node metastasis and predominantly intrahistiocytic amyloid.

Infecção pelo complexo Mycobacterium tuberculosis em carneiro da Barbária (Ammotragus lervia) no Zoológico de Curitiba, sul do Brasil: relato de caso

A tuberculose é uma das doenças mundiais de notificação obrigatória mais importantes causada pelo complexo Mycobacterium tuberculosis que pode infectar pessoas e animais. A morte repentina de um carneiro da Barbária no Zoológico de Curitiba, que apresentou nódulos multifocais no pulmão à necropsia, levantou a suspeita de tuberculose. Foi realizada a Reação em Cadeia da Polimerase Quantitativa (qPCR) de fragmentos de órgãos e fluido. A qPCR detectou a presença do complexo M. tuberculosis nas amostras de pulmão. Este estudo relata a infecção pelo complexo M. tuberculosis no carneiro da Barbária, uma zoonose de grande relevância para a saúde pública, ressaltando-se a necessidade da implementação de medidas de prevenção. Além disso, pode prover um melhor entendimento sobre conservação de espécies, ocorrência e transmissão de doenças em cativeiro, potencial reservatório e impacto na saúde pública para visitantes e funcionários dos zoológicos.

How Many Contralateral Carcinomas in Patients with Unilateral Papillary Thyroid Microcarcinoma are Preoperatively Misdiagnosed as Benign?

The decision to perform a total thyroidectomy (TT) for unilateral papillary thyroid microcarcinoma (PTMC) with nodules in the contralateral lobe remains controversial. The aim of this study was to investigate the rate of contralateral carcinomas that are preoperatively misdiagnosed as benign. From October 2011 to October 2015, a total of 347 patients with unilateral PTMC and contralateral benign nodules who were treated with a TT at a single institution were enrolled. All patients underwent preoperative fine needle aspiration and ultrasonography (US). Clinicopathological features such as age, sex, laterality, tumor size, central lymph node metastases, capsular invasion, TgAb and TPOAb levels, Hashimoto's thyroiditis, nodule number in both lobes according to preoperative US, and primary carcinoma number in the final postoperative pathology report were all analyzed to investigate the rate and predictive factors of contralateral carcinoma. A total of 100 patients (28.9%) were diagnosed with papillary thyroid carcinoma in the contralateral lobe. A multivariate analysis showed that tumor size, nodule number in the contralateral lobe, and multifocality of the primary tumor were all independent predictive factors of contralateral carcinoma in patients with unilateral PTMC and contralateral benign nodules. According to our findings, the rate at which contralateral carcinomas are preoperatively misdiagnosed as benign is 28.9%. A TT is essential for unilateral PTMC with a primary tumor size >5mm, multifocal primary carcinomas or multifocal benign nodules in the contralateral lobe.

Non-tuberculous Mycobacteriosis with T-cell Lymphoma in a Red Panda (Ailurus fulgens)

A 9-year-old male red panda (Ailurus fulgens) became emaciated and died. Necropsy examination revealed systemic lymphadenomegaly. The liver, lungs and left kidney contained multifocal yellow nodules. Microscopical examination revealed granulomatous inflammation in the liver, lungs, kidney, spleen and lymph nodes, with numerous acid-fast bacilli. Sequencing of genetic material isolated from the tissues classified the pathogen as Mycobacterium gastri. Lymphoma was found in the liver, lungs, kidney and lymph nodes. The neoplastic cells were strongly labelled for expression of CD3, Ki67 and proliferating cell nuclear antigen by immunohistochemistry. This is the first report of M. gastri infection with T-cell lymphoma in a red panda.

A Novel Mycoplasma sp. Associated with Phallus Disease in Goose Breeders: Pathological and Bacteriological Findings.

