The diagnosis and prognosis of synovial tumors in dogs: 35 cases

Although synovial cell sarcoma is reported to be the most common neoplasm of the canine synovium, this retrospective study of 35 canine synovial tumors found that the majority were of histiocytic origin. Five (14.3%) synovial cell sarcomas were identified by positive immunohistochemical staining with antibodies to cytokeratin. Eighteen (51.4%) histiocytic sarcomas were identified by cell morphology and immunohistochemical staining with antibodies to CD18. Six (17.1%) synovial myxomas were identified by histologic pattern. The remaining six (17.1%) synovial tumors represented a variety of sarcomas, including two malignant fibrous histiocytomas (actin positive), one fibrosarcoma, one chondrosarcoma, and two undifferentiated sarcomas. Rottweilers were overrepresented in the histiocytic sarcoma category and Doberman Pinschers were overrepresented in the synovial myxoma category. The average survival time was 31.8 months for dogs with synovial cell sarcoma, 5.3 months for dogs with histiocytic sarcoma, 30.7 months for dogs with synovial myxoma, and 3.5 months for dogs with other sarcomas. Among the dogs with follow-up information available, metastatic disease was detected in 25% of dogs with synovial cell sarcoma, in 91% of dogs with histiocytic sarcoma, in none of the dogs with synovial myxoma, and in 100% of dogs with other sarcomas. Immunohistochemical staining for cytokeratin, CD18, and smooth muscle actin is recommended to make the diagnosis and thereby predict the behavior of synovial tumors in dogs.     

Large anaplastic spinal B‐cell lymphoma in a cat

Abstract: A 5‐year‐old female spayed domestic shorthair cat was presented for evaluation of tetraparesis. The neurologic lesion was localized to the cervical spinal segment (C1–C6). A left axillary mass was identified, and the results of fine needle aspiration cytology indicated malignant round cell neoplasia of possible histiocytic origin. The cells were large, had marked anisocytosis and anisokaryosis, occasional bi‐ and multinucleation, and cytoplasmic vacuolation. Euthanasia was performed due to the poor prognosis associated with severe, progressive neurologic signs and a malignant neoplasm. Postmortem examination revealed spinal cord compression and an extradural mass at the C1–C2 spinal segment, with neoplastic cells in the adjacent vertebral bodies, surrounding skeletal muscle, left axillary lymph node, and bone marrow from the right femur. The initial histologic diagnosis was anaplastic sarcoma, but immunohistochemical results indicated the cells were CD20+ and CD45R+ and CD3?, compatible with a diagnosis of B‐cell lymphoma. CD79a staining was nonspecific and uninterpretable. Weak to moderate CD18 positivity and E‐cadherin positivity were also observed. Clonality of the B‐cell population could not be demonstrated using PCR testing for antigen receptor gene rearrangement. To the authors' knowledge, this is the first reported case of a feline spinal anaplastic B‐cell lymphoma exhibiting bi‐ and multinucleated cells. The prognostic significance of this cell morphology and immunophenotype is unknown.     

Metastatic balloon cell melanoma in a dog

Background: Balloon cell melanoma is a rare variant of amelanotic melanoma that is difficult to differentiate from sebaceous cell carcinoma, liposarcoma, and other clear cell neoplasms without immunohistochemistry or ultrastructural evidence of melanin or melanosomes. Objective: The purpose of this report was to describe the clinical, cytologic, histologic, immunohistochemical, and ultrastructural findings in a dog with metastatic balloon cell melanoma. Methods: A 6‐year‐old female Golden Retriever was evaluated for a white, flocculent infiltrate in the anterior chamber of the left eye and an enlarged left prescapular lymph node. Cytologic evaluation of the eye and lymph node were performed following aqueocentesis and fine‐needle aspiration, respectively. The affected lymph node was examined histologically and stained for cytokeratin, vimentin, S‐100, and Melan A. Following euthanasia a necropsy was performed and samples of the affected lymph node were examined by electron microscopy. Results: Cytologic examination of the lymph node and aqueocentesis sample revealed round neoplastic cells that had abundant clear vacuolated cytoplasm. A tentative diagnosis of metastatic sebaceous cell carcinoma or clear cell neoplasm was made. Histologically, the affected lymph node had similar polygonal clear cells arranged in sheets and packets divided by delicate fibrovascular stroma. Immunohistochemical staining of the cells was negative for cytokeratin but positive for vimentin, weakly positive for S‐100, and strongly positive for Melan A. At necropsy, metastatic lesions were identified in the diaphragm, heart, lung, kidneys, left eye, prescapular and sublumbar lymph nodes, and multiple skin sites. Ultrastructural examination of neoplastic lymph nodes revealed many membrane‐bound vacuoles, myelinlike figures, and rare melanosomes. Conclusion: Immunohistochemical staining and ultrastructural features of the neoplastic cells supported a diagnosis of metastatic balloon cell melanoma.     

