Todayโs path rounds are on ๐๐ก๐จ๐ฅ๐๐ง๐ ๐ข๐จ๐๐๐ซ๐๐ข๐ง๐จ๐ฆ๐๐ฌ!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐ก๐จ๐ฅ๐๐ง๐ ๐ข๐จ๐๐๐ซ๐๐ข๐ง๐จ๐ฆ๐๐ฌ are malignant tumours of the ๐๐ข๐ฅ๐ข๐๐ซ๐ฒ ๐๐ฉ๐ข๐ญ๐ก๐๐ฅ๐ข๐ฎ๐ฆ (the cells that line the bile ducts in the liver).
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get these! Most commonly they are reported in dogs, cats, sheep, cattle, horses and goats.
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
These tumours can often take up a large amount of the liver, causing damage. This leads to ๐ฅ๐ข๐ฏ๐๐ซ ๐๐๐ข๐ฅ๐ฎ๐ซ๐, which can lead to all kinds of downstream effects that are too numerous for this post. Additionally, these tumours commonly metastasize to nearby lymph nodes, the lungs and the ๐ฉ๐๐ซ๐ข๐ญ๐จ๐ง๐๐ฎ๐ฆ (the thin membrane that helps keep the intestines organized).
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Typically these animals will present to their veterinarian with ๐ฃ๐๐ฎ๐ง๐๐ข๐๐, or yellowing of the tissues due to accumulation of the yellow pigment ๐๐ข๐ฅ๐ข๐ซ๐ฎ๐๐ข๐ง. Bilirubin is normally processed by the liver and excreted in the bile, so if the liver is damaged, then bilirubin accumulates in the tissues causing them to turn yellow. Based on this finding on physical exam and bloodwork showing liver issues, the veterinarian may suspect that there is some type of liver disease, leading to an ultrasound. On ultrasound, the liver masses can be visualized and sampled for submission to a pathologist to confirm the diagnosis.
At necropsy, cholangiocarcinomas tend to have an ๐ฎ๐ฆ๐๐ข๐ฅ๐ข๐๐๐ญ๐๐ appearance, meaning they have a raised rim of tissue with a central depression, like a belly button! Based on this appearance, the pathologist can make an initial diagnosis, and then later confirm it on ๐ก๐ข๐ฌ๐ญ๐จ๐ฅ๐จ๐ ๐ฒ (looking at the tissue under a microscope).
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
Depending on the severity of disease, the masses may be able to be removed surgically. Unfortunately, even despite surgical treatment, the prognosis for these patients is very poor.
๐๐ก๐จ๐ญ๐จ๐ฌ
1) The classic appearance of umbilicated cholangiocarcinoma.
2-3) A very severe case of cholangiocarcinoma in a guinea pig.
4-5) A couple more examples!
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 1-3 courtesy of University of Calgary Diagnostic Services Unit.
Photo 4-5 courtesy of Noahโs Arkive.
