Pneumònia granulomatosa (de causa desconeguda) en un porc
En una canal d’una truja de 2 anys d’edat s’aprecien múltiples masses blanquinoses arrodonides en el pulmó que presenten una distribució multifocal i generalitzada. El diàmetre de les masses és variable des de 4 mm fins a 15 cm. Al tall presenten una coloració blanquinosa.
Microscòpicament aquestes masses corresponen a un intens infiltrat inflamatori format majoritària ment per macròfags, escassos eosinòfils i amb presència de cèl•lules gegants multinucleades. No s’aprecia necrosi. S’examinen seccions de limfonode mediastínic que presenten també inflamació del mateix tipus. Es tracta per tant d’una pneumònia i limfadenitis granulomatoses proliferativa.
Malauradament no s’arriba a determinar la causa d’aquesta reacció inflamatòria, les proves que s’han fet inclouen:
- Es descarta que es tracti d’una micobacteriosi mitjançant una tinció de Ziehl-Neelsen (Negatiu), una PCR per complex M. tuberculosis (Negatiu) i un cultiu de micobacteris (Negatiu).
- Es descarta la presència d’estructures fúngiques mitjançant una tinció de Grocott (Negatiu).
- Es descarta la presència de bacteris gram positius amb una tinció de gram (Negatiu) i un cultiu microbiològic estàndard (Negatiu).
- Morfològicament, es descarta també que es tracti d’un procés associat a paràsits o una neoplàsia.
Si algú s’ha trobat amb casos similars o te una idea de què pot causar aquest tipus de lesió el/la convidem a compartir-ho a la secció de comentaris que hi ha al final d’aquesta entrada.
La lesió afecta a tots els lòbuls pulmonars i als limfonodes mediastínics.
A la secció les masses presenten una coloració blanquinosa homogènia.
Al microscopi es pot observar una reacció inflamatòria granulomatosa amb abundants cèl·lules gegants multinucleades com les de la imatge.
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#2 written by Andre Broes 6 years agoDe : aavld-request@ucdavis.edu [mailto:aavld-request@ucdavis.edu] De la part de Ted Clark
Envoyé : 24 mars 2014 13:53
À : aavld@ucdavis.edu
Objet : Re: Granulomatous pneumonia (of unknown cause) in a pigI agree with Glenn and Paco this still could be Mycobacteriosis. Here is a pic of a porcine lung that I received from a slaughterhouse many years ago. The lesions were similar to the case being discussed and after much searching on AF stains (probably both ZN and Fites) I did find some AF bacteria. No cultures done. If this pic does not display properly, someone tell me.
Sorry I don’t have access to the block or slide to take a histo picture for you.Ted Clark
Calgary -
#3 written by Andre Broes 6 years ago
De : aavld-request@ucdavis.edu [mailto:aavld-request@ucdavis.edu] De la part de Glenn Songer
Envoyé : 23 mars 2014 20:24
À : aavld@ucdavis.edu
Objet : Re: Granulomatous pneumonia (of unknown cause) in a pigIt doesn’t seem like a great possibility, but Paco might be right. I’ve seen lesions like you describe in both field cases (which are mainly infections of cervical and mesenteric LN) and in experimental cases (when the person doing the inoculation was a little careless — that was me, by the way) and inoculum was partially swallowed to try to infect LN) and partially inhaled (producing the subject lesions in lungs. The experimental cases occurred with both M. avium ss avium (just M. avium in those days) and M. kansasii. It might be worth digging up the methods for mycobacterial culture (Chuck Thoen at ISU should be a good source).
Glenn
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#4 written by Andre Broes 6 years ago
De : aavld-request@ucdavis.edu [mailto:aavld-request@ucdavis.edu] De la part de Ramos-Vara, Jose A
Envoyé : 22 mars 2014 16:38
À : aavld@ucdavis.edu
Objet : RE: Granulomatous pneumonia (of unknown cause) in a pigDespite not being typical of PCV2 infection, I assume that this animal was tested for with negative results. It resembles hairy vetch eosinohilic granulomatous nephritis in cattle. Only one animal affected in the herd? Apparently Actinobacillus porcitonsillarum can produce similar inflammation but I am not sure if it includes eosinophils. Pepe Ramos
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#5 written by Andre Broes 6 years ago
De : aavld-request@ucdavis.edu [mailto:aavld-request@ucdavis.edu] De la part de Fabio Del Piero
Envoyé : 22 mars 2014 14:22
À : aavld@ucdavis.edu
Objet : RE: Granulomatous pneumonia (of unknown cause) in a pigIf it would be my case I would contact Roger Maes at MSU for a generic herpesvirus PCR from the paraffinized lung tissues. In case of positive result I would narrow the search toward gammaherpesviruses.
It is vaguely reminiscent of some gammaherpesvirus associated lesions in horses.
Fabio Del Piero
Professor of Pathology
Louisiana State University==
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#6 written by SESC 6 years agoComment from Swine Health, Nutrition and Production Professionals group in LinkedIn:
Rogerio Paulo Tovo
SwanagerDear SESC went their differential diagnosis , and quick reference to the book Diseases of Swine of the Dr. Leman et al. , recommend researching Yersinia pseudotuberculosis , and very many smaller chance of occurrence for Brucella suis . Surely the case is atypical, disease macroscopia is suggestive of tuberculosis , and to a lesser extent atypical case of Staphylococcus aureus , cases that have been discarded by laboratory tests performed .
The symptoms , if your lordship has access , it is important to suggest some way in these cases .
Good luck in continuing the search , and when you find something , let us know . Hugs , Rogério Tovo – Brazil . -
#7 written by Ted Clark 6 years ago
I have not seen porcine lung lesions just like this, but given the negative test results so far and the giant cells present, I would next run IHC for PCV2. You could do PCR for PCV2 as well, but the virus is so ubiquitous a positive result would not confirm it caused these lesions.
I assume you used a polarizer on the lesions looking for aspirated foreign material and crystals? A PAS stain might be worth doing as well. - Comment Feed for this Post
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De : aavld-request@ucdavis.edu [mailto:aavld-request@ucdavis.edu] De la part de Glenn Songer
Envoyé : 24 mars 2014 17:17
À : aavld@ucdavis.edu
Objet : Re: Granulomatous pneumonia (of unknown cause) in a pig
This picture from Ted has gross lesions very much like what I saw in M. kansasii all those years ago.
Glenn