{"id":5309,"date":"2016-05-12T14:52:16","date_gmt":"2016-05-12T13:52:16","guid":{"rendered":"https:\/\/sesc.cat\/it-is-not-always-a-lymphoma\/"},"modified":"2022-04-02T14:44:32","modified_gmt":"2022-04-02T13:44:32","slug":"it-is-not-always-a-lymphoma","status":"publish","type":"post","link":"https:\/\/sesc.cat\/en\/it-is-not-always-a-lymphoma\/","title":{"rendered":"It is not always a lymphoma"},"content":{"rendered":"<p>In a 2 year old, female, pig carcass, multiple whitish, hardened nodules were observed in the liver and mesenteric lymph nodes. The cut surface was pink with whitish margins.<br \/>\n<!--more--><\/p>\n<p>The inspectors immediately suspected of a neoplasia of lymphoid origin and submitted formalin fixed samples to confirm the diagnosis.<\/p>\n<p>We must confess that all of SESC pathologists agreed with the diagnosis of the inspectors and what we saw later, under the microscope, cought us by surprise&#8230;<\/p>\n<p>Histologically, the nodules of the liver and mesenteric lymph nodes, were formed by abundant fibrous tissue, an indicator of the chronicity of the lesion, with a granulomatous inflammatory infiltrate with abundant eosinophil polymorphonuclear leukocytes and multinucleated giant cells caused by the presence of <strong>fungal hyphae. <\/strong> It consisted therefore of a chronic fungal hepatitis and lymphadenitis.<\/p>\n<p>It is a rare lesion, probably caused by fungi of the class of the <strong>Zygomicetes<\/strong> (including genres such as <em>Mucor, Rhizopus or Cunninghamella<\/em>, among others). These fungi are found in the environment and can enter through skind wounds, is not a contagious disease. In this case, involvement of the mesenteric lymph nodes may suggest a digestive entry. The disease caused is known as Zygomycosis or mucormycosis. In the absence of fresh tissue samples, we could not attempt to cultivate and characterize the fungus causing the lesions.<\/p>\n<p>In this lesion&#8217;s differential diagnosis, besides <a href=\"https:\/\/sesc.cat\/a-new-case-of-lymphoma-in-a-porcine-carcass\/?lang=en\">neoplasia<\/a>, other agents causing granulomatous inflammation should be included such as<a href=\"https:\/\/sesc.cat\/granulomatous-disseminated-lesions-in-pig-carcasses\/?lang=en\"> mycobacteria<\/a> and <a href=\"https:\/\/sesc.cat\/what-is-your-diagnosis-21\/?lang=en\">parasites<\/a>, even though, macroscopically often have a different appearance.<\/p>\n<p>&nbsp;<\/p>\n<div id=\"attachment_3020\" style=\"width: 630px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3020\" class=\"size-large wp-image-7309\" src=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-800x482.jpg\" alt=\"Multiple whitish nodules in the liver parenchyma.\" width=\"620\" height=\"374\" srcset=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-800x482.jpg 800w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-300x181.jpg 300w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-768x463.jpg 768w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-1536x926.jpg 1536w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-1-2048x1235.jpg 2048w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-3020\" class=\"wp-caption-text\">Multiple whitish nodules in the liver parenchyma.<\/p><\/div>\n<div id=\"attachment_3021\" style=\"width: 630px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3021\" class=\"size-large wp-image-7311\" src=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-2-800x482.jpg\" alt=\"Some abdominal lymph nodes were also increased in size.\" width=\"620\" height=\"374\" srcset=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-2-800x482.jpg 800w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-2-300x181.jpg 300w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-2-768x463.jpg 768w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-3021\" class=\"wp-caption-text\">Some abdominal lymph nodes were also increased in size.<\/p><\/div>\n<div id=\"attachment_3016\" style=\"width: 630px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3016\" class=\"size-large wp-image-7301\" src=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-3-800x482.jpg\" alt=\"Details of the lesions once cut, the inner surface was pink, with white margins.\" width=\"620\" height=\"374\" srcset=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-3-800x482.jpg 800w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-3-300x181.jpg 300w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-3-768x463.jpg 768w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-3016\" class=\"wp-caption-text\">Details of the lesions once cut, the inner surface was pink, with white margins.<\/p><\/div>\n<div id=\"attachment_3017\" style=\"width: 630px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3017\" class=\"size-large wp-image-7303\" src=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-4-751x600.jpg\" alt=\"Hematoxylin and eosin staining. Compressed liver tissue (left) with a fragmetnof a nodule composed of abundant fibrous tissue and mixed inflammatory infiltrate. B Details of the inflammatory infiltrate rich in macrophages, multinucleated giant cells and eosinophilic polymorphonuclear leukocytes. C and D. Presence of thin-walled, branched fungal hyphae surrounded by inflammatory cells. \" width=\"620\" height=\"495\" srcset=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-4-751x600.jpg 751w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-4-300x240.jpg 300w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-4-768x614.jpg 768w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-4.jpg 1932w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-3017\" class=\"wp-caption-text\"><strong>Hematoxylin and eosin staining. A:<\/strong> Compressed liver tissue (left) with a fragmetnof a nodule composed of abundant fibrous tissue and mixed inflammatory infiltrate. <strong>B:<\/strong> Details of the inflammatory infiltrate rich in macrophages, multinucleated giant cells and eosinophilic polymorphonuclear leukocytes. <strong>C and D:<\/strong>\u00a0Presence of thin-walled, branched fungal hyphae surrounded by inflammatory cells.<\/p><\/div>\n<div id=\"attachment_3018\" style=\"width: 630px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3018\" class=\"size-large wp-image-7305\" src=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-5-800x540.jpg\" alt=\" Grocott stain. A and C: The Grocott stains in black the thin walls of the fungal hyphae. B: Fragments of fungal hyphae phagotyzed by a multinucleate giant cell. D: In this image one can see that the hyphae have septa. \" width=\"620\" height=\"419\" srcset=\"https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-5-800x540.jpg 800w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-5-300x202.jpg 300w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-5-768x518.jpg 768w, https:\/\/sesc.cat\/wp-content\/uploads\/2016\/05\/SESC-032-16-5.jpg 1499w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><p id=\"caption-attachment-3018\" class=\"wp-caption-text\"><strong>Grocott stain. A, C and D:<\/strong> The Grocott stains in black the thin walls of the fungal hyphae. <strong>B:<\/strong> Fragments of fungal hyphae phagotyzed by a multinucleate giant cell.<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>In a 2 year old, female, pig carcass, multiple whitish, hardened nodules were observed in the liver and mesenteric lymph nodes. The cut surface was pink with whitish margins.<\/p>\n","protected":false},"author":6,"featured_media":7307,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[235,187,179],"tags":[396,366,398],"class_list":["post-5309","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-abdominal-cavity-porcine-2","category-liver-2","category-porcine-2","tag-fungi-en","tag-liver","tag-lymphoid-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/posts\/5309","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/comments?post=5309"}],"version-history":[{"count":0,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/posts\/5309\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/media\/7307"}],"wp:attachment":[{"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/media?parent=5309"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/categories?post=5309"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sesc.cat\/en\/wp-json\/wp\/v2\/tags?post=5309"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}