Mason's autopsy pictures
Knobbly lymph node (arrow 1) and a round, ball like, liver lobe (arrow 2).
Knobbly lymph node, still inside mesentery.
Liver with nodules, very hard (impossible?) to see.
Pancreas with nodules.
Pancreas with nodules.
Masonís histopathology report(s):
The liver has a normal architecture with scattered foci of mononuclear cells within portal areas. Hepatocytes are moderately vacuolated. The pancreas includes lobules of active acinar cells as well as several small nodular structures formed from tall epithelial cells arranged in packets and nests. The cells have oval nuclei and low mitotic activity. Similar cells are scattered through the tissue associated with acinar cells. There is a diffuse mixed inflammatory infiltrate. The third structure is composed of irregular papillary processes and ducts lined by tall columnar epithelial cells. The underlying tissues are infiltrated by lymphoid cells. Mixed inflammatory cells are present within several ducts. The structure is surrounded by fibromuscular tissue.
There is no evidence of a liver tumour in these sections. The liver is showing only mild, non-specific degenerative changes. The pancreas includes multiple nodules likely to represent a form of nodular hyperplasia. There is mild pancreatitis. The third tissue is not lymph node although it includes lymphoid cells. It is ductular and may be of biliary or other origin. It is inflamed.
My vet Michaela rang the laboratory for re-sectioning the liver and pancreas because she was sure that there were tumours on both the pancreas and liver.
Further portions of the liver have been processed and within these there is now evidence of multilocular cystic mass. The cysts are lined by attenuated cuboidal epithelial cells with narrow fibrous septa. Adjacent to the cystic area there is a solid area of small polygonal cell proliferation. These cells have small oval nuclei and low mitotic activity. They are tending to form small packets and ducts. There is a little fibroplasias and a mild lymphoid infiltrate and foci of neutrophils. This is consistent with bile duct cystic hyperplasia and adenoma formation. Further processing of tissue from the pancreas also now includes several large irregular nodular masses composed of ducts and solid aggregates of quite pleomorphic cells with variable nuclei and moderate mitotic activity. There is local and vascular invasion consistent with carcinoma formation.
Dr Bruce Williams' comment on the histopathology report:
The diagnosis is likely that of a malignant biliary neoplasm - these are commonly misinterpreted as benign cysts. Best to keep a close eye on this - it may be back.
With kindest regards,
Bruce Williams DVM