Department of Pathology, Faculty of Veterinary Medicine, Zagazig University, Egypt.
Pathology of Genital System BY
Mohamed Hamed Mohamed mohamedelariny@yahoo.com +20124067373
2011
Genital System Gonadal Differentiation (Gonadogenesis) and the Intersexes: In all mammalian species, males differentiate very early and females very late. The fetal testicular Sertoli cells secrete an antiMuellerian hormone (inhibin) that causes Muellerian (paramesonephric) duct regression. At the same time, the Leydig cells of the fetal testis secrete testosterone that stimulates the development of the Wolffian (mesonephric) duct system to form the epididymis, vasa differentia and seminal vesicles. The Ychromosome contains testis-determining genes that synthesize factors to induce the embryonic gonad to become a testis
Intersexes: Animals in which the diagnosis of sex is equivocal because characteristic elements of both sexes are present at the same time. Abnormalities are of genetic or chromosomal origin, or hormonal exposure or response to hormones.
In general, intersexes can be divided into five main categories:
1-True Hermaphrodites: It is an animal possesses the gonads of both sexes and theoretically capable of impregnation and becoming pregnant. 2-Female pseudohermaphrodites: The gonads are ovaries and the accessory sex organs are predominantly male. This type of intersexes is rare in domestic animals. 3-Male pseudohermaphrodites: These are the most common forms of intersexes observed in domestic animals, in the pig and goat. The gonads are testicles which are usually retained. The external genitalia are mainly of the female type with an enlarged clitoris, or may be vestigial penile development. 4-Androgen insensitivity (testicular feminization): This type of intersex may occur in bovine or equine species. It produces a male pseudohermaphrodite in which the external genitalia are female and despite the testis-producing testosterone, the development of the Wolffian system is not achieved because of a deficiency of cytosol receptors for the binding of androgen.
5-Freemartinism: The bovine freemartin is a genetic female born co-twin with a male. Over 90% of such females have severe hypoplasia of the genital tract and are sterile. Pathogenesis of freemartin: The male and female co-twin shares a common placental circulation in uterus. Androgenic hormones produced by the testicles of male fetus may enter the circulation and suppress the development of the female genitalia (the male gonads develop earlier than the female gonads). Freemartinism also occurs in sheep and pigs, but the incidence of occurrence in these species is extremely low.
Male Genital System Developmental Disorders (Congenital Anomalies): Anorchia (Anorchism): Congenital absence of both testes. Monorchia (Monorchism): Congenital absence of one testis. Polyorchism (Polyorchidism): Testicular duplication or supernumerary testes. Synorchia (Testicular Fusion): Fusion of abdominal testes. Testicular Heterotopia: Presence of testicular tissue in abdominal site as peritoneal surface. Splenic-Testucular Fusion: Fusion of both splenic and testicular tissues.
Testicular Hypoplasia (Hypogonadia): Causes: 1-developmental causes 2-Genetic causes
it includes:
A-Gonadal hypoplasia B-Chromosomal abnormalities e.g. 1-Klinefelter’s Syndrome (phenotype of male either xxy, xxyy, xxxy) 2-Dysgenesis: a-Cystic rete testis b-Appenix testis c-Appendix epididymis Macro: i-The testes are small and flabby. ii-The capsule is tense.
Micro: 1-There are 3 grades of testicular hypoplasia according to the number of somniferous tubules involved. A-Severe type: all tubules are affected. B- Intermediate type: 50% of the tubules are affected. C-Mild type: few tubules are affected. 2-The hypoplastic tubules have a smaller lumen than normal. 3-The basement membrane is thickened and hyalinized. 4-Only single layer of spermatogonia with Sertoli cells are present. 5-Hyperplasia of leydig cells and interstitial connective tissue.
