The morphology and behavior of feline cutaneous mastocytomas

Correlation of histopathology with the behavior of cutaneous mastocytomas in 85 cats revealed two distinct histologic subtypes which were predictive of biologic behavior. The first subtype comprised 65 cats of various breeds which had solitary, discrete, dermal tumors composed of slightly atypical mast cells. Most tumors in this group were histologically and behaviorally benign. However, seven solitary tumors with marked anisocytosis and mitotic activity recurred or spread to other sites within 2 to 3 months. The second subtype occurred in 18 cats which had discrete subcutaneous nodules composed primarily of histiocyte-like cells with equivocal cytoplasmic granularity after staining with toluidine blue. They were identified as mast cells by electron microscopy. Seventeen of the 18 affected cats were Siamese. The histiocytic mastocytomas occurred predominantly in young cats (less than 4 years) and were usually multiple. In the four cats of this group for which we have prolonged follow-up data, the tumors underwent apparently spontaneous regression within 2 years of initial tumor detection. Two other cats had tumors which contained mixtures of mast cell and histiocytic morphologies.     

Feline cutaneous fibropapillomas: clinicopathologic findings and association with papillomavirus infection

Twenty-three feline cutaneous fibropapillomas with histologic features similar to equine sarcoids were diagnosed. They were characterized by dermal fibroblastic proliferation with overlying, often ulcerated hyperplastic epidermis. Electron microscopic findings supported the fibroblastic nature of the neoplastic cells. The 23 tumors came from 20 cats and were submitted from veterinary clinics in Wisconsin and Minnesota. These tumors occurred most commonly in young cats and were found primarily on the head, neck, and digits. Fifteen of the 17 cats for which breed was reported were domestic shorthair cats. In 11/20 cases, there was confirmed exposure to cattle. Local recurrence of the tumor following surgical excision was reported in 7 of the 18 cats for which follow-up information was available. Metastasis was not documented in any of the cases. Two of the 19 tumors tested by polymerase chain reaction (PCR) had no amplifiable DNA. The remaining 17 were positive for papillomavirus by PCR. No papillomavirus DNA was detected in three other feline skin tumors (cutaneous mast cell tumor, malignant lymphoma, and fibrosarcoma) that served as controls. This is the first report of detection of papillomavirus in feline tumors that have clinicopathologic features similar to equine sarcoids.     

Histopathologic, immunohistochemical, and cytologic analysis of feline myeloma-related disorders: further evidence for primary extramedullary development in the cat

Feline myeloma-related disorders (MRD) are rare neoplasms of plasma cells. The multistep transformation model of myeloma in humans is based on the premise that plasma cells undergo neoplastic transformation primarily within the intramedullary compartment and that over time they become poorly differentiated and metastasize to extramedullary locations. Historically, diagnostic criteria used for human multiple myeloma have been applied to the cat, with the assumption that feline MRD commonly arises in the intramedullary compartment. Our objectives were to describe the features of feline MRD confirmed by cytology, histopathology, histochemistry, and immunohistochemistry and to categorize these tumors. A priori hypotheses were 1) tumor category predicts survival and 2) cats with well-differentiated tumors commonly have extramedullary involvement in contrast to human myeloma patients. This multicenter, retrospective study identified 26 MRD cases. There was good agreement between histopathologic and cytologic tumor categorization. Histochemistry and immunohistochemistry were shown to be valuable adjunct tests in the diagnosis of MRD. Cats with well-differentiated tumors had increased median survival relative to those with poorly differentiated tumors (254 versus 14 days). We have reported that marked extramedullary involvement at initial clinical presentation is significantly more common in the cat than in human MRD patients. In this study, we demonstrate that cats with well-differentiated tumors more commonly have extramedullary involvement than human myeloma patients with well-differentiated tumors (90% versus 20%, P < 0.0002). These results contrast strongly with the human myeloma model of primary intramedullary neoplastic transformation and suggest that primary extramedullary neoplastic transformation may be more common in feline MRD.     

