IMAGING DIAGNOSIS—ECTOPIC SPLEEN MIMICKING HEPATIC TUMOR WITH INTRA‐ABDOMINAL METASTASES INVESTIGATED VIA TRIPLE‐PHASE HELICAL COMPUTED TOMOGRAPHY IN A DOG

A 10‐year‐old castrated male miniature dachshund was presented with an abdominal mass. The dog had a history of splenectomy. Triple‐phase helical computed tomography was utilized, revealing a hepatic mass and multiple intra‐abdominal solid masses. In triple‐phase helical computed tomography the images, hepatic mass and two of four intra‐abdominal masses were heterogenous in all phases. Therefore, we diagnosed a malignant hepatic tumor and presumed intra‐abdominal metastases. The masses were surgically removed and were histologically composed of normal spleen tissues, findings which were consistent with ectopic spleen.     

Morphologic and immunohistochemical features of two spontaneous peripheral nerve tumors in Wistar rats

Morphologic features and S-100 protein immunoreactivity of a benign and malignant peripheral nerve sheath tumor were studied in two Wistar rats. Neoplasms that developed in untreated control rats from tumor bioassays were S-100 protein positive and had similar histopathologic features. Each peripheral nerve sheath tumor was encapsulated and composed of spindle cells arranged around small thin-walled blood vessels. Palisaded tumor cells were in the benign peripheral nerve sheath tumor while cells of the malignant peripheral nerve sheath tumor had cellular atypia and moderate numbers of mitoses. Ultrastructural examination of the malignant peripheral nerve sheath tumor revealed cells with external lamina and interdigitation of cytoplasmic processes. Intracytoplasmic concentric lamellae were seen; they were regularly spaced with a periodicity of about 15 nm. Such structures, indistinguishable from myelin sheaths, have not been commonly associated with peripheral nerve sheath tumors in man. Electron microscopy and immunohistochemistry were useful in the diagnosis of these tumors as Schwannomas and in differentiation from other spindle cell tumors.     

IMAGING DIAGNOSIS—CONVENTIONAL AND FUNCTIONAL MAGNETIC RESONANCE IMAGING OF A BRAIN ABSCESS IN A GOAT

A 2‐month‐old female goat was presented for depressed mental status and multifocal central neurologic signs 3 weeks after hot‐iron disbudding. Conventional magnetic resonance imaging (MRI) findings included a large intra axial mass in the left frontal lobe that was T2 hyperintense and T1 hypointense centrally with a contrast‐enhancing peripheral capsule and perilesional T2 hyperintensity. A restrictive pattern was present in diffusion‐weighted imaging. Magnetic resonance spectroscopy demonstrated an increased amount of succinate, acetate, amino acids, lipids; minimal amounts of lactate; and decreased amounts of N‐acetyl aspartate and choline. A cerebral abscess due to Trueperella pyogenes was confirmed from necropsy and tissue culture.     

IMAGING DIAGNOSIS — UNILATERAL TRIGEMINAL NEURITIS MIMICKING PERIPHERAL NERVE SHEATH TUMOR IN A HORSE

A 16‐year old Warmblood gelding presented with a nonhealing corneal ulcer and absent corneal sensation in the left eye. A lesion affecting the maxillary and ophthalmic branches of the left trigeminal nerve was suspected. Magnetic resonance (MR) imaging identified marked thickening of the ophthalmic and maxillary branches of the left trigeminal nerve. The nerve was iso‐ to hypointense on T1‐weighted and T2‐weighted images with heterogeneous enhancement. A peripheral nerve sheath tumor was suspected, however granulomatous neuritis was histopathologically confirmed. These inflammatory changes can result in severe nerve enlargement and should be considered with MR findings suggestive of peripheral nerve sheath tumor.     