Primary ureteral giant cell sarcoma in a Pomeranian

An 8-year-old male neutered Pomeranian dog was presented to the Veterinary Teaching Hospital at Oregon State University for surgical treatment of hydronephrosis of the left kidney and a left cranial abdominal mass. A primary ureteral mass was found during exploratory surgery, and the mass was resected and ureteral anastomosis was performed. Cytologic evaluation of the mass revealed 3 distinct cell populations, including a large number of multinucleated giant cells, a moderate number of thin spindle-shaped cells, and cohesive clusters of transitional epithelial cells. The cytologic diagnosis was giant cell sarcoma. The diagnosis was confirmed by histologic examination, and immunohistochemical staining was performed. The spindle-shaped cells and multinucleated giant cells were both immunoreactive for vimentin and spindle-shaped cells for S-100. Tumor cells did not express wide-spectrum cytokeratin, broad-spectrum muscle actin, smooth muscle actin, sarcomeric actin, desmin, BLA36, Mac 387, synaptophysin, neuron-specific enolase, glial fibrillary acid protein, or von Willebrand factor. These findings are most consistent with an anaplastic sarcoma with giant cells. This is the first case report of a primary ureteral giant cell sarcoma in a dog.     

Paravertebral malignant peripheral nerve sheath tumour (MPNST) in a horse

A 10‐year‐old Lipizzaner gelding was presented with intermittent ataxia and hindlimb weakness. Ultrasonographic examination identified a mass cranial to the tuber sacrale. A provisional diagnosis of a soft tissue sarcoma was made based on a biopsy specimen. Owing to the extensive nature of the tumour and the associated poor prognosis, the horse was subjected to euthanasia on humane grounds. A post mortem examination revealed a locally infiltrative soft mass within the left lumbosacral epaxial musculature. Histologically, an infiltrative neoplasm predominantly composed of pleomorphic spindle or stellate‐shaped cells was identified. Neoplastic cells exhibited strong S‐100 protein and GFAP expression and variable vimentin, NSE, NGFR and myoglobin expression. They were uniformly negative for pan‐cytokeratin, melan A, laminin and desmin. The ultrastructural examination revealed pleomorphic cells with long cytoplasmic processes and an absence of melanosomes. Based on these results, a diagnosis of malignant peripheral nerve sheath tumour was made. This report contributes further information to assist in the diagnosis of these poorly defined neoplasms in animals, especially when they occur in uncommon locations.     

Adenocarcinoma of the parotid salivary gland in a cow

A 6‐year‐old Girolando dairy cow was presented for evaluation of a large subcutaneous facial mass. Fine‐needle aspirates of the mass contained many neoplastic cells with high nuclear:cytoplasmic ratios arranged in sheets and loosely cohesive clusters with streaming erythrocytes and neutrophils in the background. Neoplastic cells were 13–25 μm in diameter and were round to cuboidal with variably distinct borders. Based on the signalment, anatomic location, and cytologic findings, differential diagnoses included salivary adenocarcinoma, squamous cell carcinoma, and mucoepidermoid carcinoma. The cow was euthanized and a necropsy was performed. The primary neoplasm arose from the left parotid salivary gland and meastatic tumor was found in the regional lymph nodes and lung. Histologically, the tumor was composed of anastomosing and irregular solid islets surrounded by scant stroma. Cells were negative for periodic acid‐Schiff (PAS), PAS‐diastase, and Alcian blue pH 2.5 stains, used to detect mucin. On immunohistochemical analysis, neoplastic luminal salivary gland cells expressed cytokeratin, but not S100, α‐smooth muscle actin, or vimentin. Peripheral cells of neoplastic islets were immunoreactive for p63. The final diagnosis was nonsecretory adenocarcinoma of the parotid salivary gland.     