In April 2014, poor fertility in a major commercial goose breeder operation in California triggered the submission of six live affected Toulouse ganders ( Anser anser ) to the California Animal Health and Food Safety Laboratory, Turlock branch (University of California-Davis). Toulouse were principally affected among all breeds, and their egg fertility dropped from 65.7% to less than 33.9% in the first 40 days of the 2014 breeding season. The flock consisted of 410 adult birds, 90 males and 320 females, between 2 and 5 yr of age. Inspection of the flock revealed that 44.4% of the Toulouse ganders had severe phallic deformities that prevented them from mating. At postmortem examination, severe yellowish fibrocaseous exudate disrupted the architecture of the phallus and occasionally produced fistulating tracts through the wall of the organ. Microscopically, multifocal lymphoid nodules were noted in the mucosa and submucosa of the phallus and were associated with extensive granulomatous reaction, intralesional bacteria, and spermatozoa. Mycoplasma spp. were isolated from the phallus of affected and nonaffected birds, and PCR protocols targeting the 16S-23S ribosomal RNA intergenic spacer regions and the RNA polymerase beta subunit gene were performed to identify the isolates. Three distinct species were identified on sequencing and analysis using the National Center for Biotechnology Information basic local alignment search tool: Mycoplasma cloacale , Mycoplasma anseris , and an unknown novel Mycoplasma sp. Additionally, Pasteurella multocida , in combination with other bacteria, was also isolated from the phallic lesions and identified as serotype 3 with a DNA profile of 1511 (National Veterinary Service Laboratory). This is the first report of these Mycoplasma spp. and other bacteria associated with reproductive disease in ganders in the United States.

Clinical analysis of lymphocytic thyroiditis coexistent with papillary thyroid carcinoma

To analyse the clinical features and treatment strategies of papillary thyroid carcinoma(PTC) coexistent with lymphocytic thyroiditis (LT). A total of 292 patients including 25 males and 267 females with LT and thyroid nodules treated in the department of head and neck surgery between Sep 2011 and Sep 2014 was analysed retrospectively and divided into two groups according to pathological results, of them 262 patients, with a median age of 47 years old, were LT with PTC and 30 patients, with a median age of 54 years old, were LT with benign nodules. Among 262 patients having LT with PTC, 259 were diagnosed as having malignant or suspicious malignant nodules and 3 having benign nodules with ultrasound before surgery, 98 cases were considered multifocal malignant nodules by preoperative ultrasound, and 112 cases were positive in cervical lymph nodes, including bilateral positive in 37 cases. Of 30 patients having LT with benign nodules, 14 were diagnosed malignant or suspicious malignant nodules and 16 benign nodules. The mean age in 262 patients with PTC was less significantly than that in 30 patients with benign nodules (P<0.05). Ultrasound showed a high proportion of calcification and microcalcification in patients with PTC (34%) compared to patients with benign nodules(13%)(P<0.05). There were not significant differences in the mean levels of serum thyroid stimulating hormone(TSH) (2.80 vs 2.99 mU/L, P=0.233), thyroglobulin(TG) (27.14 vs 18.60 μg/L, P=0.747), and anti-thyroglobulin antibodies(ATG)(417.3 vs 378.7 U/ml, P=0.834) between patients with PTC and those with benign nodules. In patients with PTC, multifocal tumor accounted for 42%. The central and lateral lymph node metastasis rates were respectively 50% and 24%, and the occult metastasis rate of lateral neck lymph node was 16%. Univariate analysis showed that age less than 45 years old, multifocal tumor, tumor diameter more than or equal to 2cm and extrathyroidal extension were associated with central lymph node metastasis (P<0.05), but not with lateral neck metastasis. Multivariate analysis showed a closed correlation only between the lymph node metastases in central and lateral neck levels (P<0.05). Calcification and microcalcification have the same importance in the ultrasonic diagnosis for PTC in patients with LT. Total thyroidectomy and prophylactic central lymph node should be a choice for LT with PTC. Lymph node metastasis in level Ⅵ indicates the possibility of lateral cervical lymph node metastasis in the patients having LT with PTC.

Multifocal metastatic cutaneous and mucosal transmissible venereal tumour in a female puppy

An eight-month old female entire mixed breed dog in Arizona was presented for a 15-day history of multifocal cutaneous nodules and plaques, with progressive stertor, anorexia, haemorrhagic gingival masses, peripheral...

