What is your diagnosis? Subcutaneous mass fluid from a febrile dog

Abstract: A 10‐month‐old spayed female Doberman Pinscher was presented for lameness. On physical examination, the dog was lethargic and febrile and had a 2‐cm raised subcutaneous mass at the base of the left ear. Fluid from the mass was drained. Direct smears of the fluid, stained with modified Wright's and new methylene blue, were highly cellular and contained large numbers of degenerate neutrophils with moderate numbers of macrophages. Large numbers of round yeast organisms, 8–20 μm in diameter, were observed extracellularly. The organisms had a thick blue wall and granular internal contents and broad‐based budding was seen frequently. Branching hyphae or pseudohyphae, with parallel sides and 2–4 μm in diameter, appeared to extend from the surface of the yeast. The morphology of the yeast organisms was consistent with Blastomyces dermatitidis, with atypical hyphae formation. Culture results were not definitive because it was not possible to induce transition from the mycelial to the yeast form at 37°C and because the morphology of the mycelial form of B. dermatitidis could not be differentiated from that of Emmonsia parvae. The organism was confirmed as Ajellomyces dermatitidis (the mycelial form of B. dermatitidis) using 18S ribosome RNA gene sequencing and comparison with an available databank. The mycelial form of B. dermatitidis is rarely found in the tissue of dogs, and may have been induced in this case by low environmental temperatures and the time delay between sample collection and slide preparation.     

What is your diagnosis? Lingual mass in a dog

A 3.5-year-old female spayed Rat Terrier was presented for evaluation of a submucosal lingual mass. Fine-needle aspiration of the mass revealed a population of neoplastic cells composed predominantly of small, round cells and large, round to spindle-shaped cells, which occasionally had blunt cytoplasmic borders and multiple nuclei. The neoplastic cells had moderate to marked anisocytosis and anisokaryosis. The cytologic interpretation was malignant neoplasia, most likely sarcoma. Histopathologic examination of a biopsy specimen revealed an unencapsulated, poorly demarcated, moderately cellular neoplasm composed of individualized, infiltrative spindle cells. Elongate skeletal muscle cells with prominent, rectangular borders (strap cells) were observed. A morphologic diagnosis of rhabdomyosarcoma was made. Staining with phosphotungstic acid-hematoxylin revealed haphazardly arranged skeletal muscle cross-striations. Immunohistochemical staining results for vimentin, Myo D1, desmin, and myoglobin were positive, though staining intensity of tumor cells varied with the degree of differentiation. Using transmission electron microscopy, irregular, disorganized Z-bands were identified. Rhabdomyosarcomas are uncommon tumors in the dog, and rarely may involve the tongue or oral cavity. Cytologic evaluation of a rhabdomyosarcoma may reveal a pleomorphic population of cells and definitive diagnosis may require histologic examination, immunohistochemical staining, and electron microscopy.     

What is your diagnosis? Intracranial mass in a dog

Abstract: A 9‐year‐old, spayed female Chihuahua was presented for evaluation of acute, progressive neurologic disease. On physical examination the dog was depressed and laterally recumbent. The dog had marked neutrophilia with a toxic left shift and monocytosis. Using computed tomography with contrast enhancement a large intracranial mass lesion was identified in the rostral portion of the brain. The mass extended from the central thalamic region rostral to the cribiform plate and obliterated the lateral ventricles. A fine needle aspirate of the mass contained moderately pleomorphic polygonal cells with many intranuclear cytoplasmic pseudoinclusions (ICPs). The primary differential diagnosis was meningioma, based on cell morphology and the presence of ICPs. At necropsy, the mass was well‐demarcated, unencapsulated, and densely cellular. Cells were arranged in papillary projections on fibrovascular stalks, and eosinophilic ICPs and nuclear folding were frequently seen. Cavitated areas of necrosis throughout the tumor mass were filled with intact and degenerated neutrophils. The histopathologic diagnosis was malignant papillary meningioma. ICPs are not frequently observed in Wright‐stained cytologic preparations but may be found in many types of neoplasms, including meningiomas.     

What is your diagnosis? Vertebral mass in a dog

Abstract: A 1‐year‐old, castrated male, mixed‐breed dog was presented for sporadic episodes of kyphosis, tremors, and vocalizing. On neurologic examination, the lesion was localized to spinal cord segments T3–L3. Magnetic resonance imaging of the spine showed an expansile mass occupying most of the ventral aspect of the spinous process of T6. Fine‐needle aspirates of the mass were examined cytologically. A moderately cellular population of pleomorphic spindle cells and abundant mucinous matrix were observed. The cytologic diagnosis was spindle cell neoplasia, with myxosarcoma and fibrosarcoma as the primary differential diagnoses. The dog was euthanized. Histopathologic evaluation of the mass and surrounding tissue confirmed a low‐grade spindle cell sarcoma, with severe compressive myelopathy and mild neutrophilic inflammation. The neoplastic cells stained positive for mucopolysaccharides with Alcian blue, resulting in a final diagnosis of low‐grade (grade 1) myxosarcoma. Fine‐needle aspiration was useful in making a preliminary diagnosis of myxosarcoma in this case. Myxosarcoma should be included in the differential diagnosis for a vertebral mass in a young dog.