NECROPSY RESULTS

Slide 1: Lung, Liver, Left Adrenal Gland

Lung: Diffusely, the lung parenchyma is congested.  Multifocally, alveoli area coalesced into variably-sized cavitated spaces (emphysema).  Occasional macrophages are present within the alveoli (minimal edema).

Left Adrenal Gland: The zone fasiculata is prominently expanded and compresses the overlying zona glomerulosa.  Celis in the zona fasiculata are markedly increased in number and minimally increased in size (hyperplasia and hypertophy).

Liver: Extensive multifocal to coalescing areas of hepatocellular vaculation (glycogen type) are present; hepatocytes are moderately to severely swollen with large irregular clear intracytoplasmic clearings.  There is mild bile duct hyperplasia and periportal infiltration by lymphocytes and plasma cells.  Occasional clusters of macrophages containing yellow-brown pigment (lipogranulomas) are noted.  Multifocally and randomly scattered are small areas of loss of hepatocellular differential staining (coagluative necrosis), or loss of hepatocytes and replacement by eosinophilic cellular and karyorrheotic debris (hepatocellular necrosis).

Slide 2: Right Adrenal, Heart, Spleen

Spleen:  There is mild to moderate lymphoid depletion and few scattered clusters of hernosiderin-laden macrophages.

Heart: There is mild fatty infiltration of the myocardium

Right Adrenal: The zona fasiculata is prominently expanded and compresses the overlying zona glomerulosa.  Celis in the zona fasiculata are markedly increased in number and minimally increased in size (hyperplasia and hypertophy).

Slide 3: Kidney

The cortex has multiple variably-sized cysts lined by a single layer of cuboidal epithelium.  In one section a large portion of the renal parenchyma is replaced by a cystic structure, lined by a single layer of cuboid to attenuated epithelium, with clear contents, and with severe compression and fibrosis of adjacent parencyma, with corresponding loss of normal structures.  Multifocally, the cortical interstitium is mildly to moderately expanded by mature fibrous connective tissue with few to moderated numbers of admixed lymphocytes, plasma cells and macrophages.  Multifocally few glomerular tufts are shrunken, hypercellular, with synechiae and/or with fusion with surrounding interstitium (glomerulosclerosis).  Rare tubular epithelial celis harbor eosinophillic rectangular intranuclear inclusion bodies (‘brick inclusions’).

Slide 4: Urinary Bladder, Right Ventral Skin

Urinary Bladder:  There are few lymphocytes and plasma cells in the lamina propria of the urinary bladder along with small neutrophilic clusters that extend into the muscular layers.

Right Ventral Skin:  The epidermis is severely thinned (one cell layer thick in most areas) and overlain by a diffuse thick layer of loosely woven orthokeratoid hyperkeratosis.  Most follicles are moderately to markedly distended by keratin (follicular keratosis).  Hair follicles are decreased in number and usually in telogen phase with small atrophied bulbs.  The dermis contains markedly decreased amounts of thinned, fragmented collagen bundles, separated by abundant clear space (edema).  Multifocally the superficial dermis contains moderate amounts of extravasated erythrocytes (hemorrhage).