Asymptomatic diffuse “encephalitic” cerebral toxoplasmosis in a woman with systemic lupus erythematosus

Classic cerebral toxoplasmosis typically presents with neurologic symptoms such as seizures and mental status changes and histological examination shows focal lesions with necrosis. However, in the diffuse “encephalitic” form, patients are asymptomatic with diffuse, inflammatory, non-necrotic lesions. Asymptomatic diffuse “encephalitic” toxoplasmosis has been reported only in four acquired immunodeficiency syndrome patients and one human immunodeficiency virus (HIV) negative patient with chronic lymphocytic leukemia. We present a 36-year-old HIV-negative woman with systemic lupus erythematosus and lupus nephritis who was on immunosuppression for 9years after cadaveric renal transplant and died from pulmonary hemorrhage and cytomegalovirus pneumonia. Brain autopsy findings revealed multifocal microglial nodules containing Toxoplasma bradyzoites and associated astrogliosis. These nodules were prominent in the cerebellum, midbrain and medulla and also present in the cortex and thalamus. No coagulative necrosis, necrotizing abscesses, or other opportunistic infections were present. The patient had previously exhibited no neurologic symptoms and there was no clinical suspicion for toxoplasmosis. To the best of our knowledge, this is the first case of diffuse, non-necrotizing, “encephalitic” cerebral toxoplasmosis reported in a lupus patient and also the first reported female case.

Typhocolitis by Cyathostomins Larvae on a Donkey

Background: Cyathostomosis is the infection by nematode larvae of small strongyles belonging to the subfamily Cyathos tominae (cyathostome). It is primarily a disease of young horses with global distribution. The parasites cause severe injuries to the intestine and the clinically affected animals have severe diarrhea, colic, intussusception, and less frequently intestinal infarction. The aim of this study is to describe the pathological fndings of enteritis by cyathostome on a donkey in Brazil.Case: A donkey (Equus asinus), crossbred female mongrel, approximately four-months-old, was referred to the Veterinary Hospital of the Federal University of Campina Grande, Patos, PB, Brazil with a history of trauma. On clinical examination, complete fracture of the left femur was identifed. After performing euthanasia the donkey was necropsied. The animal wasskinny with pale mucous membranes. The perineal region, base of the tail and hind limbs were dirty with yellowish fecal content. At necropsy, the large intestine had a pasty content and the mucosa was thickened with the multifocal whitish or dark red nodules. The cut surface of these nodules showed caseous material, sometimes associated with larvae in the submucosa. Microscopically, it was observed granulomatous and eosinophilic chronic multifocal associated with intralesional larvae of cyathostome-like nematodes. In the mucosa and submucosa of the colon and cecum, there were multifocal to coalescing granulomas composed by moderate inflammatory infltrate composed of eosinophils, macrophages, epithelioidcells, neutrophils and occasional multinucleated giant cells, surrounded by fbrous tissue and infltrated by lymphocytes and plasma cells. At the center of these granulomas transverse and longitudinal sections of nematode larvae with approximately 160-550μm in diameter were observed within the necrotic material. The parasites presented a smooth, thick andeosinophilic outer cuticle, clear platymyarian muscles, internal cuticular crests, vacuolated lateral strings, and intestine composed of multinucleated cells in the large colon and caecum. There were no mature gonads, featuring the larval stage.Discussion: Parasitic infections are the most common diseases that threaten donkey health and performance. In this species, small strongyles infections are severe, since the larvae can infltrate and form cysts in the wall of the large intestine causing serious damage. The most common clinical signs caused by cyathostome are weight loss and diarrhea, which are non-specifc and consequently can lead to an underestimation of the disease occurrence. In this case, massive infection of small strongyles was observed in the large colon and caecum. In contrast to the large strongyles, the small strongyles do not migrate through tissue but severely injure the large intestine of donkeys, zebras and horses. Other possible causes of enteritis in horses include Salmonella spp., Rhodococcus equi, Clostridium perfringens, Clostridium diffcile, Neorickettsia (Ehrlichia) ristcii infections, and idiopathic and neoplastic conditions (lymphoma). In the present report, the diagnosis of larval ciatostomose was based on clinical signs, and especially in the severity of pathological fndings associated withmorphological characteristics of the larvae of nematodes compatible with cyathostome in the large intestine.Keywords: nematodes, diarrhea, donkey, cyathostomins.

