Using Medical Terminology in Pathology

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Using Medical Terminology in Pathology

• With special emphasis on Inflammation
• PBS 559 General Pathology
• Philip N. Bochsler, DVM, PhD
• Diplomate, American College of Veterinary
  Pathology

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An image of a gross lesion will be shown and you
should try to formulate a morphologic diagnosis
(mdx).Use your class notes and tables or
terminology to assist you.

• Then go to the next slide, try to answer the
  questions, and check the mdx and other comments.
• Remember Some latitude in the mdx is present in
  many cases. Spelling is always important.

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Lungs from a horse that died after a two-day
illness.
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Horse lungs

• Mdx ______________________________ .
• Alternatively, if you (logically) suspect that
  the dark areas are bloody/hemorrhagic
• Mdx _______________________________ .
• If you know that the etiology was Streptococcus
  zooepidemicus, the etiologic diagnosis is
  _________ .
• Severe acute locally extensive pneumonia
• Severe acute locally extensive hemorrhagic
  pneumonia
• Streptococcal pneumonia

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Brain from a horse infected with Streptoccus equi
with a localized area of pale, soft exudate in
the cerebral cortex
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Brain from a horse infected with Streptoccus equi

• Mdx _________________________________ .
• Comment Its difficult to identify the time
  frame from the image. If you knew that there was
  a fibrous capsule around the lesion, it would be
  ___________ (time frame).
• If there was no fibrous capsule around the
  suppurative exudate, the time frame would likely
  be ______________________ .
• Another simple, common medical term for a local
  area of severe suppurative inflammation, usually
  well-demarcated, which is visible to the naked
  eye is _______________ .
• If you know that the etiology was Streptococcus
  equi, the etiologic diagnosis is
  __________________ .
• Severe (time frame) focal suppurative
  encephalitis
• Chronic
• Acute or subacute
• Abscess
• Streptococcal encephalitis/abscess
• naked eye, i.e.., grossly visible

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Numerous red foci on and in the lungs of a
term-aborted equine fetus
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Lungs of a term-aborted equine fetus

• Mdx ____________________________ .
• Comment Hemorrhagic lesions are usually acute.
• (Microsopically there is necrosis, too.)
• If you know that the etiology was Equine Herpes
  Virus -1, the etiologic diagnosis is
  _____________ .
• Moderate to severe acute multifocal hemorrhagic
  pneumonia
• Herpes viral pneumonia/abortion
• Note The modifier bilateral between acute
  -and- multifocal results in an even better mdx.

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A Holstein heifer with yellowish, easily torn,
slightly rubbery material on peritoneal surfaces
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Yellowish, easily torn, slightly rubbery material
on peritoneal surfaces

• Mdx ___________________________________ .
• Comment Its so widespread that its almost
  diffuse, which would also be ok as an adjective.
• Comment Fibrinous lesions are often acute.
• Microsopically there is often suppuration with
  the fibrin, too.
• If you could grossly see pus along with the
  sheets of fibrin, what would the mdx be?
• Severe acute multifocal/diffuse fibrinous
  peritonitis
• Severe acute multifocal/diffuse
  fibrinosuppurative peritonitis
• or, Severe acute multifocal/diffuse
  fibrinopurulent peritonitis
• or, Severe acute multifocal/diffuse fibrinous
  and suppurative/purulent peritonitis

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Bovine calf with an abscess of the vertebral
column with extension into the spinal canal
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Bovine calf with an abscess of the vertebral
column with extension into the spinal canal

• Remember If it looks like you have pure
  liquid/viscous pus without a fibrous capsule, the
  time frame is most likely acute.
• Inflammation of bone is called __________ .
• Inflammation of bone marrow is __________ .
• In all likelihood, if bone marrow is inflamed the
  surrounding and adjacent bone is also inflamed,
  which in combination is called ________________
  .
• Inflammation of the spinal cord is
  _________________ .
• This situation is a bit of a sticky wicket.
  (myelitis and myelitis)
• continued
• Osteitis
• Myelitis
• Osteomyelitis. Its not often heard, but this
  can also be called central osteitis.
• Myelitis
• A difficult problem or situation.

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Bovine calf with an abscess of the vertebral
column with extension into the spinal canal

• Youll need to be creative in this kind of case.
• Try to incorporate inflammation of the bone, bone
  marrow, and spinal cord in a mdx
• ________________________________ .
• Severe acute focal suppurative osteomyelitis
  and spinal myelitis
• locally extensive is acceptable
• or purulent

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Lungs from a dog which started coughing 2-3 weeks
ago
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Lungs from a dog which started coughing 2-3 weeks
ago

• This is a case of severe pulmonary blastomycosis
  (Blastomyces dermatitidis).
• The etiologic diagnosis is __________________ .
• Blastomyces induces numerous neutrophils and
  macrophages to chemotax into alveolar spaces.
• An exudate consisting primarily of neutrophils is
  referred to as ___________________ .
• An exudate consisting primarily of macrophages is
  referred to as ____________________ .
• A prefix referring to pus is _____ .
• An exudate consisting of both neutrophils and
  macrophages is called __________________________
  __ .
• Continued

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Lungs from a dog which started coughing 2-3 weeks
ago

• Mdx _____________________________________ .
• Blastomyces pneumonia, or fungal pneumonia
• Suppurative or purulent
• Granulomatous
• Pyo-
• Pyogranulomatous, or Suppurative and
  Granulomatous, or Purulent and Granulomatous
• Severe chronic diffuse pyogranulomatous
  pneumonia
• Chronic-Active is also ok.
• It consists of thousands of small foci
  (multifocal) of pyogranulomatous inflammation
  which are packed very closely together and which
  are distributed in every lung lobe, so call it
  diffuse.

