Exploring alternatives for securing anatomical structures in capturing digital images: A comparative analysis.

Teaching veterinary anatomy using digital platforms requires improved image quality, which may influence the fixation process. This study aimed to compare four embalming solutions for high-colour-quality images of different tissues compared to the original image. Four equine left pelvic limbs were cut into metameres and divided equally for application of 10% formaldehyde, 96% glycerine, 33% hypersaturated NaCl solution and modified Larssen solution, respectively, which was maintained for 3 days. After drying for 3 days at room temperature, photographs were obtained at time 0 (T0), without any fixation process (original colour); time 1 (T1), immediately after removal from the solutions; and every 24 h for 3 days (T2-T4). The image colour quality was investigated by digitally evaluating the cortical bone, tendon and bone marrow using histograms and CIEDE2000 as well as by 10 specialists in an online survey. CIEDE2000 and histograms revealed that all fixation solutions changed the original tissue colour at all the time points (p < 0.0001). According to the specialists, the 33% saline solution produced the best results compared to the original one. The modified Larssen solution demonstrated better results for the tendon, marrow and cortical bone at T3 (p = 0.0015). Considering the colour of digital images, the modified Larssen solution provided the best results; however, the visual evaluation by the specialists revealed the 33% saline solution as the best.

An introduction to lesions and histology of scleractinian corals.

Stony corals (Scleractinia) are in the Phylum Cnidaria (cnidae referring to various types of stinging cells). They may be solitary or colonial, but all secrete an external, supporting aragonite skeleton. Large, colonial members of this phylum are responsible for the accretion of coral reefs in tropical and subtropical waters that form the foundations of the most biodiverse marine ecosystems. Coral reefs worldwide, but particularly in the Caribbean, are experiencing unprecedented levels of disease, resulting in reef degradation. Most coral diseases remain poorly described and lack clear case definitions, while the etiologies and pathogenesis are even more elusive. This introductory guide is focused on reef-building corals and describes basic gross and microscopic lesions in these corals in order to serve as an invitation to other veterinary pathologists to play a critical role in defining and advancing the field of coral pathology.

The Role of Histopathology in Ruminant Diagnostics.

Histopathology remains an important tool for ruminant disease diagnostic investigations. Some ruminant diseases require histopathology to make a definitive diagnosis. Clinical history, proper tissue sampling and handling, and proper fixation all increase the efficiency of a histopathologic examination and the likelihood of an accurate diagnosis. This article discusses some of the main organ systems of ruminants and highlights common ruminant diseases encountered by diagnosticians where histopathology is particularly important. Where applicable, correlative gross lesions, special considerations regarding tissue sampling, and histologic report interpretation are discussed.

An international collaborative approach to learning histology using a virtual microscope.

Histology is often taught in higher education settings using online virtual microscopes (VM). This study aimed to develop and evaluate the use of VM in teaching on a BSc degree at the University of Nottingham by surveying students and staff. A key development was the use of an e-workbook so that students were actively engaged in creating their own bespoke revision material. Subsequently, this approach was used in a second study evaluating the use of VM in teaching the histology and pathology of the gastrointestinal (GI) tract via group work with students from two BSc courses at the University of Nottingham; one based at Derby (RDHC) and the other in Malaysia (UNMC). Students worked together in groups to complete an e-workbook, develop a presentation, and decide how to collaborate and communicate. An evaluation of these activities revealed advantages in developing transferrable skills, and good engagement with both the histology topic and group work. Analysis of assessment of the module at UNMC showed that student performance improved in the histology-based module after the intervention (p < 0.01) and that this improvement was not evident in other modules taken by the cohort. Furthermore, when interrogating the questions from the examination paper that asked students to identify features from histological images, fewer questions were seen as 'difficult' (p < 0.001) and more were seen as 'average' (p < 0.01). This study demonstrates that the use of VM in histology combined with active learning in creating a revision resource enhances engagement and depth of learning. When further combined with collaborative active group work, students developed a range of histology knowledge and transferrable skills, with notable improvement in examination performance relative to other contemporaneous modules.

Leiomyosarcoma with widespread metastases in a capybara.