Malignant granulosa-theca cell tumor in a two-year-old Miniature Horse.

A 2-year-old female Miniature Horse that presented with a history of progressive weight loss, depression, and diarrhea was diagnosed at necropsy with a highly malignant abdominal neoplasm involving the left ovary, kidneys, adrenal glands, intestines, and various abdominal and thoracic lymph nodes. Microscopic examination of these masses revealed large pleomorphic cells that stained positive for vimentin and inhibin and negative for epithelial membrane antigen and placental alkaline phosphatase. Ultrastructural examination of the cells revealed a high nucleocytoplasmic ratio and indented euchromatic nuclei with large nucleoli. Based on the gross, microscopic, immunohistochemical, and ultrastructural features, the neoplasm was identified as a malignant granulosa-theca cell tumor, a rare neoplasm in young horses.     

Carcinosarcoma mimicking a feline injection‐site sarcoma in a cat

A 15‐year‐old spayed female domestic short‐haired cat with cutaneous/subcutaneous well‐circumscribed, alopecic mass approximately 25 × 30 mm in diameter, localized to the left shoulder region was brought to the veterinary surgery department. Despite the suggestive location and macroscopic appearance, feline injection‐site sarcoma was not suspected based on the cytologic examination of fine‐needle aspirates. The tumor was surgically resected, and tissue sections were evaluated microscopically. The tumor was found to be nonencapsulated with a distinct border between the neoplastic parenchyma and surrounding connective tissue. The neoplastic tissue consisted of 2 cell populations: elongated to spindle‐shaped cells arranged in bands and cords and malignant epithelial‐like cells. Both populations showed microscopic features of malignancy. Multinucleate giant cells with irregular cytoplasm were scattered among the neoplastic cells. The spindle‐shaped cells strongly expressed vimentin but did not express α‐smooth muscle actin (α‐SMA) or cytokeratin. Desmin was strongly expressed in about 0‐5% of cells. Epithelial‐like cells expressed cytokeratin, but not vimentin, desmin, or α‐SMA. Multinucleate giant cells expressed vimentin, but did not α‐SMA, desmin, or cytokeratin. Based on microscopic observations and IHC results, the final diagnosis was carcinosarcoma with histologic features compatible with feline injection‐site sarcoma, but without the clinical aggressiveness of this tumor.     

Co-existing squamous cell carcinoma and hemangioma on the ocular surface of a cat

A 14-year-old spayed female domestic short-haired cat was presented for evaluation of a mass in the right eye. Ophthalmic examination revealed a blind right eye and presence of two distinct masses: a pink and a red-to-brown mass, the latter occupying most of the cornea and part of the conjunctiva. Exenteration was performed under general anesthesia, and the ocular tissues were processed routinely for histopathology. Upon microscopic examination, a malignant epithelial neoplasm and a benign vascular neoplasm were present in the cornea. The conjunctiva and the third eyelid were also affected. Upon immunohistochemistry, the epithelial tumor was positive for cytokeratin and negative for vimentin and the endothelial tumor was negative for cytokeratin and positive for vimentin. A diagnosis of squamous cell carcinoma (SCC) and hemangioma was made. The SCC was affecting the cornea, bulbar conjunctiva (lateral and inferior) and the base of the third eyelid, whereas the hemangioma was affecting the cornea and medial limbus. To the authors' knowledge, this is the first report of concomitant SCC and hemangioma affecting the ocular surface in a cat.     