Forelimb amputation for treatment of a peripheral nerve sheath tumor in an African pygmy hedgehog

CASE DESCRIPTION: A 6-year-old female African pygmy hedgehog was evaluated because of a mass of unknown duration on the lateral aspect of the right shoulder region. CLINICAL FINDINGS: A fine-needle aspirate of the mass was collected for cytologic examination; findings were consistent with a spindle cell tumor. A CBC, plasma biochemical analyses, and whole-body radiography revealed no other abnormalities. TREATMENT AND OUTCOME: An initial surgery performed in an attempt to remove the mass with preservation of the limb failed in that tumor-free surgical margins were not obtained. Histologically, the mass was identified as a peripheral nerve sheath tumor (neurofibrosarcoma). A second surgery to amputate the forelimb was successful. After 1 year, there had been no further development of peripheral nerve sheath tumor at this or other sites. CLINICAL RELEVANCE: In African pygmy hedgehogs, potential differential diagnoses for a subcutaneous mass should include peripheral nerve sheath tumor. If necessary, forelimb amputation can be performed successfully in this species with procedures modified from those used in dogs. Information gathered during the treatment and recovery of the hedgehog of this report may assist practicing veterinarians in counseling owners of hedgehogs that are undergoing forelimb amputation with regard to the course of recovery that may be expected following this procedure.     

Retrobulbar pigmented peripheral nerve sheath tumor in a dog

A 1‐year‐old male castrated Pug was referred for unilateral exophthalmos unresponsive to oral antibiotic and anti‐inflammatory therapy. Clinical findings included exophthalmos of the left eye with lateral strabismus, resistance to retropulsion, and an elevated nictitans. Hematologic and biochemical analyses were within normal limits. Findings following computed tomography (CT) of the head included an expansile retrobulbar soft tissue mass with bony lysis extending into the left nasal cavity and nasopharynx. Ultrasound‐guided fine‐needle aspirates and biopsy samples obtained via rhinoscopy were nondiagnostic. Palliative exenteration was elected; the patient was euthanized 13 weeks following exenteration due to development of neurologic signs and perceived poor quality of life. The histopathologic diagnosis was a malignant pigmented peripheral nerve sheath tumor.     

Malignant peripheral nerve sheath tumour of the urinary bladder in a cat

A 14-year-old domestic shorthair cat presented with a 5-month history of urinary incontinence and inappro-priate elimination. Ultrasonography revealed a well-marginated, vascular mass of mixed echogenicity ex-tending from the dorsal wall of the urinary bladder into the lumen. Partial cystectomy was performed for re-moval of the urinary bladder mass; histopathological evaluation revealed a spindle cell neoplasm with a prominent palisading pattern. Histomorphologic features and immunohistochemical demonstration of vimentin, glial fibrillary acidic protein and S-100 protein, combined with negativity for smooth muscle actin and desmin were consistent with malignant peripheral nerve sheath tumour. This case report describes a novel location of malignant peripheral nerve sheath tumour; to the authors' knowledge, the bladder has not been described as a site of origin in the cat or any other domestic species.     

MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A CAT

A report of a cat with a cranial tumor of nerve sheath origin is presented. The cranial mass, with a cyst-like character on presentation to the referring veterinarian suggested a benign lesion, but the clinical course was rapid and indicative of central nervous system involvement. The tumor was poorly differentiated by histologic examination, but immunohistochemistry was consistent with Schwann cell origin. Features of peripheral nerve sheath tumors in cats and other species are briefly discussed.     

AN INTRATHORACIC MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A DOG

A 7-year-old, neutered male Labrador Retriever presented for a persistent, productive cough and regurgitation. Radiography, ultrasonography, and computed tomography confirmed a large, smoothly marginated intrathoracic mass causing tracheal compression. The mass was removed via a thoracotomy, and a malignant peripheral nerve sheath tumor, most likely originating from the ventral spinal nerve roots, was confirmed using immunohistochemistry.     

Diagnosis of sciatic nerve tumour in two dogs by electromyography and magnetic resonance imaging

Sciatic nerve tumour was diagnosed in a Staffordshire Bull Terrier cross-bred and a Bichon Frise, both presenting with chronic left hind limb lameness. Neurological examination in each case was consistent with left sciatic nerve deficits and this was confirmed by EMG studies. Rectal examination of both dogs revealed a palpable intrapelvic mass that was not apparent on survey radiographs. A sciatic nerve tumour was identified using MRI in each case. Histological examination of tissue taken from the Staffordshire Bull Terrier cross-bred was consistent with a malignant peripheral nerve sheath tumour.     