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The thoracic cavity of this cat is filled with
pus.(The lungs are collapsed.)
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The thoracic cavity of this cat is filled with
pus.

• A one-word description of this condition is
  _______________________________ .
• If the abdominal cavity were filled with pus how
  would you describe it? __________________________
  ____ .
• Pyothorax
• No, its not pyoperitoneum nor pyoabdomen.
  Although these may technically be correct, they
  are not used, probably because they are
  phonetically clumsy. Suppurative peritonitis
  is a better choice.
• Note Take it on faith that what Ive told you
  in this case is true, that it is really pus in
  the thoracic cavity. However, without supporting
  data, e.g., cytology, etc., you might also
  consider from the photo that a pale liquid in the
  thoracic cavity could be chyle, a
  noninflammatory fluid with high lipid content.
  This condition, chylothorax, may result from
  fluid leaking from a perforated thoracic duct, or
  may be an idiopathic condition.

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Intestinal tract from a chicken with coccidiosis
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Intestinal tract from a chicken with coccidiosis

• You can see the bloody exudate is in some parts
  of the intestinal tract, but not others.
• Inflammation of the small intestine is called
  _____________ .
• Inflammation of the cecum/ceci is called
  _____________ .
• Mdx ____________________________ .
• Sanguineous
• Enteritis
• Typhlitis
• Severe acute segmental hemorrhagic
  enterotyphlitis
• Or, Severe acute multifocal hemorrhagic
  enterotyphlitis
• Or, Severe acute segmental/multifocal hemorrhagic
  enteritis and typhlitis

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An equine placenta which accompanied an aborted
fetus necrosis and suppuration are present.
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An equine placenta which accompanied an aborted
fetus necrosis and suppuration are present.

• Mdx ____________________________________ .
• Fungal hyphae were present in the placenta.
• Etiologic diagnosis _________________________ .
• Severe acute locally extensive suppurative and
  necrotizing placentitis (or, purulent and
  necrotizing). Some people might say
  necrosuppurative. Your choice.
• Fungal placentitis

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The trachea from this bovine steer contains pus,
fibrin, and blood. (Note the hole in the glove)
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The trachea from this bovine steer contains pus,
fibrin, and blood.

• Mdx ___________________________________ .
• What if a similar exudate was also in the nasal
  cavity? Mdx ____________________________ .
• What if a similar exudate was also in the larynx?
  Mdx ____________________________ .
• Bovine Herpes Virus-1 (IBR) and secondary
  bacterial infection was the etiology.
• Severe acute diffuse fibrinopurulent and
  hemorrhagic tracheitis
• Severe acute diffuse fibrinopurulent and
  hemorrhagic rhinotracheitis
• Severe acute diffuse fibrinopurulent and
  hemorrhagic laryngotracheitis

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A 10-year-old male dog was finally neutered. The
veterinarian bisected the testes and found these
neoplasms.
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A 10-year-old male dog was finally neutered. The
veterinarian bisected the testes and found these
neoplasms.

• Mdx ____________________________________ .
• Multiple/multifocal neoplasms.
• These are interstitial/Leydig cell tumors, so
  Multiple/multifocal interstitial cell tumors is
  correct.
• Remember If its not inflammation, you dont
  need to used the formula for describing
  inflammatory lesions. If its cancer, just call
  it that.

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This is a saggitally-sectioned kidney from a dog
that died from acute ethylene glycol toxicosis.
The kidney is pale (rather than the usual
mahogany red color) because the renal tubular
epithelium has undergone necrosis.
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Kidney from a dog that died from acute ethylene
glycol toxicosis

• Mdx ______________________________________ .
• Severe acute nephrosis
• There is no signficant inflammation present the
  lesion is the result of a toxin, not bacteria,
  virus, protozoa, foreign body, etc. which cause
  an inflammatory reaction.
• -osis is attached to latin word roots and
  indicates the presence of damage, necrosis, etc.
  It is not used in all situations, however, by
  common convention. For instance, you wont hear
  the term encephalosis its just not used.
  Youll pick these nuances up as you continue in
  your career.
• Remember -opathy is another suffix used in
  noninflammatory situations. It indicates that a
  problem is present in a certain organ, but the
  etiology is not known, not sufficiently
  understood, or may be understood but you need to
  emphasize that it is noninflammatory e.g.,
  cardiomyopathy. Examples encephalopathy,
  hepatopathy, nephropathy, osteopathy, etc.

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If you learn this terminology now you will be a
step ahead for the rest of your veterinary
education and your career. Refer to your notes
from class including the table and list of word
roots. Good luck!
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