What is your diagnosis? Ventral neck mass in a dog

Abstract: A 14‐year‐old male Labrador Retriever was presented for lethargy and collapse. On physical examination, numerous abnormalities were found, including a large ventral neck mass (100 cm³) in the area of the thyroid gland. Fine‐needle aspirates revealed 2 apparent populations of cells: one suspected to be a well‐differentiated thyroid carcinoma, and the other consisting of large pleomorphic to spindloid cells suggestive of sarcoma. Two days later, the dog died at home. A full necropsy was not performed, but examination of the head and neck revealed a well‐encapsulated mass adjacent to the cranial trachea and larynx. A section of the mass was evaluated histologically and a diagnosis of anaplastic thyroid carcinoma was made. Immunohistochemical evaluation with antibodies to thyroglobulin, cytokeratin, and vimentin confirmed distinct populations of malignant epithelial and malignant mesenchymal cells, and the diagnosis was amended to thyroid carcinosarcoma. Thyroid carcinosarcoma is a rare neoplasm in dogs in which the cell type comprising the mesenchymal component can vary. Immunochemistry to demonstrate the 2 cell types may be necessary to differentiate thyroid carcinosarcoma from anaplastic thyroid carcinoma.     

Symptomatic granular cell tumor involving the pituitary gland in a dog: a case report and review of the literature

A granular cell tumor involving the pituitary gland, optic chiasm and ventral pyriform lobes was discovered in a 12-year-old Labrador Retriever. Clinical signs included acute blindness, seizures, ataxia, weakness, and behavioral changes. The diagnosis was established by histopathologic and ultrastructural examination of neoplastic tissues collected at necropsy. Granular cell tumors involving the central nervous system are well documented in humans but rarely have been described in dogs. The location of the neoplasm and the clinical symptoms seen in this dog closely parallel those of a rare syndrome in humans commonly described as symptomatic parasellar or pituitary granular cell tumors. The cell of origin for these tumors is still highly debated, and attempts to characterize human granular cell tumors through immunohistochemistry have produced conflicting results. An immunohistochemical profile of this neoplasm revealed focal positive staining for vimentin with a lack of staining for neuron-specific enolase, glial fibrillary acidic protein, S-100, and synaptophysin. All neoplastic cells were strongly positive with the periodic acid-Schiff reaction.     

Firm rib mass aspirate from a dog

A 9-year-old intact male Miniature Schnauzer presented laterally recumbent, cachexic, and dehydrated with multiple firm bone masses and a bilaterally enlarged prostate. Fine-needle aspiration of a rib mass revealed numerous basophilic polygonal to fusiform cells predominantly found in small to large clusters. The cells exhibited cytologic criteria of malignancy and infrequently displayed large cytoplasmic vacuoles containing finely- to coarsely-stippled azurophilic material. The cytologic diagnosis was metastatic adenocarcinoma and was suspected to be prostatic or transitional cell in origin because of the azurophilic vacuoles within malignant cells. Gross and histologic findings confirmed the clinical and cytologic diagnosis of prostatic adenocarcinoma with widespread metastasis. Cytochemical and immunohistochemical investigation confirmed glycogen was a component of the vacuolar material. The vacuoles observed in the tumor in this case are not a consistent finding in tumors of the prostate or urinary bladder; however, when associated with an epithelial tumor, they may aid in limiting the differentials of the primary tumor and in the selection of further diagnostics.     

What is your diagnosis? Perifemoral mass in a cow

Abstract: A 15‐year‐old female Simmental cross‐breed cow was presented to the Purdue University Veterinary Teaching Hospital for evaluation of a perifemoral soft tissue mass. Impression smears made from an excisional biopsy contained a population of pleomorphic mesenchymal cells with abundant, periodic acid–Schiff‐positive (PAS), intracytoplasmic granular material, and rare elongated multinucleated cells consistent with strap‐like cells. A second population of small round cells suggestive of lymphocytes or progenitor cells was also noted. A cytologic diagnosis of sarcoma was made, with rhabdomyosarcoma considered most likely based on the large amount of PAS‐positive material (presumed to be glycogen) and the rare strap‐like cells. Histopathologic sections contained an unencapsulated, densely cellular neoplasm composed of haphazardly arranged highly pleomorphic mesenchymal cells and a few small round cells. The mesenchymal cells were positive for vimentin, non‐specific muscle actin, and myoglobin, and negative for phosphotungstic acid‐hematoxylin, smooth muscle actin, and desmin. Glycogen granules were confirmed by transmission electron microscopy. A diagnosis of pleomorphic rhabdomyosarcoma was made. While cytologic findings may suggest rhabdomyosarcoma, cytologic features can be highly variable, and a definitive diagnosis usually requires cytochemical and immunohistochemical staining.     