Cryptorchidism (Undescended or Hidden testicle): It is permanent retention of one or both testes inside -The abdominal cavity Abdominal cryptorchidism -The inguinal Canal Inguinal cryptorchidism It is frequent in horses and uncommon in cattle, dogs and sheep. Bilateral cryptorchidism leads to sterility with “Satyriasis�. Satyriasis: It is an increase of sexual desire. Macro: 1-The testis is small in size after puberty. 2-Soft in consistency. 3-The secondary sex characters developed normally. 4-The spermatogenic function does not developed (high temperature). Micro: (similar to embryonic testis). 1-The somniferous tubules are rudimentary and have no spermatogenesis. 2-The leydig cells may be numerous.
Complication: i-Unilateral cryptorchidism hypertrophy of another testis. ii-Bilateral cryptorchidism Sterility with satyriasis. iii-The undescended testis It is liable to trauma, torsion, inguinal hernia and malignant disease.
Testicular Atrophy or Degeneration: The germinal epithelial lining of the seminiferous tubules is highly liable to degenerative changes, leading to testicular atrophy (decrease the size of the testis after reach to the mature size).
Causes: 1-Generalized diseases. 2-Neutritional deficiency or vascular occlusion 3-Senility and autoimmunity 4-hormonal deficiency or excess
Macro: 1-The testes are small in size 2-Firm in consistency
Micro: i-No spermatogenesis ii-The seminiferous tubules are lined by a single layer of cells, which become vacuolated and necrotic. iii-Spermatocytic giant cells are present. iv-The basement membrane of the seminiferous tubules may be hyalinized.
v-Connective tissue proliferation replaced the necrotic tissues. vi-The leydig cells are present and may increased in number.
Differentiation Between Testicular Hypoplasia and Degeneration Testicular Hypoplasia
Testicular Atrophy or Degeneration
Regular tubular circumference
irregular tubular circumferences
Regular Sertoli cell lining
Lack of tubular lining and collapse
Tense capsule
Wrinkled or wavy capsule
No inflammatory cells
Secondary inflammation
Absence of lipofuscin
Presence of lipofuscin in tubular cells
Definitions: Aspermia: No semen. Azospermia: No sperms in the semen. Necrospermia: Dead sperm in normal count. Oligospermia: Decrease the number of sperm in the semen. Polyzoospermia: Increase the number of sperm in semen. Asthenzoospermia: Poor motility with normal count of sperms. Orchitis: Inflammation of the testis. Epididymitis: Inflammation of epididymis. Funiculitis: Inflammation of spermatic cord. Hydrocele: Abnormal accumulation of fluid in tunica vaginalis in scrotum. Pyocele: Accumulation of pus in tunica vaginalis in scrotum.
Varicocele: It is the varicosity of the pumpiniform plexus of the spermatic cord (usually in left side testis which descend early than right one and the plexus of left form acute angle with renal vein but the right is oblique angle).
Causes: 1-Primary Varicocele: due to congenital, long standing and weakness of the muscle of the veins 2-Secondary Varicocele: caused by indirect cause as tumor of kidneys increases the intraabdominal pressure varicose.
Macro: Dilation of the pumpiniform plexus. The veins are tortuous and filled with blood.
Complications: -Hydrocele -Degeneration of spermatogenic cells -Atrophy of the testes -Thrombosis -infertility
ORCHITIS Orchitis may start as periorchitis with an inflammatory reaction in the tunica vaginalis gradually involving the testes. A preceding peritonitis is the usual cause of such pathogenesis as there is a direct connection between the peritoneum and the layers of the tunica vaginalis via the inguinal ring.
Causes: 1-Trauma eg. Kick: 2-Infections: Either A- Ascending through the urethra. B-Descending through the epididymis. C-Hematogenous through the blood. NB: The most important microorganisms are: -Brucella species (abortus in bull, ovis in ram, suis in boar). -Salmonella abortus equi
in horse -Pasteurella and pseudotuberculosis (Coryne pyogens) in ram. -Pseudomonas aerogenes (blue pus).