Evaluation of strontium 90 irradiation in treatment of cutaneous mast cell tumors in cats: 35 cases (1992-2002)

OBJECTIVE: To determine the efficacy of strontium 90 beta irradiation in the management of cutaneous mast cell tumors (CMCTs) in cats. STUDY DESIGN: Retrospective case series. ANIMALS: 35 client-owned cats with CMCTs. PROCEDURE: Medical records of cats with CMCTs in which tumors were radiated by use of a strontium 90 ophthalmic applicator from 1992 to 2002 were reviewed. Cats were included if CMCT was diagnosed, there were no other sites of MCT involvement at the time of treatment, and records contained adequate follow-up information to permit retrospective assessment of local tumor control. RESULTS: 54 tumors in 35 cats were treated with a median dose of 135 Gy of strontium 90 beta irradiation, resulting in local tumor control in 53 of 54 (98%) tumors with a median follow-up time of 783 days after treatment. Median survival time was 1,075 days. Adverse effects of treatment appeared to be infrequent and of mild severity. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that strontium 90 beta irradiation resulted in long-term tumor control and should be considered an effective alternative to surgical resection in management of CMCTs in cats.     

Feline vaccine-associated fibrosarcoma: an ultrastructural study of 20 tumors (1996-1999)

Twenty feline vaccine-associated sarcomas were examined by transmission electron microscopy. Tumors contained pleomorphic spindle cells, histiocytoid cells, and giant cells. Most tumors contained myofibroblasts, which had morphologic features similar to those of fibroblasts. These cells were further distinguished by subplasmalemmal dense plaques and thin cytoplasmic actin myofilaments organized as elongated bundles concentrated at irregular intervals forming characteristic dense bodies. Intracellular crystalline particulate material was found in 5 of the 20 tumors. Energy dispersive X-ray spectroscopy was used to identify the crystalline material within one tumor as aluminum-based. One tumor from a feline leukemia virus-infected cat contained budding and immature retroviral particles.     

RADIOGRAPHIC APPEARANCE OF PRIMARY LUNG TUMORS IN CATS

The radiographic findings in 41 feline primary lung tumors are reported. Case material includes 29 adenocarcinomas, six bronchiolog-alveolar carcinomas, and six squamous cell carcinomas. Adenocarcinomas tended to occur as focal, solitary, well-circumscribed masses (eight cats), as localized consolidations (six cats), or as multiple, poorly circumscribed masses (five cats). Bronchiolo-alveolar cell carcinomas and squamous cell carcinomas were radiographically pleomorphic. Calcification was recognized in only five cats, four with adenocarcinomas and one with bronchiolo-alveolar carcinoma. Cavitation was identified in seven adenocarcinomas, one squamous cell carcinoma, and one bronchiolo-alveolar carcinoma. Nearly 50% (20 cats) of the patients had radiographic evidence of pleural involvement. Fifteen cats had evidence of regional lymph node involvement.     

Feline conjunctival melanoma: histopathological characteristics and clinical outcomes

Purpose  We report on the histopathology and clinical features of 21 cases of feline conjunctival melanoma.
Methods  A total of 18 cases are from the COPLOW collection and three cases from Antech Diagnostics. We tabulated the location of the tumor, pigmentation, cell shape, mitotic index and presence of multinucleated tumor cells. Surveys were sent to referring ophthalmologists to obtain further information about each case.
Results  The mean age of the cats was 12.4 years. A total of 11 cases were neutered males, six spayed females, and one each of intact female and male. Thirteen of the 21 cases were located on the bulbar conjunctiva, three on third eyelid only, three on palpebral conjunctiva. Sixteen tumors were pigmented while five were amelanotic. Seventeen of the cases consisted of round cell only while four cases were mixed populations of round and spindle cell. Fourteen of the cases contained multinucleated cells. The mitotic index ranged from 0 to 45 mitotic figures/10 HPF. Of the 13 cases with adequate follow-up information, four showed local recurrence while three reported metastasis. Eight cats had died at the time of the survey. Survival time post-diagnosis ranged from 0.5 to 36 months. Two cases had metastasized to the submandibular lymph nodes and in a third case, an abdominal mass was detected.
Conclusions  Feline conjunctival melanoma is most frequently found on the bulbar conjunctiva, are mostly round cells and suggest that conjunctival melanoma in cats has a poorer long term prognosis than the same neoplasm in dogs.     

Cutaneous neoplasia in 340 cats.

A total of 340 cases of cutaneous neoplasia were diagnosed in 340 of 3,564 cats that were examined by biopsy or necropsy during a 41-month period from January 1, 1986 through May 31, 1989. Eighteen types of tumor occurred, but four types comprised 77% of the cases. These were basal cell tumor, 89 cases (26%, mean age 10.3); mast cell tumor, 72 cases (21%, mean age 8.6); squamous cell carcinoma, 52 cases (15%, mean age 11.6); and fibrosarcoma, 50 cases (15%, mean age 10.2). For each of these four types of tumors, peak number of cases occurred in cats older than 10 years. Mast cell tumor was the only tumor diagnosed in cats younger than 1 year. The head was the most common site for basal cell tumors, mast cell tumors, and squamous cell carcinomas. The legs were the most common location of fibrosarcomas. Siamese cats had approximately three times as many mast cell tumors as statistically expected, but only one-fourth as many squamous cell carcinomas. Breed predilection for other skin tumors was not apparent. Sex predilection was not detected for any skin tumor.     