A 10.5-y-old intact female capybara (Hydrochoerus hydrochaeris) with a history of chronic weight loss was euthanized following discovery by palpation of a large intra-abdominal mass. Postmortem examination revealed a large, firm, tan mass expanding the uterine body and extensively adhered to the jejunum and abdominal wall. Numerous pinpoint to 3-cm diameter, tan-to-red, raised masses were present throughout the parietal peritoneum, liver, lungs, and intestinal serosa. Histologic examination of the uterine mass revealed well-differentiated smooth muscle intermixed with abundant collagen, interspersed with a highly anaplastic spindle cell population extending to the serosa; the masses in the lung, liver, and peritoneum were histologically very similar to the anaplastic uterine spindle cells. Immunohistochemical staining of the uterus and lung confirmed smooth muscle origin of the anaplastic cells. To our knowledge, leiomyosarcoma has not been reported previously in a capybara, and the widespread metastases in this case represent an unusually aggressive presentation of this rare malignancy. The animal also had an incidental dermal histiocytoma, a tumor that has also not been reported previously in this species, to our knowledge.

Using virtual microscopy for the development of sampling strategies in quantitative histology and design-based stereology.

Only a fraction of specimens under study are usually selected for quantification in histology. Multilevel sampling or tissue probes, slides and fields of view (FOVs) in the regions of interest (ROIs) are required. In general, all parts of the organs under study should be given the same probability to be taken into account; that is, the sampling should be unbiased on all levels. The objective of our study was to provide an overview of the use of virtual microscopy in the context of developing sampling strategies of FOVs for stereological quantification. We elaborated this idea on 18 examples from multiple fields of histology, including quantification of extracellular matrix and muscle tissue, quantification of organ and tumour microvessels and tumour-infiltrating lymphocytes, assessing osseointegration of bone implants, healing of intestine anastomoses and osteochondral defects, counting brain neurons, counting nuclei in vitro cell cultures and others. We provided practical implications for the most common situations, such as exhaustive sampling of ROIs, sampling ROIs of different sizes, sampling the same ROIs for multiple histological methods, sampling more ROIs with variable intensities or using various objectives, multistage sampling and virtual sampling. Recommendations were provided for pilot studies on systematic uniform random sampling of FOVs as a part of optimizing the efficiency of histological quantification to prevent over- or undersampling. We critically discussed the pros and cons of using virtual sections for sampling FOVs from whole scanned sections. Our review demonstrated that whole slide scans of histological sections facilitate the design of sampling strategies for quantitative histology.

Systemic mucoid degeneration of the arterial tunica intima in a young dog.

A 27-mo-old, spayed female mixed-breed dog was presented with left forelimb pain, which progressed to full thickness necrosis of the soft tissues of multiple limbs. Clinical imaging and postmortem examination suggested multiple large arterial thromboemboli. Histologic examination of vascular lesions revealed markedly thickened tunica intima with polypoid intraluminal projections, which partially to entirely occluded the arterial lumen. The expanded tunica intima was comprised of intimal accumulation of Alcian blue-positive matrix with scattered spindle-to-satellite cells. These cells were positive for von Willebrand factor and vimentin but negative for α-smooth muscle actin, suggesting endothelial origin. Deposition of the intimal mucoid matrix was observed in the elastic and muscular arteries associated with regional ischemic changes. Mucoid emboli, likely from fragmentation of proliferative intimal tissue, were identified in smaller vessels supplied by affected arteries. Based on these findings, we diagnosed systemic mucoid degeneration of the arterial tunica intima. Such systemic arterial degeneration characterized by deposition of mucoid matrix in the tunica intima has not been reported previously in dogs, to our knowledge, and should be distinguished from thromboembolism and other degenerative vascular diseases.

Endoparasite diversity and liver alterations in Hoplerythrinus unitaeniatus and Cichlasoma bimaculatum in a quilombola area in Maranhão, Brazil / Diversidade endoparasitária e alterações hepáticas em Hoplerythrinus unitaeniatus e Cichlasoma bimaculatum de área quilombola maranhense, Brasil

Our aim was to assess endoparasite diversity and liver alterations in Hoplerythrinus unitaeniatus (jeju) and Cichlasoma bimaculatum (acará preto) in a quilombola area in Maranhão, Brazil. For this, 21 H. unitaeniatus and 21 C. bimaculatum were caught in a natural environment and transported to a laboratory. After these had been euthanized, endoparasites were collected and identified. Liver alterations were evaluated histological analysis based on the severity of each lesion: stage I, organ functioning not compromised; stage II, more severe lesions that impair normal functioning of the organs; and stage III, very severe and irreversible lesions. Among the fish evaluated, 71.43% H. unitaeniatus and 61.90% C. bimaculatum were parasitized. Contracaecum sp. was found in both species; while acanthocephalans, only in H. unitaeniatus. The alterations were vacuolization, nucleus in the cell periphery, deformation of the cell outline, melanomacrophage center, hyperemia, cytoplasmic degeneration and nuclear vacuolization. Through calculating a histological alteration index, it was found that 26.19% of the specimens presented lesions in stage I; 38.09% lesions in stage II and 9.52% lesions in stage III. It was concluded that there is high prevalence of Contracaecum sp. and that the liver lesions may be adaptive responses by the fish to endoparasitic infection.(AU)

