Photomicrograph of liver biopsies from a dog with agglutinating immune-mediated hemolytic anemia (IMHA) demonstrating severe obstruction of sinusoidal flow by agglutinated RBCs and Kupffer cells engorged with damaged phagocytized RBCs. A: Note agglutinated RBCs (black arrows) and occasional Kupffer cells filled with phagocytized RBCs. Extreme hyperbilirubinemia due to hemolysis has caused canalicular cholestasis (white arrows). Globular free hemoglobin is observed in sinusoids (cell free red globs). H&E stain. B: Liver section from the same dog. The tinctorial characteristics assist with visualizing agglutinated RBCs and Kupffer cells engorged with phagocytized RBCs (black arrow). Rhodanine stain; scale bar = xxx mcm.
Courtesy of Dr. Sharon Center.