Periocular cutaneous mast cell tumors in cats: evaluation of surgical excision (33 cases)

Objective  To describe feline periocular cutaneous mast cell tumor (CMCT) clinical features, rates of local tumor recurrence and metastases, and cat survival time following surgical excision.
Animals studied  Thirty-three cats with periocular CMCTs.
Procedures  Medical records of cats diagnosed with periocular CMCTs were reviewed; cats were included if CMCTs were surgically excised and the diagnosis confirmed by histopathology. The appearance, size, location and histopathology findings of CMCTs were recorded. Rates of local recurrence, metastasis, and survival time following surgical excision were collected when available.
Results  All periocular CMCTs were restricted to the eyelids. In addition to surgical excision, three cats were treated with adjunctive therapy (strontium-90 irradiation or cryotherapy) intraoperatively. Local tumor control was achieved in 22/23 cats with a minimum follow-up of 30 days (median follow-up time of 711 days); one cat developed disseminated CMCTs but no local recurrence. Cats with periocular CMCTs had a median survival time of 945 days. Metastatic disease involving peripheral lymph nodes or abdominal viscera was not detected in any cat at any time during the study. All periocular CMCTs were classified as low-grade based on histopathology, and complete excision was achieved in approximately 50% of cases.
Conclusions  Surgical excision of periocular CMCTs in cats is an effective treatment option with rare local recurrence and metastases, even following incomplete surgical excision.     

Ultrasonographic findings in abdominal mast cell disease: a retrospective study of 19 patients

A retrospective survey from January 1989 to January 1999 of Tufts University Foster Hospital for Small Animals radiology records of 12 dogs and seven cats with cytologically or histopathologically confirmed abdominal mast cell disease was performed. Ultrasound changes in hepatic mast cell infiltration in dogs included a subjective increase in size, a diffuse increase in echogenicity, and one or more hypoechoic nodules. Ultrasound findings in the affected canine spleen included one or more hypoechoic nodules and a subjective increase in size. Two ultrasonographically unremarkable canine livers and one unremarkable spleen were found to be infiltrated by mast cells. The mast cell-infiltrated feline spleen was subjectively increased in size, mottled, irregular, or contained nodules. The affected lymph nodes in both dogs and cats were hypoechoic or inhomogeneous, subjectively increased in size, and rounded. Gastrointestinal involvement in cats was characterized by a thickened ileocecocolic junction or colon with loss of wall layering. Mast cells were not found in the gastrointestinal tract in any dog. One dog with mast cell infiltrate of the kidneys had multiple hypoechoic nodules in the cortex that distorted the outer contour of the kidney. Although these findings are not specific to the disease in either species, abdominal ultrasound is considered a useful tool for determining the extent of disease in small-animal patients with mast cell tumor if used in conjunction with histopathology or cytology.     

A subcutaneous mass on the neck of a horse

A 25-year-old Arabian gelding was presented for investigation of a subcutaneous neck mass. Fine-needle aspirates and impression smears revealed mast cells with widely varying degrees of cytoplasmic granulation and scattered eosinophils. Histopathology revealed a poorly circumscribed mass composed of sheets and bundles of mast cells with a large population of eosinophils. The mast cells were separated into numerous lobules by a heavy collagenous stroma, and multifocal collagen necrosis was present. Strong reactivity of the tumor cells for both Giemsa and toluidine blue stains confirmed the diagnosis of a mast cell tumor, and a Luna stain accentuated the eosinophilic infiltrates. Cutaneous mast cell tumors are found in many domestic animals but are uncommonly encountered in horses. Equine cutaneous mast cell tumors are usually benign, and there are no reports of visceral metastasis. Surgical excision is thought to be curative.     