Objetivou-se avaliar a diversidade de endoparasitos e alterações hepáticas em Hoplerythrinus unitaeniatus (jeju) e Cichlasoma bimaculatum (acará preto) de área quilombola maranhense, Brasil. Assim, 21 H. unitaeniatus e 21 C. bimaculatum foram capturados de ambiente alagável e transportados vivos ao laboratório. Após a eutanásia, procedeu-se à coleta, identificação de endoparasitos e avaliação de alterações hepáticas por meio de análise histológica, baseada na severidade das lesões: (i) alterações de estágio I, não comprometem o funcionamento dos órgãos; (ii) estágio II, lesões mais severas que prejudicam o funcionamento normal dos órgãos; (iii) estágio III, lesões muito severas e irreversíveis. Dos peixes avaliados, 71,43% H. unitaeniatus e 61,90% C. bimaculatum estavam parasitados. Contracaecum sp. foi encontrado nas duas espécies e acantocéfalos apenas em H. unitaeniatus. As alterações hepáticas foram vacuolização, núcleo na periferia das células, deformação do contorno celular, centro de melanomacrófagos, hiperemia, degeneração citoplasmática e vacuolização nuclear. Com o cálculo do índice das alterações, constatou-se que 26,19% dos exemplares apresentaram alterações de estágio I; 38,09% de estágio II e 9,52% de estágio III com a constatação de larvas de Contracaecum sp. encistadas no fígado. Conclui-se que existe alta prevalência de Contracaecum sp., e lesões hepáticas podem ser respostas adaptativas dos peixes à infecção endoparasitária.(AU)

Diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in 106 dogs with nontraumatic hemoabdomen.

OBJECTIVE: To assess the diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in dogs with nontraumatic hemoabdomen. ANIMALS: 106 dogs with a nontraumatic hemoabdomen that underwent abdominal ultrasonography and splenectomy with histologic examination of splenic lesions between 2005 and 2018. PROCEDURES: Medical records were reviewed for abdominal ultrasonographic and histologic findings. Diagnostic performance of ultrasonographic description of a splenic mass or nodule as cavitated as evidence of hemangiosarcoma or any malignancy was evaluated. RESULTS: Ultrasonographic description of splenic lesions as cavitated had poor diagnostic utility in predicting presence of hemangiosarcoma or malignancy. Sensitivity and specificity of this test were 41.9% (95% CI, 30.5% to 54.3%) and 51.2% (95% CI, 36.8% to 65.4%), respectively, for detecting hemangiosarcoma, with positive and negative predictive values of 55.3% (95% CI, 41.2% to 68.6%) and 37.9% (95% CI, 26.6% to 50.8%), respectively. Results were similar for detecting malignancy. Cavitated lesions outside of the spleen were too rare for statistical analysis to be of value. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that relying on ultrasonographic description of cavitation to diagnose splenic lesions as malignant in dogs with nontraumatic hemoabdomen is unfounded. Other preoperative diagnostic tests may be more valuable in determining short- and long-term prognoses.

Influence of locoregional lymph node aspiration cytology vs sentinel lymph node mapping and biopsy on disease stage assignment in dogs with integumentary mast cell tumors.