Malignant peripheral nerve sheath tumor of the diaphragm in a dog

An 11-year-old, castrated male greyhound was referred to the Michigan State University Veterinary Teaching Hospital for surgical removal of a thoracic mass. Thoracic radiographs revealed a smoothly marginated mass obscuring the diaphragm in the left caudal thorax. Ultrasonographic and computed tomographic imaging modalities demonstrated a mass originating from the left hemidiaphragm. The mass was surgically removed and submitted for histopathological evaluation. Histopathology and immunohistochemical staining confirmed a malignant peripheral nerve sheath tumor.     

Malignant peripheral nerve sheath tumor arising from the spinal canal in a cat

A 10-year-old female mongrel cat with back pain was brought to the Nihon University Animal Medical Center. Palpation demonstrated a mass in the back region. Radiography revealed partial destruction of the processus spinosus and the arch of the T8 and T9 vertebrae. On magnetic resonance imaging, the mass was found to have compressed the spinal cord and extended to the outside of the spinal canal. We performed extirpation of the mass, and confirmed that it arose from the spinal canal. Histopathologically, the mass was a malignant peripheral nerve sheath tumor.     

Anterior uveal spindle cell tumor in a cat

Purpose To describe a case of anterior uveal spindle cell tumor in a cat with features similar to spindle cell tumor of blue eyed dogs. Methods A 10‐year‐old female spayed domestic short‐haired cat was referred for an iris mass OS. The mass was solitary, nodular, nonpigmented, located medially, and causing dyscoria. A diagnosis of a benign epithelial tumor was suggested by a FNA of the mass. The cat was lost to follow‐up for 2 years, after which time she re‐presented with glaucoma, blindness and grossly evident iridal mass enlargement OS. Transconjunctival enucleation was performed and the globe submitted for histopathology. Results Histopathology of the enucleated globe revealed the superior iris to be infiltrated and effaced by a large population of neoplastic spindle cells. The cells were arranged in streams and bundles and exhibited Antoni‐A and Antoni‐B tissue patterns, which are characteristic of Schwann cell tumors. Mitotic figures were rare and cellular pleomorphism moderate. Immunohistochemical staining was positive for S‐100 protein and glial fibrillary acidic protein (GFAP), and negative for Melan‐A. Interestingly, there was no histological evidence of glaucoma. Conclusions Based on its histopathologic characteristics, this iris tumor was diagnosed as a Schwann cell variant of a peripheral nerve sheath tumor (PNST) closely resembling the spindle cell tumor of blue‐eyed dogs. Anterior uveal PNST has not been previously reported in cats to the authors’ knowledge. The presence of Antoni type A and type B tissue patterns along with immunohistochemical staining may facilitate a diagnosis of PNST and rule out malignant melanoma.     

MAGNETIC RESONANCE IMAGING OF ACQUIRED TRIGEMINAL NERVE DISORDERS IN SIX DOGS

The medical records and magnetic resonance (MR) images of dogs with an acquired trigeminal nerve disorder were reviewed retrospectively. Trigeminal nerve dysfunction was present in six dogs with histologic confirmation of etiology. A histopathologic diagnosis of neuritis (n=2) or nerve sheath tumor (n=4) was made. Dogs with trigeminal neuritis had diffuse enlargement of the nerve without a mass lesion. These nerves were isointense to brain parenchyma on T1-weighted (T1W) precontrast images and proton-density-weighted (PDW) images and either isointense or hyperintense on T2-weighted (T2W) images. Dogs with a nerve sheath tumor had a solitary or lobulated mass with displacement of adjacent neuropil. Nerve sheath tumors were isointense to the brain parenchyma on T1W, T2W, and PDW images. All trigeminal nerve lesions enhanced following contrast medium administration. Atrophy of the temporalis and masseter muscles, with a characteristic increase in signal intensity on T1W images, were present in all dogs.     