Surgical removal of a choroid plexus oncocytoma in an adult cat

An 11‐year‐old male castrated domestic shorthair cat presented with left central vestibular dysfunction. Magnetic resonance imaging of the brain revealed a large, extra‐parenchymal, strongly contrast‐enhancing mass at the level of the left cerebellopontine angle and compressing the cerebellum and brainstem. The mass was surgically excised via left rostral and sub‐tentorial craniectomies and histopathology revealed an epithelial neoplasm composed of anastomosing cords of neoplastic cells that contained large amounts of finely granular hypereosinophilic cytoplasm and round nuclei. The cytoplasmic granules were variably positive with periodic acid‐Schiff and modified Gomori trichrome. Immunohistochemical staining with anti‐cytokeratin AE1/AE3 was diffusely positive. Electron microscopy revealed neoplastic cells that were full of electron‐dense organelles consistent with mitochondria. This is the first case of a choroid plexus oncocytoma in the central nervous system of any domestic animal species and highlights the role of successful surgical intervention in extra‐parenchymal neoplasia in the central nervous system.     

Prostatic sarcomatoid carcinoma in a dog: cytologic and immunohistochemical findings

An 8-year-old neutered male Boxer was presented with tenesmus, hemorrhagic urethral discharge, and dysuria. Abdominal ultrasound and radiographic examinations revealed irregular prostatic enlargement. Laparotomy was performed and intraoperative cytology was done on imprint smears of a biopsy specimen obtained from a prostatic mass. The cytologic preparation was highly cellular and contained a predominant population of atypical, large, loosely cohesive spindle cells, with rare multinucleated cells and mitotic figures. The cytologic findings were consistent with undifferentiated sarcoma. At necropsy, a large cystic prostatic mass and numerous satellite nodules in the soft tissues around the pelvis were found. On histologic examination the tumor was composed primarily of bundles of neoplastic spindle cells. Rare pseudo-acinar structures and signet-ring cells also were observed. On immunohistochemical examination, the neoplastic cells co-expressed cytokeratin and vimentin. Based on histologic and immunohistochemical findings, the tumor was diagnosed as primary prostatic sarcomatoid carcinoma. This is a rare tumor in dogs, in which biphasic morphology of epithelial and mesenchymal cells can complicate the diagnosis, requiring immunochemical stains for confirmation.     

Intra-abdominal mass aspirate from a cat in heat

A 3-year-old intact female domestic shorthair cat was presented for the evaluation of a palpable intra-abdominal mass in the left caudal abdomen. The cat had a history of anorexia, depression and prolonged estrus over a period of about 1 month. Smears prepared from a fine needle aspirate of the mass revealed large round to oval cells arranged individually or in loose clusters surrounded by pink, fibrillar matrix material. Cytoplasm was basophilic, with many variably-sized vacuoles and variable numbers of small purple granules. The vacuoles within the cells were strongly positive with Oil-Red-O stain. The cytologic features were most suggestive of a neoplasm of epithelial cell origin or inadvertent aspiration of a fatty liver. At laparotomy, the mass was found to involve the left ovary. Histologically, the tumor consisted of dense sheets and nests of irregular polyhedral, pleomorphic cells with abundant, finely vesiculated cytoplasm. The tumor cells were separated into lobules by strands of connective tissue. Based on histologic evaluation, a diagnosis of ovarian luteoma was made. In this report, we document the cytologic and histologic features of an uncommon feline tumor, a luteoma, and address its possible misdiagnosis as hepatic lipidosis when using cytology alone to make a diagnosis.     