Visseral Leşmanyaziste Dalakta Nodüller

Visceral leishmaniasis (VL) is transmitted to humans by the bite of sandflies. VL is an endemic parasitic disease which is characterized by fever, splenomegaly and pancytopenia in most of the cases. Delays in diagnosis of VL are common because of nonspecific symptoms and variable incubation time. Specific serology and polymerase chain reaction are useful for the diagnosis. Anti- K39 strip test is highly sensitive. Splenic multifocal hypoechoic nodules should be evaluated for VL with clinical and laboratory features in patient. Herein we report a twenty-two month-old female infant with diagnosis of VL who presented with recurrent fever, pancytopenia and ultrasonography revealed enlarged spleen with multifocal hypoechoic nodules. We considered that splenic nodules can help to diagnosis of VL in children as literature case reports support to this situation.

The macroscopic and associated histopathological abnormalities in liver and bile duct of buffalo (Bubalus Bubalis), naturally infected with amphistome, slaughtered in different areas of Kashmir valley

This study reports the infection of liver and bile ducts, carried out from July 2012 to June 2014 on 282 randomly selected buffaloes—Bubalus bubalis, infected with the amphistome trematode parasite. Liver samples of buffaloes infected with amphistome were collected from the different abattoirs of Kashmir valley. Histological studies of infected livers revealed severe damage resulting in disrupted hepatic cords, inflammation, atrophy and necrosis. Bile duct hyperplasia was prominent with proliferation of epithelial cells. Macroscopic examination revealed massive infection of adult fluke in bile ducts and intrahepatic ductules in 49 (17.37) cases. The predominant features were multifocal granulomatous nodules throughout the luminal surface of the bile ducts. Histopathological study of 4 μm thick tissue sections cut adjacent to and through the site of attachment of individual worm and stained with hematoxylin and eosin revealed intense infiltration of inflammatory cells such as lymphocytes, macrophages, plasma cells, eosinophils as well as fibrocytes. This was associated with fibrosis and thickening of the bile ducts. Due to high level of prevalence and intensity of natural infection, amphistomiasis appears to be endemic in this geographical region and probably represent one of the most important animal health problems. The purpose of this paper is to overview the gross pathology (Macroscopic) and histopathological findings of amphistome infectionof liver of buffalo. It is hoped that the study may draw attention to the need for educating farmers, regarding the economic importance of infection of these amphistome parasites and also for the development of control strategies to prevent the spread of infection to ruminants. Normal 0 false false false EN-US X-NONE FA /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Times New Roman; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;}

MEDULLOBLASTOMA IN A GRIZZLY BEAR (URSUS ARCTOS HORRIBLIS)

A 3-yr-old female spayed grizzly bear (Ursus arctos horribilis) was evaluated for seizure activity along with lethargy, inappetence, dull mentation, and aggressive behavior. Magnetic resonance (MR) examination of the brain revealed a contrast-enhanced right cerebellar mass with multifocal smaller nodules located in the left cerebellum, thalamus, hippocampus, and cerebrum with resultant obstructive hydrocephalus. Cerebrospinal fluid analysis revealed mild mononuclear pleocytosis, with differentials including inflammatory versus neoplastic processes. Blood and cerebrospinal fluid were also submitted for polymerase chain reaction and agar gel immunodiffusion to rule out infectious causes of meningitis/encephalitis. While awaiting these results, the bear was placed on steroid and antibiotic therapy. Over the next week, the bear deteriorated; she died 1 wk after MR. A complete postmortem examination, including immunohistochemisty, revealed the cerebellar mass to be a medulloblastoma. This is the only case report, to the authors' knowledge, describing a medulloblastoma in a grizzly bear.