OBJECTIVE: To compare the effect of sentinel lymph node (SLN) histology vs locoregional lymph node (LRLN) fine needle aspiration (FNA) cytology on assigned disease stage and adjunctive treatment recommendations and describe the incidence of anatomic disparity between the LRLN and SLN. STUDY DESIGN: A pre-post study refers to a study design type in which subjects are compared pre and post the intervention of interest. ANIMALS: Seventeen dogs undergoing primary excision of 20 cutaneous and subcutaneous mast cell tumors (MCT). METHODS: Client-owned dogs presenting to the Cornell University Hospital for Animals for surgical removal of a cytologically confirmed cutaneous or subcutaneous MCT >1 cm in diameter were enrolled. Cytological examination of FNA from the LRLN was compared with histology of the SLN. The SLN was identified by indirect computed tomographic lymphangiography (ICTL) after peritumoral injection of iopamidol and scanning at 1, 3, 5, 10, and 15 minutes. Histopathologic node score > 1 was considered metastatic. After case review by an oncologist, LRLN FNA cytology was compared with SLN histology for effect on changes in stage assignment and adjunctive treatment recommendations. RESULTS: Mast cell tumors were graded as 2 low (n = 11), 2 high (n = 2), and subcutaneous (n = 7). Optimal scan timing was 10 minutes after injection of iopamidol. Sentinel lymph node differed anatomically from LRLN in 5 of 18 scans. Metastases were detected by histology in 9 of 20 SLN compared with in 1 of 20 FNA of LRLN (P = .001), changing stage and adjunctive treatment recommendations 8 of 20 tumors. Only 6 of 19 LRLN FNA samples were diagnostic. CONCLUSION: Sentinel lymph nodes were consistently identified with ICTL and differed from LRLN in one-quarter of tumors. Histopathological examination of SLN altered recommendations in half of the dogs compared with the previous standard of care. CLINICAL SIGNIFICANCE: Indirect computed tomographic lymphangiography and SLN excision should be considered as a new standard for dogs with MCT.

Preliminar histological study of the thymus in regularly slaughtered Chianina beef cattle to improve methods for the detection of illicit treatments.

Chianina is an Italian cattle breed appreciated for its meat and resilience skills. No standard values are present in literature regarding Chianina thymic involution. A possible early physiological involution has been reported during the Italian National Residue Plan screening tests. The aim of this work was to perform an anatomo­histopathological study of the thymus in Chianina cattle to improve knowledge about thymic involution in this breed. Forty Chianina bulls (16­24 months old), never treated with corticosteroids and regularly slaughtered in the Umbria region (Italy), were enrolled. Animals aged 19­21 months which received score 3 thymic atrophy had a prevalence of 0.15 (CI 95%: 0.02­0.45%), while the prevalence was 0.29 (CI 95%: 0.10­0.56%) among animals aged 22­24 months. The thymus/carcass weight and thymic cortex/medulla ratio resulted close to those reported in cattle experimentally challenged with corticosteroids. Results suggest that the Chianina breed could be characterized by a physiological premature involution of the thymus gland in comparison to other breeds. These results represent a starting point to increase the reliability of the National Residue Plan histological screening test.

Comparison of histologic methods for the detection of Desmozoon lepeophtherii spores in the gills of Atlantic salmon.

Desmozoon lepeophtherii is a microsporidian associated with gill disease in farmed Atlantic salmon (Salmo salar). Detection of the parasite in histologic tissue sections is challenging using common histochemical stains given that the small, widely distributed parasite spores typically occur individually or in small clusters. We compared the ability of 4 histologic methods to detect D. lepeophtherii spores in serial sections of Atlantic salmon gill tissue: hematoxylin and eosin (H&E), Gram-Twort (GT), calcofluor white (CW), and immunohistochemistry (IHC). Using CW as a benchmark to calculate a relative ratio, IHC consistently detected more spores than CW (median: 1.3), followed by GT (median: 0.2) and H&E (median: 0.1). IHC detected significantly more spores than GT (p < 0.05) and H&E (p < 0.05), and GT more than H&E (p < 0.05). We found significant underestimation of numbers of microsporidia spores in gill disease in Atlantic salmon using conventional histochemical stains and recommend the use of CW or IHC to detect the parasite in tissue sections.

Computerized Calculation of Mitotic Count Distribution in Canine Cutaneous Mast Cell Tumor Sections: Mitotic Count Is Area Dependent.

Mitotic count (MC) is an important element for grading canine cutaneous mast cell tumors (ccMCTs) and is determined in 10 consecutive high-power fields with the highest mitotic activity. However, there is variability in area selection between pathologists. In this study, the MC distribution and the effect of area selection on the MC were analyzed in ccMCTs. Two pathologists independently annotated all mitotic figures in whole-slide images of 28 ccMCTs (ground truth). Automated image analysis was used to examine the ground truth distribution of the MC throughout the tumor section area, which was compared with the manual MCs of 11 pathologists. Computerized analysis demonstrated high variability of the MC within different tumor areas. There were 6 MCTs with consistently low MCs (MC<7 in all tumor areas), 13 cases with mostly high MCs (MC ≥7 in ≥75% of 10 high-power field areas), and 9 borderline cases with variable MCs around 7, which is a cutoff value for ccMCT grading. There was inconsistency among pathologists in identifying the areas with the highest density of mitotic figures throughout the 3 ccMCT groups; only 51.9% of the counts were consistent with the highest 25% of the ground truth MC distribution. Regardless, there was substantial agreement between pathologists in detecting tumors with MC ≥7. Falsely low MCs below 7 mainly occurred in 4 of 9 borderline cases that had very few ground truth areas with MC ≥7. The findings of this study highlight the need to further standardize how to select the region of the tumor in which to determine the MC.