Histology and immunohistochemistry of seven ferret vaccination-site fibrosarcomas

The anatomical location, histology, and immunohistochemistry of 10 ferret dermal and subcutaneous fibrosarcomas were examined. Seven of the 10 tumors were from locations used for vaccination. All fibrosarcomas contained spindle-shaped cells surrounded by variable quantities of connective tissue stroma. However, vaccination-site fibrosarcomas (VSFs) subjectively contained a higher degree of cellular pleomorphism. Multinucleated cells were present in three of seven VSFs but not in any of the nonvaccination-site fibrosarcomas (NVSFs). Large histiocytic cells, interpreted as macrophages, containing intracytoplasmic basophilic granular material were observed in two VSFs but not in any of the NVSFs. Five VSFs contained peripheral lymphoplasmacytic aggregates. Immunohistochemically, three VSFs stained with anti-smooth muscle actin antibodies and one stained with antibodies against desmin. No expression of muscle cytoskeletal filaments was observed in any NVSF. Filaments interpreted as actin were visible in both the VSFs examined ultrastructurally. One of the VSFs examined ultrastructurally contained intracytoplasmic crystalline material. The preferential development of subcutaneous fibrosarcomas in vaccination sites suggests that, as in cats, vaccination may promote local sarcoma development in ferrets. Additionally, some of the histologic, immunohistochemical, and ultrastructural features of these tumors are similar to those reported for feline vaccine-associated sarcomas. To the authors' knowledge, vaccination has not previously been reported to be oncogenic in any species other than cats.     

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.     

Prognosis Factors for Survival in Cats After Removal of a Primary Lung Tumor: 21 Cases (1979–1994)

Objective —To identify possible prognostic factors for survival time in cats with a primary lung tumor after surgical excision.
Study Design —Retrospective clinical study.
Animal Population —21 cats with histologically confirmed primary lung tumors removed surgically.
Methods —Medical records for cats treated between 1979 and 1994 at 14 participating veterinary referral hospitals were reviewed.
Results —After surgical resection and recovery, 18 cats died from metastatic disease with a median survival time of 115 days (range, 13 to 1,526 days). Three cats were lost to follow-up at 119 days, 251 days, and 410 days after the surgical procedure. Contingency table analysis to determine if an association existed between clinical findings (breed, age, gender, body weight, clinical signs, duration of clinical signs, and radiographic findings) or histological features and survival time was performed. Only histological morphology of the primary lung tumor showed a significant association with survival time. Twelve cats with moderately differentiated tumors had a significantly longer survival time (median, 698 days; range, 19 to 1,526 days) than the nine cats with poorly differentiated tumors (median, 75 days; range, 13 to 634 days).
Conclusions —Surgical resection of a solitary primary lung tumor in cats is indicated.
Clinical Relevance —A poor prognosis for long-term survival is warranted for those cats having a poorly differentiated primary lung tumor.     

Multiple epulides in 13 cats

Epulides account for 0-7.8% of tumors in surveys of feline oral neoplasms. A review of the literature revealed no reports of multiple epulides in cats. Multiple, concurrent epulides were diagnosed microscopically in 13 cats. Fibromatous and ossifying epulides were diagnosed in 11 of 13 cats and fibromatous epulides were diagnosed in 2 of 13 cats. Microscopically, these epulides were nonencapsulated, well-vascularized, infiltrative, highly cellular neoplasms that expanded the gingiva and were composed of haphazardly arranged, spindle-shaped to stellate cells amid a dense, collagenous stroma. Osseous foci were a feature in the fibromatous and ossifying epulides. The mitotic rate was low and there was marked hyperplasia of the overlying gingiva with a prominent downgrowth of epithelial cords. These tumors recurred in 8 of 13 cats following surgical excision. While uncommon, multiple epulides in cats have a high incidence of recurrence but do not appear to have metastatic potential.     

Expression of receptor activator of nuclear factor kappa-B ligand (RANKL) in neoplasms of dogs and cats

BACKGROUND: Receptor activator of nuclear factor kappa-B (RANK), RANK-ligand (RANKL), and the soluble decoy receptor osteoprotegerin (OPG) form a key axis modulating osteoclastogenesis. In health, RANKL-expressing bone stromal cells and osteoblasts activate osteoclasts through RANK ligation, resulting in homeostatic bone resorption. Skeletal tumors of dogs and cats, whether primary or metastatic, may express RANKL and directly induce malignant osteolysis. HYPOTHESIS: Bone malignancies of dogs and cats may express RANKL, thereby contributing to pathologic bone resorption and pain. Furthermore, relative RANKL expression in bone tumors may correlate with radiographic characteristics of bone pathology. ANIMALS: Forty-two dogs and 6 cats with spontaneously-occurring tumors involving bones or soft tissues were evaluated. METHODS: A polyclonal anti-human RANKL antibody was validated for use in canine and feline cells by flow cytometry and immunocytochemistry. Fifty cytologic specimens were collected from bone and soft tissue tumors of 48 tumor-bearing animals and assessed for RANKL expression. In 15 canine osteosarcoma (OSA) samples, relative RANKL expression was correlated with radiographic characteristics of bone pathology. RESULTS: Expression of RANKL by neoplastic cells was identified in 32/44 canine and 5/6 feline tumor samples. In 15 dogs with OSA, relative RANKL expression did not correlate with either radiographic osteolysis or bone mineral density as assessed by dual energy x-ray absorptiometry. CONCLUSIONS AND CLINICAL IMPORTANCE: In dogs and cats, tumors classically involving bone and causing pain, often may express RANKL. Confirming RANKL expression in tumors is a necessary step toward the rational institution of novel therapies targeting malignant osteolysis via RANKL antagonism.     