Peripheral Nerve Sheath Tumor in the Pelvic Limb of a Domestic Rabbit (Oryctolagus cuniculus)

A 3-year-old, 4.0 kg, female, spayed Silver Marten cross rabbit (Oryctolagus cuniculus) was presented for evaluation of a suspected recurring spindle cell sarcoma following primary excision by the referring veterinarian. Physical examination revealed a large subcutaneous mass on the left metatarsus and a fine needle aspirate revealed suspected neoplastic spindle cells. Hematologic evaluation was unremarkable and a computed tomography scan revealed invasion of the mass into skeletal muscles but showed no evidence of metastatic disease. An amputation was performed, after which the patient recovered uneventfully. However, the rabbit was found suddenly dead at time of discharge from unknown cause. Gross, histologic, and immunohistochemical evaluation was performed, which diagnosed a peripheral nerve sheath tumor. To the authors’ knowledge, this is the first detailed case report of a lagomorph peripheral nerve sheath tumor specifically confirmed with immunohistochemistry. Wide surgical excision is considered the treatment of choice and may be combined with radiation therapy. Further research is required to determine risk factors, the role of adjunctive therapy, as well as long-term prognoses for peripheral nerve sheath tumors in rabbits.     

MAGNETIC RESONANCE IMAGING OF INTRACRANIAL INFLAMMATORY CONDITIONS IN DOGS: SENSITIVITY OF SUBTRACTION IMAGES VERSUS PRE‐ AND POST‐GADOLINIUM T1‐WEIGHTED IMAGE PAIRS

Ante mortem diagnosis of canine meningoencephalitis is usually based on the results of neurologic examination, cerebrospinal fluid analysis and magnetic resonance (MR) imaging. It has been hypothesized that subtraction MR imaging may increase the sensitivity of MR for intracranial inflammatory lesions compared to conventional post‐gadolinium T1‐weighted imaging. Sensitivity of pre‐ and post‐gadolinium (C‐/C+) image pairs and dynamic subtraction (DS) images was compared in a retrospective diagnostic accuracy study of 52 dogs with inflammatory cerebrospinal fluid and 67 dogs with idiopathic epilepsy. Series of transverse C‐/C+ and DS images were reviewed independently for signs of abnormal enhancement affecting the pachymeninges, leptomeninges or intra‐axial structures. Sensitivity of C‐/C+ image pairs and DS images was 48% (95% CI: 35–61%) and 65% (95% CI: 52–77%), respectively (P = 0.01). Intra‐axial lesions were observed more frequently than meningeal lesions in both C‐/C+ (43% vs. 31%) and DS images (61% vs. 22%). The difference in sensitivities of C‐/C+ and DS series was entirely due to increased sensitivity of DS images for intra‐axial lesions. Eight (12%) dogs with epilepsy had evidence of intra‐axial gadolinium accumulation affecting the cerebral cortex in DS images. This finding may represent a false‐positive result or a true sign of pathology, possibly associated with a leaky blood–brain barrier in areas of the brain affected by neovascularization secondary to repeated seizures. Results suggest that DS imaging has higher sensitivity than comparison of pre‐ and post‐gadolinium image pairs for inflammatory intra‐axial lesions.     

Unilateral limb enlargement in a dog with a malignant peripheral nerve sheath tumor

A 3- to 4-month-old female Golden Retriever dog presented with right hind limb enlargement. Physical examination of the limb and radiographic findings initially included soft tissue swelling with elongation, bowing, and cortical irregularity of the femur and tibia. During a period of approximately 7 months, pathology in the limb progressed to include tarsal laxity, muscle atrophy, avulsion of the gastrocnemius muscle, and luxation of the patella. During surgical intervention to shorten the limb and repair the patellar luxation, a large soft tissue cyst was identified along the caudal aspect of the femur and stifle. The limb was later amputated, and a final diagnosis of malignant peripheral nerve sheath (PNS) tumor of the sciatic nerve and surrounding soft tissues was made. The unilateral limb enlargement in this dog appears to have been because of the development and progression of a malignant PNS tumor. The presentation and associated pathologic changes in the limb are unusual for canine PNS tumor but have similarities with neurofibromatosis in the limbs of humans.