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study.

BACKGROUND: Free-living cetaceans are exposed to a wide variety of stressful situations, including live stranding and interaction with human beings (capture myopathy), vessel strikes, and fishing activities (bycatch), which affect their wellbeing and potentially lead to stress cardiomyopathy (SCMP). METHODS: Here, the authors aimed to characterise SCMP of stranded cetaceans as an injury resulting from extreme stress responses, based on pathological analyses (histological, histochemical and immunohistochemical). Specifically, the authors examined heart samples from 67 cetaceans found ashore (48 live strandings, seven dead from ship collision and 12 dead from bycatch) on the coast of Spain, more specifically in the Canary Islands from 2000 to 2016 and Andalusia from 2011 to 2014. RESULTS: The microscopic findings were characterised by vascular changes, acute or subacute cardiac degenerative necrotic lesions, interstitial myoglobin globules, and infiltration of inflammatory cells. Immunohistochemically, cardiac troponin I, cardiac troponin C and myoglobin were depleted, along with fibrinogen being expressed in the degenerated/necrotic cardiomyocytes. A perivascular pattern was also identified and described in the damaged cardiomyocytes. CONCLUSIONS: This study advances current knowledge about the pathologies of cetaceans and their implications on conserving this group of animals by reducing mortality and enhancing their treatment and subsequent rehabilitation to the marine environment.

Histological examination of the interspinous ligament in horses with overriding spinous processes.

The equine interspinous ligament (ISL) consists of an oblique crossing arrangement of collagenous bundles which are thought to counteract the tensile and rotational forces of distraction between the spinous processes (SPs) in the caudal thoracic and cranial lumbar spine. The aim of this controlled histological study was to assess the structural anatomy and innervation of the ISL in horses with clinically significant overriding (dorsal) SPs (ORSPs) and to compare the findings with the ISL of normal horses. Samples of the ISL were obtained from 10 horses that underwent subtotal ostectomy for treatment of ORSPs. Control samples were obtained from horses without spinal pathology. Histological staining of ISL sections with haematoxylin and eosin was performed to assess the morphology of the ligaments and with Alcian blue-periodic acid-Schiff to determine the proteoglycan and glycosaminoglycan content. Immunohistochemistry for S100 was performed for quantitative evaluation of nerves within the ISL. The ISL in horses with ORSPs had an altered collagen fibre alignment and arrangement of the ligamentous layers when compared to healthy controls. A significant increase in fibrocartilaginous tissue with evidence of fibrocartilaginous metaplasia was detected (P=0.001). The number of nerves in the ISL samples was significantly higher in horses with ORSPs than in controls (P=0.017). Structural alterations of the ISL, including loss of fibre alignment and fibrocartilaginous metaplasia, are associated with ORSPs in the equine thoracolumbar spine. In addition, an increase in innervation of the ISL in horses with ORSPs, compared to normal, may explain the thoracolumbar pain experienced by some horses with ORSPs.

Sensitivity of histology for the detection of the amphibian chytrid fungus Batrachochytrium dendrobatidis.

Histology is often underappreciated for the detection of the amphibian pathogenic fungus Batrachochytrium dendrobatidis, the cause of the potentially lethal skin disease chytridiomycosis. We evaluated the sensitivity of histology to detect chytrids in 20 wild specimens of 2 frog species from Uruguay that were clinically normal, but confirmed by PCR to be infected by B. dendrobatidis. We detected maturing and sporulated sporangia in 15 of 20 (75%) frogs, which is more sensitive than previously reported for histology. The effort needed to identify chytrids in histologic skin sections of Physalaemus henselii and Pleurodema bibroni required examination of 3.2 and 8.7 mm of skin sections for each frog species, respectively.

Bonamia in Ostrea angasi: Diagnostic performance, field prevalence and intensity.

