Digital images have revolutionised the workflow of veterinary pathology, bringing multiple advantages to the industry, ranging from the provision of a comprehensive view of samples and accurate measurements of surgical margins to the ability to quickly share images for second opinions or teaching purposes.
In this article, you are invited to discover the power of digital pathology by joining Dr Marvin Firth – a pathologist from NationWide Laboratories – as he explores three canine cases presented for analysis as digital images. This unique experience will not only provide valuable learning opportunities but encourage discussion among nurses, technicians and those seeking to enhance their involvement in veterinary diagnostics.
The power of digital pathology
With traditional microscopy, pathologists are limited to a narrow field, potentially missing important details. Digital pathology, on the other hand, offers a unique advantage by providing a comprehensive scanning view of the entire sample, unrestricted by the constraints of the microscope’s field of view, before embarking on more detailed assessment at higher magnifications.
Digital pathology offers a unique advantage by providing a comprehensive scanning view of the entire sample, unrestricted by the constraints of the microscope’s field of view
Additionally, accurate measurements of surgical margins are crucial for determining the extent of the lesion and planning appropriate treatment. Digital pathology enables precise measurements, leading to improved diagnostic precision and ultimately better outcomes for our patients.
One of the most significant benefits of digital pathology is the ability to share images instantaneously. As soon as a sample is scanned, it can be shared with a pathologist anywhere in the world, expediting the reporting process and enabling faster treatment decisions. Seeking second opinions or specialist consultations through instant image sharing has become seamless, allowing for enhanced diagnostic accuracy and collaboration.
Digital images also provide exceptional educational opportunities. They can be shared with trainee pathologists and veterinary students, allowing them to learn from real cases and enhance their understanding of pathology. This facilitates the growth of knowledge within the field and contributes to improved diagnostic abilities across the veterinary community.
How it works in the laboratory – case studies
A grass seed found in the mammary tissue of a dog
This surgical biopsy (Figure 1) was taken from a dog that presented with an ulcerated lesion and thickening in the left mammary chain.
Histologically, there is extensive pyogranulomatous inflammation in the dermis centred around an embedded seed. Note the intact seed coat, inner integument and endosperm (as seen in the digital images, haematoxylin and eosin (H&E) stain). Multiple bacterial colonies surround the embedded organic material.
The good news in this case is that there is no noted neoplastic process and that with complete surgical removal, which has been detected in the sections examined digitally, this dog should make a good recovery.
This lesion highlights the seasonal issue that grass seeds present: looking at soft tissue swellings and inflammation associated with grass seeds, they can end up anywhere!
Dermal canine haemangioma
Figure 2 is a skin mass from a nine-year-old crossbreed canine. This is a 7.5mm diameter, well-demarcated, unencapsulated, multinodular pedunculated mass in the dermis of haired skin.
The mass consists of vascular spaces of various calibre, which predominantly contain erythrocytes but with some also containing fibrin or pale eosinophilic material. These spaces are bordered by plump neoplastic endothelial cells and supported by variably abundant fibro-collagenous stroma that have rare small accumulations of lymphocytes and plasma cells. The proliferating endothelial cells have oval nuclei with finely stippled chromatin and indistinct nucleoli. There is moderate eosinophilic, fibrillar cytoplasm and indistinct cell borders, and mild anisocytosis and mild anisokaryosis with typically less than one mitosis per high power field (2.37mm2). The subepithelial dermal regions contain mild to moderate lymphoplasmacytic infiltrates with increased numbers of neutrophils in the dermis of the stalk. There are clear borders of haired skin in this tissue section.
Haemangiomas are typically benign, solitary, deep dermal tumours in dogs, whereas haemangiosarcomas are often present as a disseminated malignancy involving the spleen, heart, lung, liver and soft tissues of the trunk and extremities (Cooley et al., 1997). Canine cutaneous haemangiomas are common when compared to primary canine cutaneous haemangiosarcomas, and haemangiomas occur more frequently in younger dogs.
Accurate and clear digital imaging assists pathologists in determining whether a mass is benign or malignant by being able to assess the neoplastic cell population – in this case, the fine endothelial cells lining the vascular channels.
Colour dilution alopecia in a three-year-old male Doberman
Our final case is a three-year-old male Doberman exhibiting generalised dermatitis and alopecia over the trunk. It had been non-responsive to conventional medical treatment.
A series of biopsies were examined digitally at NationWide Laboratories (Figure 3). They showed mild changes in the epidermis, including irregularly spaced hyperpigmented basal epithelial cells and some pigmentary incontinence. There was very noticeable follicular dysplasia and dense clumps of melanin pigment in the hair bulbs and follicles of the dermis and even in the hair shafts, including enlarged melanophages surrounding the base of the hair follicles. Overall, the hair follicles were atrophied and there were minimal inflammatory cells throughout the sections. There was pigmentary intrafollicular and intra-epidermal melanin clumping and pigmentary incontinence consistent with colour dilution alopecia or black hair follicular dysplasia, which are observed in colour dilute dogs (eg blue or fawn colours). Follicular dysplasia often leads to poor hair-coat quality and, though variably, alopecia, as reported in this case.
Hair loss is usually most severe on the trunk, especially dorsally. Secondary bacterial infection can sometimes be seen. This form of colour dilution alopecia is commonly seen in the Doberman Pinscher. As such, this was a classic case and the use of digital pathology allows us to accurately diagnose the condition while effectively sharing the key histological findings with our trainee pathologists and students. The ability to pan the whole slide image allowed us to quickly make judgements of the most important pathology and focus our attention on these changes.
Conclusion
Digital pathology has undoubtedly revolutionised veterinary diagnostics, offering a wide range of benefits to pathologists, practitioners and patients alike. By embracing digital pathology workflow, veterinary professionals can enhance their diagnostic accuracy, collaborate globally and not only contribute to the growth of knowledge in the field but provide the best possible care for our animal companions.
By embracing digital pathology workflow, veterinary professionals can enhance their diagnostic accuracy, collaborate globally and not only contribute to the growth of knowledge in the field but provide the best possible care
About NationWide Laboratories
NationWide Laboratories is committed to making a positive impact on animal health by offering innovative products, technology and laboratory services. They offer friendly advice and rapid, reliable results to help fulfil your diagnostic and therapeutic objectives, and their expert teams can assist you in making decisions on relevant testing for companion, exotic and farm animals. They offer full interpretation across a range of testing areas, including biochemistry, haematology, cytology, histopathology, endocrinology, microbiology and more.
NationWide Laboratories is focused on keeping their service modern and relevant to the veterinary field. They have added a new, extra-fast and super-efficient slide digitalisation system into the workflow, which means improved turnaround times and better first-time results for you. They are also able to receive images from practices and offer a slide scanning service.
NationWide Laboratories is customer focused, passionate about animal welfare and always advancing! Their teams have the depth of knowledge and experience to help you help your clients.
To learn more please visit their website and follow them on LinkedIn and Twitter.