3-In diagnostic test (Straus reaction):
3-In diagnostic test (Straus reaction): in male guinea pigs, injected with glanders bacilli It induces “necrotizing suppurative orchitis. NB: Orchitis may be unilateral or bilateral. Inflammation of one testis can produce thermal injury in the contralateral testis.
Lesions: A-Acute Orchitis: 1-It either focal or diffuse suppurative inflammation with abscess 2-The surrounding tissues are usually hyperemic and edematous (scrotum) 3-The cut surface is hyperemic, moist and showed yellowish foci of necrosis or suppuration. 4-The spermatic cord is thickened. 5-The epididymis is enlarged.
B-Chronic Orchitis: It is characterized by 1-Fibrous connective tissue proliferation in the testis. 2-The germinal epithelium are completely destructed. 3-The regeneration does not occur.
NB: The chronic orchitis is due to -Non-specific causes:
Bad management and acute type
-Specific Causes:
Tuberculous and filarial orchitis.
Sequelae: 1-Chronic orchitis may leads to sterility. 2-The more severe form cause severe destruction of tissue makes severe pain and may cause generalization and fatal septicemia.
Sperm granuloma (Immune Orchitis): Obstruction of the sperm passages (epididymis and spermatic cord) Leads to accumulation of sperm in the seminiferous tubules cyst formation rupture passages of sperm in the blood act as emboli stimulate antibody formation then go back to the affected testis to form antigen-antibody complex, surrounded by granulomatous reactions (macrophages, giant cells and lymphocytes).
Neopasms of the testes: Seminoma: It is benign tumor of somniferous tubules. Sertoli (Sustantacular) cell tumor: cause feminizing tumor (estrogen). Leydig or interstitial cell tumor: Masculinization (testosterone).
Teratoma: it is either Teratocarcinoma
Chorion carcinoma
Dermoid cyst
Funiculitis: It is the inflammation of the spermatic cord (usually chronic proliferative suppurative or necrotic).
Causes: Staph. aureus Actinomyces bovis Actinobacillus ligniersi Spherophorus necrophorus Spirochetes (swine) Tuberculosis
Macro: 1-The spermatic cord is enlarged. 2-Firm (in early stage) and fluctuating with bad smelling fluid (later on).
Micro: 1-The lesion is an abscess with a thick wall of granulation tissue, surrounding a necrotic center. 2-Leukocytic infiltrations. 3-Thrombosed blood vessels.
Scirrhous Cord: It is an excessive granulation tissue formation in the stump of the spermatic cord following castration.
Epididymitis: It is inflammation of the epididymis. Macro: 1-The tail of epididymis is enlarged and irregular. 2-Firm in consistency. 3-Tunica albuginea is thickened. 4-The epididymis contains creamy pus. 5-Adhesion between the parietal and visceral layer of tunica vaginalis. 6-Spermatocele (presence of sperm in T. vaginalis) may present.
Micro: 1-Interstitial perivascular edema 2- Lymphocytic infiltrations. 3-Focal or diffuse suppurative inflammation. 4-Spermatostasis and rupture of tubules with formation of sperm granulomas.
Seminal Vesiculitis (spermatocystitis): It is the inflammation of the seminal vesicles, caused by brucellosis, vibriosis, trichomoniasis and pseudomonas aerogenes.
Prostatitis: It is inflammation of prostate ( usually suppurative).
Hypertrophy of prostate: It is enlargement of prostate. It is common in old dogs.
Causes: 1-Hormonal imbalance between estrogen and testosterone. 2-Chronic inflammation with lymphocytic infiltration and fibrosis. 3-Benign tumors of prostate (as adenoma).
Macro: 1-The prostate gland is enlarged (3 times). 2-Firm in consistency. 3-The surface is smooth or nodular. 4-Cut surface show distinct lobulations. 5-Compensatory hypertrophy of the muscles of urinary bladder.