Bonamia spp. parasites threaten flat oyster (Ostrea spp.) farming worldwide. Understanding test performance is important for designing surveillance and interpreting diagnostic results. Following a pilot survey which found low Bonamia sp. intensity in farmed Ostrea angasi, we tested further oysters (n = 100-150) from each of three farms for Bonamia sp. using heart smear, histology and qPCR. We used a Bayesian Latent Class Model to assess diagnostic sensitivity (DSe) and specificity (DSp) of these tests individually or in combination, and to assess prevalence. Histology was the best individual test (DSe 0.76, DSp 0.93) compared to quantitative polymerase chain reaction (qPCR) (DSe 0.69, DSp 0.93) and heart smear (DSe 0.61, DSp 0.60). Histology combined with qPCR and defining a positive from either test as an infected case maximized test performance (DSe 0.91, DSp 0.88). Prevalence was higher at two farms in a high-density oyster growing region than at a farm cultivating oysters at lower density. Parasite intensities were lower than in New Zealand and European studies, and this is probably contributed to differences in the performance of test when compared to other studies. Understanding diagnostic test performance in different populations can support the development of improved Bonamia surveillance programs.

New Similarity Metric for Registration of MRI to Histology: Golden Retriever Muscular Dystrophy Imaging.

OBJECTIVE: Histology is often used as a gold standard to evaluate noninvasive imaging modalities such as a magnetic resonance imaging (MRI). Spatial correspondence between histology and MRI is a critical step in quantitative evaluation of skeletal muscle in golden retriever muscular dystrophy (GRMD). Registration becomes technically challenging due to nonorthogonal histology section orientation, section distortion, and the different image contrast and resolution. METHODS: This study describes a three-step procedure to register histology images with multiparametric MRI, i.e., interactive slice localization controlled by a three-dimensional mouse, followed by an affine transformation refinement, and a B-spline deformable registration using a new similarity metric. This metric combines mutual information and gradient information. RESULTS: The methodology was verified using ex vivo high-resolution multiparametric MRI with a resolution of 117.19 µm (i.e., T1-weighted and T2-weighted MRI images) and trichrome stained histology images acquired from the pectineus muscles of ten dogs (nine GRMD and one healthy control). The proposed registration method yielded a root mean squares (RMS) error of 148.83 ± 34.96 µm averaged for ten muscle samples based on landmark points validated by five observers. The best RMS error averaged for ten muscles, was 128.48 ± 25.39 µm. CONCLUSION: The established correspondence between histology and in vivo MRI enables accurate extraction of MRI characteristics for histologically confirmed regions (e.g., muscle, fibrosis, and fat). SIGNIFICANCE: The proposed methodology allows creation of a database of spatially registered multiparametric MRI and histology. This database will facilitate accurate monitoring of disease progression and assess treatment effects noninvasively.

Evaluation of Cytology for Diagnosing Avian Pox in Wild Turkeys ( Meleagris gallopavo).

Avian pox virus is a common cause of proliferative skin disease in wild turkeys ( Meleagris gallopavo); however, other etiologies may produce grossly indistinguishable lesions. Common methods for diagnosing avian pox include histopathology, virus isolation, and PCR. While these methods are sufficient in most cases, each has their limitations. Cytology is a cost-effective and rapid approach that may be useful when traditional diagnostics are not feasible. The objective of this study was to evaluate the performance of cytology relative to histopathology and PCR for avian pox diagnosis in wild turkeys. Fifty wild turkeys were submitted for necropsy due to nodular skin lesions on unfeathered skin of the head. Of these, five had similar skin lesions on the unfeathered legs and 26 had plaques on the mucosa of the oropharynx or esophagus. Representative skin, oropharyngeal, and esophageal lesions from all birds were examined with cytology and histopathology. Skin lesions on the head of each bird were also tested for avian pox virus via PCR. Histopathology and PCR were equally sensitive in diagnosing avian pox from skin lesions on the head. There were no significant differences between cytologic and histopathologic diagnosis of avian pox from skin lesions on the head (sensitivity = 97.4%, specificity = 100.0%), legs (sensitivity = 75.0%, specificity = 100.0%), or from lesions in the oropharynx and esophagus (sensitivity of 62.5%). Similarly, there were no significant differences between PCR and cytology for diagnosis of pox viral skin lesions of the head. Relative to PCR detection of avian pox virus, cytology had a sensitivity of 90.0% and a specificity of 90.0%. These results suggest that cytology is a useful tool for diagnosis of avian pox in wild turkeys.