Histology and immunohistochemistry of severe inflammatory bowel disease versus lymphoma in the ferret (Mustela putorius furo)

Abstract

Inflammatory bowel disease (IBD) is a common disorder of ferrets (Mustela putorius furo) that may progress to lymphoma. Although routine histology is used to distinguish between these diseases, misclassifications may occur. Immunohistochemistry (IHC) is commonly used to distinguish between IBD and lymphoma in small animals. The objective of our study was to determine the agreement in the diagnosis reached solely using hematoxylin and eosin (HE)-stained, full-thickness sections versus using a combination of HE and IHC. Enteric sections from 44 ferrets previously diagnosed with IBD or intestinal lymphoma and 3 control ferrets were analyzed by pathologists with expertise in ferrets. A pathologist blinded to the original diagnosis assessed the same HE-stained sections. Analysis was then repeated using HE sections in parallel with sections stained using antibodies against CD3 and CD79a. No significant difference was found between the original HE diagnosis and the HE diagnosis reached by the blinded pathologist (p = 0.91) or between the blinded pathologist's HE versus HE with IHC diagnosis (p = 0.16). In the 2 cases where disagreement was present, IHC was pivotal in reaching a final diagnosis. There was no significant age (p = 0.29) difference between diagnoses; however, significantly more male ferrets were affected with IBD than females (p = 0.004). Immunophenotype of the lymphoma was not correlated with predilection for location in the intestinal wall (p = 0.44). Results suggest that although IHC is not necessary to distinguish IBD from intestinal lymphoma in ferrets, it can be useful a definitive diagnosis in cases of severe IBD.

Therapeutic comparison between treatments for Vulvar Lichen Sclerosus: study protocol of a randomized prospective and controlled trial

“…The few studies of VLS treatments applying PDT are described with 5-aminolevulinic acid, a precursor of the photosensitive agent protoporphyrin IX, or its methyl ester, which is more lipophilic. However, at physiological pH, ALA forms zwitterions, which prevents its ability to cross biological barriers such as cell membranes, resulting in slow and non-homogeneous distribution in the target tissue, even as its high cost and phototoxicity [ 32 ].…”

“…Nowadays we know that immunohistochemistry is an indispensable technique for solving differential diagnosis problems caused by basic routine staining of HE [ 32 ]. Although we know that the diagnosis of LEV is clinical, we insist to collect the biopsies so that we can cross-check the data (HE versus immunohistochemistry) for a better understanding of the disease and the mechanisms involved after the different therapies.…”

Proposed grading scheme for inflammatory bowel disease in ferrets and correlation with clinical signs

“…For the first grading scheme, the following parameters were recorded for all H&E sections, as in the 2011 study in cats 23 : location, distribution, and density of the lymphocytic population but with modifications as described below. Parameters used to differentiate inflammation from neoplasia, such as immunohistochemistry, had been used in a previous study 29 to identify cases of lymphoma but were considered irrelevant for our study. The deepest location of infiltrates (i.e., which layer of the intestine farthest from the lumen was affected) was recorded as mucosa, submucosa, tunica muscularis, or serosa in each section.…”

“…4,5 The distinction between IBD and lymphoma necessitates histologic analysis, and, in more severe cases of IBD, it may also require the aid of immunohistochemistry. 29 The etiology of IBD in ferrets, as in other species, is unknown. It is hypothesized that the underlying cause involves a complex interaction between microorganisms, dietary proteins that are not part of the diet in the wild for this species, and the mucosal immune system.…”

Intestinal T-cell lymphoma in an Asian small-clawed otter: case report and literature review of lymphoma in the subfamily Lutrinae

“…4 Lymphomas in other locations have been reported on rare occasions, such as a T-cell lymphoma in the brain of a sea otter. 13 Among mustelids, except for domestic ferrets, 8,17 alimentary lymphomas have only been reported in a fisher (Pekania pennanti) and a Eurasian otter. 1 Similar to our case, the Eurasian otter had a history of nephrolithiasis.…”