Micro: 1-There is an increase in the glandular, the muscular and connective tissue elements. 2-The epithelial lining of the gland may form papillary projections inside the lumen or may become atrophied due to increase the secretion (cystic dilation). The abundant secretion may induce formation of “Corpora amylacea� 3-Inflammatory cells infiltrations.
Complications of Hypertrophy of Prostate: 1-The Prostate Glands: i-Infection and abscess formation. ii-Secondary carcinoma. ii-Calculi formation. 2-The Urethra: i-Partial or complete obstruction of urethra. ii-Elongation of urethra. iii-The internal sphincter is widened (in urinary bladder) due urine retention.
3-The Urinary Bladder: i-Hypertrophy of the muscles of urinary bladder. ii-Acute or chronic urine retention. iii-Stasis of urine with stones formation. vi-Hemorrhage from mucosa. v-Atony of the wall of the bladder.
4-The Ureters and Kidneys: i-Dilation of the ureter due to back pressure (hydroureter and hydronephrosis). ii-Bilateral pyelonephrosis, pyelonephritis and uremia. iii-Stones formation.
5-Sexual Complications: i-At the first, there is an increase of sexual desire (False erection) due to engorgement of the penis from impairment of its venous drainage by the enlarged prostate. ii-Later on, formation of new veins and accommodate the venous drainage, where the erection and desire are lost.
6-General Complications: -General weakness and loss of weight. NB: Calculi in Prostate Gland are rare in animal, but usually seen in dogs.
Urethra, Prepuce and Penis Hypospadias: It is a congenital anomaly of the urethra, where the external opening is situated behind its normal site. Epispadias: It is a congenital anomaly of the urethra, where the external opening is situated infront its normal site. Stricture of the urethra: It is the narrowing of the lumen of the urethra. Diphallus: It is the presence of double penis.
Phemosis: It is the narrowing of the preputial orifice and prevent the extension of the penis from the sheath.
Paraphemosis: It is the swelling of the prepuce, when the penis is protruded and impossible to withdraw.
Posthitis: It is the inflammation of the prepuce.
Balanitis: It is the inflammation of the glans penis.
Balanoposthitis: It is the inflammation of the penis and prepuce. Neoplasms: as skin + transmissible venereal tumor (in dogs).
Female Genital System Anomalies: Female hypogonadism: It may be acquired (Inflammation, chemotherapy with cyclophosphamides or radiation) destroy the function of a cyclic ovary. Or Congenital ovarian hypoplasia may affect one or both ovaries and there may be partial or complete ovarian dysfunction. The condition of ovarian hypoplasia is also described as “streak hypogonadism�.
Segmental aplasia: The condition may affect various portions of the paramesonephric duct (Muellerian) system. As in White Shorthorn cattle "White Heifer Disease".
Uterus didelphys: Failure of proper fusion of the caudal portions of the paramesonephric (Muellerian) ducts may result in double vagina, double cervix or a divided uterine fundus.
Ovary Ovarian Function: 1-Produce mature ova.
2-Provide hormones to regulate the reproductive tract and secondary sex changes (estrogen, progesterone, androgens, oxytocin and relaxin).
Ovary of mare (Cut section): In contrast to those of other domestic animal species, the mare's ovary has different morphological and functional features. 1-The medulla lies external to the cortex. 2-The mare ovulates from the ovulation fossa. 3-The follicles grow toward the ovulation fossa at the time of ovulation. 4-The Graafian follicles of the mare's ovary becomes quite large prior to ovulation. They may be as large as 3-6 cm in diameter and should not be confused with cystic follicles. 5-The texture of the equine ovary is firm due to a very fibroblastic stroma. 6-Several corpora lutea may develop during certain phases of gestation in the ovary of a pregnant mare.
Atretic Follicles: Atresia: It is a normal process for those follicles do not attain maturity. Follicular atresia: It is pathological when unnatural influences inhibit the final maturation process (as occurs in case of anestrus of inanition and debility). Inanition (weakness) means exhausted state due to prolonged starvation.
