SESC case archive

28/04/2021 | Abdominal cavity (bovine)

What is your diagnosis? (94)

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In a 13-year-old cross-breed cow carcass, multiple hardened nodular lesions of varying size in the lung, parietal and visceral pleura, and also in the peritoneum were observed. The thoracic lymph nodes are enlarged and, when sectioned, have granulomatous-looking lesions.  (EV)

Multiple hardened yellowish nodules in the parietal pleura.

Details of the pleural nodules, some of them coalescent and with fibrous adhesions to the visceral pleura. Notice that a few nodules can also be observed on the other side of the diaphragm on the peritoneum (upper half of the image).

Detail of the lung lesion, inside the parenchyma nodules could also be palpated.

Image of the lesion when sectioning the caudal mediastinal lymph node.

What is your diagnosis? (94)

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Histopathology confirmed that these were tuberculosis-compatible lesions. Chronic multifocal lesions in the lung and pleura, but also with hematogenous/lymphatic dissemination to the peritoneum. PCR confirmed the presence of Mycobacterium tuberculosis complex (MTC) DNA. It is unknown whether it is an anergic animal (skin-test negative), a recent infection with early generalization, or an animal that has not been correctly diagnosed. In any case, the need to keep alert TB passive surveillance mechanisms in slaughterhouses and the need for a laboratory study of any compatible lesion are reinforced, since in this case, being a very old animal, subject to an annual testing, the odds were in favor of a neoplasm such as mesothelioma.

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Question 1
What is your diagnosis?
It sure looks like a case of chronic tuberculosis with early signs of dissemination.
A 13 years old cow? It's a mesothelioma, no less!
Old cow means neoplasia indeed! But rather a squamous cell carcinoma.
Chronic bacterial polyserositis! If it were tuberculosis it'd have definitely been diagnosed in vivo.
Parasitic granulomas (Echinococcus granulosus).
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