Cyclooxygenase-2 expression in feline pancreatic adenocarcinomas.

Cyclooxygenase-2 (COX-II) is an inducible enzyme that is responsible for the production of prostaglandin E2 (PGE2), which is often upregulated in neoplastic conditions. Expression of COX-II is documented in the majority of human pancreatic adenocarcinomas and in many epithelial neoplasms in humans and animals. The purpose of this study was to assess a series of feline pancreatic adenocarcinomas for the expression of COX-II. Eight feline pancreatic adenocarcinomas (5 poorly differentiated ductular variants and 3 well-differentiated acinar variants) were included. Immunohistochemical staining showed that COX-II was expressed in 2 (both poorly differentiated ductular variants) of the 8 neoplasms (25%). Approximately 10% of the epithelial cells from these 2 neoplasms expressed intense cytoplasmic staining. However, because feline pancreatic adenocarcinoma does not appear to consistently express COX-II, it is not a useful prognostic indicator for this group of feline neoplasms. In addition, COX-II inhibitors are not likely to be effective therapeutics for cats with this neoplasm.     

Proposal of a 2-tier histologic grading system for canine cutaneous mast cell tumors to more accurately predict biological behavior

Currently, prognostic and therapeutic determinations for canine cutaneous mast cell tumors (MCTs) are primarily based on histologic grade. However, the use of different grading systems by veterinary pathologists and institutional modifications make the prognostic value of histologic grading highly questionable. To evaluate the consistency of microscopic grading among veterinary pathologists and the prognostic significance of the Patnaik grading system, 95 cutaneous MCTs from 95 dogs were graded in a blinded study by 28 veterinary pathologists from 16 institutions. Concordance among veterinary pathologists was 75% for the diagnosis of grade 3 MCTs and less than 64% for the diagnosis of grade 1 and 2 MCTs. To improve concordance among pathologists and to provide better prognostic significance, a 2-tier histologic grading system was devised. The diagnosis of high-grade MCTs is based on the presence of any one of the following criteria: at least 7 mitotic figures in 10 high-power fields (hpf); at least 3 multinucleated (3 or more nuclei) cells in 10 hpf; at least 3 bizarre nuclei in 10 hpf; karyomegaly (ie, nuclear diameters of at least 10% of neoplastic cells vary by at least two-fold). Fields with the highest mitotic activity or with the highest degree of anisokaryosis were selected to assess the different parameters. According to the novel grading system, high-grade MCTs were significantly associated with shorter time to metastasis or new tumor development, and with shorter survival time. The median survival time was less than 4 months for high-grade MCTs but more than 2 years for low-grade MCTs.     

Feline paediatric oncology: retrospective assessment of 233 tumours from cats up to one year (1993 to 2008)

Objectives : To determine which types of tumour occur in cats up to the age of 12 months based on biopsies submitted to Idexx Laboratories, Wetherby, UK. Methods : Retrospective review of histopathological diagnoses of tumours in cats up to the age of 12 months from biopsies received between September 1993 and March 2008. Results : A total of 4196 submissions from cats 12 months old or younger were identified; 233 biopsies (6%) were neoplastic and fulfilled the search criteria. Tumours were categorised as haematopoietic (n=73, 31%), malignant epithelial (n=44; 19%), malignant mesenchymal (n=38; 16%), benign epithelial (n=37; 16%), benign mesenchymal (n=30, 13%) and miscellaneous (n=11; 5%). The most frequent tumours were lymphoma (n=51; 22%), soft-tissue sarcoma (n=34; 15%), mast cell tumour (n=22; 9%) and squamous cell carcinoma (n=16; 7%). The most common tumour site was the skin and soft tissues (41% of tumours). In all, 164 neoplasms (70%) were malignant or had malignant potential. Clinical Significance : These data provide unique epidemiological information on a poorly characterised subgroup of feline cancer patients in the UK.