NB: During the estrus cycle of uniparous animals, many follicles develop but only one is suppose to mature and ovulate. The remainder undergo atresia (degenerate and disappear).
Ovarian Cysts: These cysts either A-Congenital cysts B-Acquired cysts
Derived from mesonephric ducts remnants. Formed during ovarian cycle.
Types of Ovarian Cysts: 1-Cystic Graafian Follicles (Follicular cysts). 2-Lutein cysts. 3-Theca Lutein cysts. 4-Dermoid cysts. 5-Retained Corpus luteum. 6-Paraovarian cysts.
1-Cystic Graafian Follicles (Follicular cysts):
Pathogenesis: It is formed during estrus and associated with a failure of the release of LH (luteinizing hormone) and granulosa cells to degenerate. The granulosa cells continue to produce estrogen stimulate the adrenal cortex to produce ACTH retention of sodium in the follicular fluid increase the osmotic pressure absorption and accumulation of fluid inside the Graafian follicle become cystic.
Macro: 1-The follicular cyst appear singly or multiple in one or both ovaries. 2-Its size may reach to 20 cm in diameter. 3-The wall of the cyst is thin and tense. 4-Its content is clear serous fluid.
Micro: 1- The ovum is absent. 2-The granulosa is shrunk or flattened due to pressure atrophy.
Sequelae: i-Chronic cysts in cows leads to development of hydro- or mucometra. ii-Nymphomania (elongation of estrus). iii-After a period of time, the cysts may be entirely disappear.
2-Lutein cysts: They are rare and of little significance, where there is abnormal accumulation of fluid in corpus luteum (CL).
Causes: -Insufficient blood supply. -Diseases of uterus especially endometritis as in brucellosis. NB: The difference between the lutein and follicular cysts: The presence of spherical or polyhedral lipoid containing cells. Remnants of atrophic and degenerated CL.
3-Theca Lutein cysts: -It is similar to lutein cysts, but the polyhedral lipoid containing cells are derived from the theca interna. -These cysts are connected with the chorionic villi. -Similar to the neoplasm.
4-Dermoid Cysts: -It is a type of teratoma. -In the cyst-cavity may be revealed the layers of the skin, hair, teeth,..
5-Retained Corpus Luteum: -The cause is usually due to excess of LH Anestrum. -It occurs in bovine, which failed to undergo normal involution. -It appeared enlarged (up to 4 cm). -Its removal could retain the cycle into the normal.
6-Paraovarian cysts: -They occur frequently in bovine as one or several cysts. -They are persistent of embryonic mesonephric (Walffian) ducts. -They occur in mesoovarian or mesosalpinx ligaments.
Ovaritis (Oophoritis): inflammation of the ovaries. Neoplasms of the Ovaries: A-Surface Epithelial tumors: 1-Serous 2-Mucinous 5-Transitional cell
3-Endometrial 4-Clear cell 6-Undifferentiated
B-Germ cell tumors: 1-Dysgerminoma
2-Teratoma (mature or immature)
C-Sex-Cord Stromal tumors: 1-Granulosa cell tumor.
2-Fibroma (theca group).
D-Metastatic Tumors: -Metastatic colonic carcinoma.
Fallopian tubes (Oviducts): Salpingitis: It is the inflammation of fallopian tubes (usually bilateral).
Causes: -Ascending Causes: extension from endometritis. -Descending Causes: extension from oophoritis. -It is usually strept., staph., reach via the blood. Salmonella typhi or pullorum in chickens (descending)
Macro: -It is usually not detectable except in extensive affections as: 1-Pyosalpinx: the lumen is distended with pus. 2-Hydrosalpinx: the lumen is distended with fluid. 3-In chronic cases (T.B.) adhesion between the fimbria of the tube to the ovary.
Micro: 1-Active hyperemia. 2-Leukocytic infiltration. 3-The lumen of oviduct is distended with a-Eosinophilic granular material (hydrosalpinx). b-Homogenous basophilic material (pus) pyosalpinx. c-In addition, desquamated epithelium and necrotic debris d-Loss of cilia. 4-The wall is thickened due to lymphocytic infiltration and C.T. proliferation.