52 Clinical characteristics and diagnosis of NTM infection in children with cystic fibrosis (CF) in the North East of England

Objective Non-tuberculous mycobacterial (NTM) infection is an emerging clinical problem in people with CF but the threshold for treatment is uncertain. American Thoracic Society (ATS) criteria exist for the diagnosis of NTM infection but are not CF specific and their usefulness in children is uncertain. We audited whether NTM affected patients in our service met these criteria relative to decisions regarding treatment. Methods Clinical, radiographic and microbiological data were collected on all NTM affected patients. The ATS diagnostic criteria are a. presence of pulmonary symptoms; b. nodular or cavitary opacities on CXR OR multifocal bronchiectasis plus nodules on HRCT; and c. positive cultures from 2 or more sputum samples. Results Ten children (7 male, median age 13.5 years, 6 × DF508/ DF508) isolated Mycobacterium abscessus between 1 and 18 times (median 5.5). Median % predicted FEV1 pre-NTM isolation was 82.5% and post was 82.0% (p=NS). Median weight-for-age Z score pre-isolation was 0.18 and post-isolation was –0.25 (Kruskal–Wallis p = 0.056). Four of ten patients fulfilled clinical, radiographic and microbiological criteria at isolation of NTM. Five patients were treated for NTM infection; of these three met the ATS criteria at the time of commencing treatment. Conclusion Acquiring NTM was not associated in a decline in lung function in children in our service. ATS criteria were of limited clinical utility in our clinic but the recent publication of consensus guidelines will help to improve this situation.

A 53-year-old woman with multifocal subcutaneous nodules

A 53-year-old woman with vitiligo presented with a 6-month history of an enlarging, nonpainful nodule on her left forearm and 3 smaller nodules on her left hand and knee. Although she was evaluated 1 month earlier for dyspnea on exertion, attributed to deconditioning (negative stress test and normal chest radiographs), she currently denied shortness of breath, cough, fever, and chest pain. No recent travel history was elicited. The physical examination revealed a 13- × 4-cm firm, somewhat mobile, subcutaneous linear plaque spanning the length of the left extensor forearm (Fig 4).

Comparative pathological study of liver fluke infection in ruminants

A comparative study was conducted from October 2013 to June 2014 on 135 cattle, 175 sheep and 190 goats with a total of 500 ruminants to assess pathological changes on liver infected with fluke at ELFORA export abattoir in Bishoftu, Ethiopia. The animals were included in the study using systematic random sampling. The gross lesions included firm and enlarged livers with tense capsule, haemorrhagic spots, multi focal nodules and enlarged hepatic lymph nodes. The bile ducts were thickened and distended with adult fluke especially in chronic cases. Frequently observed histologic lesions were, hepatic portal fibrosis with large amount of fibrin in the portal area, hepatocytes degeneration, fatty changes and periportal necrosis. Fibrous connective tissue of various amount with fibroblasts and infiltration of mononuclear cells, in particular lymphocytes were common lesions in tracts migrated by parasites. Biliary cirrhosis with epithelial hyperplasia were also observed in cattle and sheep. Eosinophilic hepatitis, talengechtasis and hepatocytes degeneration and necrosis were evident in the parenchyma. Chronic lesions were less prominent in goats’ and even no cirrhotic case examined in goat. Cytological examination showed large number of lymphocytes and few plasma cells and eosinophils. The findings of the present study indicated that gross, histopathological and cytological examination supports one another in characterization of liver lesions hence could be used together in diagnosis of ruminant fasciolosis. However, additional diagnostic tests would be added for better confirmation.

Probable Pulmonary Blastomycosis in a Wild Coyote (Canis latrans)

A female coyote (Canis latrans) was fatally injured by a vehicle on a road in San Luis Potosi, Mexico. Because of deteriorating clinical signs, the animal was euthanized. Postmortem examination of the lungs showed numerous small multifocal white nodules (0.5–1 cm diameter) disseminated throughout. Histopathologic examination revealed multifocal coalescing granulomas with abundant macrophages, numerous neutrophils, fibroblasts, plasma cells, and lymphocytes. Abundant intracellular and extracellular thick-walled, refractile, spherical yeasts (10–15 μm) were observed within the granulomas. The yeasts were intensely PAS-positive, with granular protoplasm. Broad-based single budding yeasts were occasionally present. Based on the microscopic findings of the pulmonary lesions and the morphological features of the organism, a diagnosis of chronic pyogranulomatous pneumonia caused byBlastomyces dermatitidiswas made. To our knowledge, the case described herein is the first report of pulmonary blastomycosis in a wild coyote.