Pleomorphic sarcoma with giant cells infiltrating the infraorbital canal in an aged Thoroughbred mare

A 27-year-old Thoroughbred mare presented for computed tomography (CT) of the head following a 3-month history of facial swelling at the infraorbital foramen, unilateral self-mutilation and head-shaking. Standing CT imaging showed soft tissue attenuation surrounding the infraorbital canal, with extensive bony lysis of the canal and maxillary bone at the infraorbital foramen. The mare was subjected to euthanasia, and post-mortem examination revealed a proliferative tan soft tissue mass overlying the infraorbital nerve. A histopathological diagnosis of pleomorphic sarcoma with giant cells was made. Immunohistochemical analysis failed to fully elucidate the mesenchymal cell of origin of the sarcoma. Pleomorphic sarcoma with giant cells involving the infraorbital canal of the horse has not been previously described. This case highlights chronic subtle behavioural changes attributable to this neoplasm prior to the development of clinical signs and the utility of advanced imaging in the diagnosis.     

Cytologic findings from a benign giant cell tumor of the tendon sheath in a dog

A 6‐year‐old male neutered Australian Shepherd dog was presented for evaluation of a subcutaneous mass on the plantar aspect of the proximal left metatarsus. Fine‐needle aspirate smears contained numerous plump spindle cells and large multinucleated cells amongst a considerable amount of pink extracellular matrix. Histopathologic diagnosis of the tissue obtained during initial biopsy and eventual surgical cytoreduction of the mass was a benign giant cell tumor of the tendon sheath (GCTTS). Immunohistochemically, the synovioblastic neoplastic cells were diffusely strongly positive for vimentin and S‐100, were multifocally moderately positive for cytokeratin AE1/3, and were negative for CD18, muscle‐specific actin (MSA), and melanoma‐associated antigen (mutated) 1 (MUM‐1). The dog recovered from surgery and underwent definitive radiation therapy to treat the local residual disease. Eight months later, the mass had not recurred. The diagnosis of GCTTS in this case supports previously published reports describing GCTTS as a relevant disease entity in dogs, and provides the first documentation of cytologic findings with this tumor. Further investigation is needed to correlate pathologic features with clinical behavior and response to therapy in dogs.     

Phagocytic plasmacytoma in a dog

A 4-year-old neutered male Golden Retriever was presented to the oncology service of the North Carolina State University Veterinary Teaching Hospital for staging of a histiocytic sarcoma of the left forelimb, diagnosed on the basis of biopsies submitted by the referring veterinarian. Cytologic assessment of aspirates of 2 splenic nodules identified on ultrasonographic examination of the abdomen revealed a highly phagocytic population of neoplastic round cells morphologically suggestive of plasma cells. Histologic assessment of the forelimb mass after amputation of the limb revealed a neoplastic round cell population demonstrating extensive cytophagia and erythrophagia. Immunohistochemical analysis of the tumor population revealed it to be negative for BLA.36 with sporadic positivity for lysozyme and CD79a. Immunofluorescent evaluation revealed weak tumor cell positivity for immunoglobulin (Ig) A and IgM, but extensive strong positivity for IgG, confirming the plasma cell origin of the tumor. Although extensive phagocytic activity may strongly suggest histiocytic origin, plasma cell origin must also be considered among the differential diagnoses for phagocytic round cell tumors.     

Cytologic,histologic, and immunohistochemical features of maxillofacial alveolar rhabdomyosarcoma in a juvenile dog

Abstract: A 15‐month‐old castrated male dog with a history of intermittent epistaxis and sneezing was admitted for the examination of a maxillofacial mass. An impression smear of a biopsy sample from the cauliflower‐shaped gingival mass contained numerous round cells, 5–25 μm in diameter, which contained a moderate amount of clear to pale blue cytoplasm and resembled lymphoid cells. Mitotic figures were frequently observed. The mass was diagnosed as malignant round cell neoplasia. On histologic examination the tumor was composed of diffusely arranged, small, atypical round cells with a small amount of fibrovascular stroma. Immunohistochemically, the cells were negative for CD3, CD18, CD20, CD79α, cytokeratin, melan‐A, chromogranin A, α‐smooth muscle actin, and myoglobin but positive for vimentin and desmin. The cells also had strong positive nuclear staining for myogenin and MyoD1. A diagnosis of solid‐pattern alveolar rhabdomyosarcoma was made on the basis of morphologic and immunohistochemical results. Alveolar rhabdomyosarcoma should be considered in the differential diagnosis of tumors in juvenile dogs, especially when cytologic findings reveal round, undifferentiated cells.