Sequelae: The salpingitis prevents the conception by occlusion of the ductal lumen or production of toxins kill the sperms or by destruction of cilia.
Types of Salpingitis: -Catarrhal
-fibrinous,
-hemorrhagic
-Suppurative.
Uterus Uterine Displacement: Uterine Torsion: It is the rotation of the uterus along its longitudinal axis (leads to partial or complete closure of cervix) Uterine Inversion (Eversion): protrusion of the uterus from cervix and vagina. Uterine Prolapse: protrusion of the uterus from vulva.
Metrocele (Herniation): protrusion of the uterus through diaphragm or inguinal canal.
NB: Metrorrhagia: It is a hemorrhage from the uterus
Endometriosis: Endometriosis refers to the presence of endometrial tissue in an ectopic location i.e. outside the uterus. The most common sites for endometriosis are the ovaries, pelvic and peritoneum. Less commonly, endometriosis can found in abdominal scars, appendix, colon, lung and pleura.
Pathogenesis: The endometrial tissue can pass during menstruation through fallopian tube to the ovaries and peritoneum or circulate in the blood to other organs.
Clinically: The manifestations depend on the site of involvement. Regardless of the site, the ectopic endometrial tissue responds to the same hormonal stimuli that affect normal endometrium, leading to cyclic secretory changes and menstrual bleeding in the site. -It induce severe pain and enlargement of the affected tissues. -Fibrosis and adhesions. -If it is present on the wall of intestine (pressure) luminal narrowing and obstruction with hypertrophy of the smooth muscles. -If it is present on the ovaries, large endometrial cysts (Chocolate Cysts) filled with old blood.
Microscopically: -These cysts are lined by endometrial epithelium and stroma.
Inflammation of the Uterus: It includes: 1-Endometritis (endometrium). 2-Myometritis (myometrium). 3-Metritis (whole uterus). 4-Peri- or para- metritis (broad ligament)
1-Endometritis: It is the inflammation of the uterine mucosa (endometrium).
Types of endometritis: A-Acute Catarrhal Endometritis. B-Chronic Catarrhal Endometritis.
A-Acute Catarrhal Endometritis: Causes: (mild irritants). i-Chemicals e.g. antiseptic. ii-Thermic e.g. hot uterine douches. iii-Mechanical. iv-Infections e.g. vibrio, trichomonas.
Macro: 1-The mucosa is congested and thickened. 2-The uterine lumen is filled with dark cloudy fluid. 3-Focal necrotic areas (easily detached).
Micro: 1-Active hyperemia. 2-Leukocytic infiltrations. 3-Excessive mucus mixed with desquamated epithelium and necrotic tissues.
B-Chronic Catarrhal Endometritis. Causes: As the acute type; but persist for long time. Macro: 1-The mucosa is thickened. 2-Firm in consistency. 3-Rough surface (coarse appearance).
Micro: 3 forms of chronic catarrhal endometritis are seen as sequelae for fibrous connective tissue proliferation and obstruction of the ducts of endometrial glands: 1-Chronic Cystic Catarrhal Endometritis (cystic dilation of the gland) 2-Chronic Polypoid Catarrhal Endometritis (polypoid glands with rough surface of endometrium) 3-Chronic Atrophic Catarrhal Endometritis (the gland atrophied with thin endometrium).
3-Metritis: It is the inflammation of the uterus as a whole.
Types of Metritis: A-Suppurative Metritis
B-Necrotic Metritis
A-Suppurative Metritis
B-Necrotic Metritis
Acute
Chronic
I-Acute Suppurative Metritis: Causes: -Pyogenic bacteria (Staph, Strept, E. coli,..).
Macro: 1-The mucosa is congested and thickened. 2-The lumen of the uterus is filled with pus. 3-The mucosa may be covered by fibrinous exudate.
Micro: 1-Active hyperemia. 2-Leukocytic infiltrations (neutrophils) 3-Thrombosis of small arterioles. 4-Necrosis in the endometrium.
II-Chronic Suppurative Metritis (Pyometra): It may be: A-Closed Pyometra. B-Opened Pyometra (Leukorrhea).
A-Closed Pyometra: It is an accumulation of pus in the uterus with closed cervix.
Causes: -Trichomonas fetus in cow. -Pyogenic bacteria ((Staph, Strept, E. coli,..).
The Closed Cervix is due to: 1-Mechanical Obstruction to discharge: The pyometra is due to prolonged endometritis with indurated and stenotic cervix (usually caused by strept). It prevent the expulsion of the uterine content.
2-Functional Obstruction to discharge: The pyometra is due to endometrial pyogenic infection with retained corpus luteum that stimulate to secrete progesterone, which make the uterus calm and the cervix close as in case of pregnancy
The closed Pyometra is characterized by -The uterine wall is thin (overdistended with thin creamy pus) -The serosal surface of the uterus is congested.
B-Opened Pyometra (Leukorrhea): It is the discharging of pus from uterus through opened cervix and Characterized by : 1-The uterine wall is thickened due to fibrous connective tissue proliferation 2-The lamina propria of the endometrium infiltrated with round cells 3-Atrophy of the endometrial glands. 4-Squamous metaplasia of the epithelium of endometrial glands.
III-Acute Necrotic Metritis: Causes: -Spherophorus necrophorus after parturition in cattle. Macro: 1-The endometrial mucosa is congested and thickened. 2-Necrotic sheath on the uterine wall (coagulative necrosis). 3-Gray, green or grayish-red necrotic areas. 4-The lumen of uterus is empty (no secretion or exudate).
Micro: 1-Necrosis of endometrial epithelium (coagulative necrosis). 2-Line of defense between the necrotic and healthy tissues. 3-Thrombosis in small blood vessels. 4-Leukocytic infiltrations.
IV-Chronic Necrotic Metritis: Causes: Macro:
Staphylococcal infection
1-The uterine wall is thick. 2-The sheath cover the uterus is necrotic and fibrinous.
Micro: 1-Connective tissue proliferation. 2-Atrophy of the endometrial glands. 3-Leukocytic infiltrations.
Cystic Hyperplasia It means hyperplasia of the endometrial glands followed by cystic formation due to excessive secretion. It is associated with purulent inflammation as in case of (E. coli, Staph and strept infections).
Types of Cystic Hyperplasia: 1-Uncomplicated Cystic Hyperplasia: It is characterized by: i-Only hyperplasia of the epithelium of the endometrial glands. ii-Cystic dilation. iii-Excessive mucus secretion. iv-No inflammatory cells.
2-Complicated Cystic Hyperplasia: It is characterized by: i-it is accompanied with inflammatory cell infiltrations. ii-Hyperplasia of the endometrial glands. iii-Cystic dilation. iv-Connective tissue proliferation.
3-Atrophy Cystic Hyperplasia: It is characterized by: i-Hyperplasia of the endometrial glands. ii-Excessive mucus secretion iii-There is inflammatory cells infiltration.
atrophy of the glands
Myometritis:
inflammation of myometrium. Para- or peri-metritis: inflammation of the serous coat of the uterus and broad ligaments.
Adenomyosis It is a common condition in which the endometrial glands and stroma are found deep in the myometrium (in women). It causes pelvic pain, abnormal menstrual bleeding and uterine enlargement. Grossly, the myometrium is thickened and occasionally small cysts (dilated endometrial glands) can be recognized in the myometrium. Microscopically, presence of endometrial glands and stroma deep within the myometrium with hyperplasia of surrounding smooth muscles. Cervicitis: It is inflammation of the cervix. Vaginitis: It is inflammation of the vagina. Prolapse of Vagina: Protrusion of the vaginal mucosa through the vulva. Vulvitis: It is inflammation of the vulva.
Mammary Gland (Udder)
Structure of the mammary gland
Diseases of the mammary gland Inflammation / infection: Mastitis (mammitis): Inflammation of entire gland tissue. Galactophoritis: Inflammation of the lactiferous ducts. Mammillitis (Thelitis): Inflammation of the Teat. Response of Gland to infection: 1-Acute infections: a-Most infections are bacterial b-Edema, hemorrhage, necrosis of alveolar epithelium c-Exotoxins cause vasculitis and infarction – vascular thrombi and marked edema.
2-Chronic infection: a-Abscesses (Coryne) or granulomas (TB) b-Gangrenous mastitis sloughing or sequestrum c-Heal with fibrosis d-Acinar atrophy e-Squamous metaplasia of duct epithelium, granulation tissue, fibrous polyps.
Organisms causing mastitis I-Streptococcal mastitis i-Strept. agalactiae: a-Chronic in ducts (hyperplastic thickening and carnification of the epithelial lining). b-Spreading and destroying glandular tissue. c-Formation of microabscesses. d-Fibrosis. e-Glandular involution.
ii-Strept. dysgalactia (and others): Acute mastitis (self limiting and with dysfunction of affected quarter).
II-Staphylococcal mastitis i-Acute: necrotizing and gangrenous. ii-Chronic: granulation tissue or abscess formation (Botryomycosis).
III-Coliform mastitis: i-Endotoxic injury to microvascular results in massive PMNs response, tissue necrosis, systemic toxemia (lead to severe acute mastitis). ii-Gangrene can occur.
IV-Actinomyces pyogenes: (Corynebacterium pyogenes) Necrotizing suppurative galactophoritis with intraductal and interstitial abscesses (Excessive pus formation and destruction of the tissue). Replace the whole quarter.
V-Mycoplasma mastitis: i-Rapid onset, multiple quarters, nodular appearance. ii-Lymphoid aggregates and fibrosis iii-Multiple animals are affected.
VI-Tuberculosis: Chronic granulomatous mastitis and includes: i-Miliary TB. Mastitis. ii-Chronic Productive TB. Mastitis. iii-Diffuse Caseous Mastitis.
VII-Lentiviral mastitis of sheep and goats: i-Maedi-visna virus or ovine progressive pneumonia (OPP) in sheep ii-Caprine arthritis-encephalitis (CAE) virus in goats. iii-It is characterized by interstitial infiltrates of macrophages, lymphocytes, and plasma cells.
VIII-Diseases affecting the skin: i-Orf or contagious ecthyma in sheep and goats – parapox (Contagious ovine ecthyma, bovine popular stomatitis and pseudocowpox) - proliferative and ulcerative lesions. ii-BHV-2 (Herpesvirus mammillitis) iii-Cow pox
Classification of Mastitis according to Exudate: Acute Mastitis: It includes Serous, Suppurative, Hemorrhagic, Necrotic and Gangrenous.
Macro: i-The affected quarter is enlarged and firm. ii-Cut section is moist, smooth and pale or dark red (hemorrhagic). iii-Serous fluid (serous), bloody fluid (hemorrhagic), colored pus (suppurative) oozed from its cut surface.
Micro: i-The lining epithelia of affected acini are degenerated (swollen and vacuolated). ii-Leukocytic infiltration (Neutrophils) and congested blood vessels. iii-Eosinophilic material (Serous), RBCs. (hemorrhagic), Necrosis (necrotic), Pus (suppurative) and Gangrene (gangrenous).
NB: Serous mastitis may occur but its diagnosis is difficult because the secretory nature of epithelium. There is no mucus-producing epithelium in udder; thus there is no catarrhal mastitis.
Chronic Mastitis: i-Suppurative ii-Non-Suppurative Definitions: 1-Polythelia: The number of teats more than normal and usually accompanied with Polymastia. 2-Gynecomastia: It is the hypertrophy of the mammae in males .