Recurrent adnexal lymphoma in a horse

Lymphoma is a relatively uncommon neoplasm in the horse; however, it is considered the most common neoplasia of the equine haemolymphatic system. Limited reports of adnexal lymphoma have been documented in the literature, with no known reports of recurrence nearly a decade after mass excision. The objective is to describe a case of recurrent adnexal lymphoma in a 20-year-old Quarter Horse gelding presented to the Ophthalmology service at the University of Florida Veterinary Hospital (UFVH) for evaluation of a solitary subconjunctival mass of the right eye (OD). A focal, pink, fleshy mass associated with the dorsomedial bulbar conjunctiva was noted. An excisional biopsy was performed. Histopathology revealed lymphoma with clean margins. The client declined staging and further therapy at the initial visit. Approximately 8 years later, the horse began to exhibit intermittent mild to moderate diffuse swelling of the conjunctiva OD. Six months after onset, the swelling worsened acutely and was accompanied by severe swelling of the left conjunctiva (OS). The horse then returned to UFVH and was diagnosed with diffuse, bilateral conjunctival lymphoma. Humane euthanasia was elected. T cell lymphoma was confirmed with immunohistochemistry performed post-mortem. At necropsy, neoplastic tissue was observed throughout the adnexal and ocular tissues of both eyes and in the submandibular lymph nodes. Adnexal lymphoma is an uncommon neoplasm in the horse. To the authors’ knowledge, this is the first documentation of a nodular adnexal lymphoma that involved an 8-year period without recurrence followed by development of diffuse, bilateral disease. Typically, surgical excision of the nodular form of lymphoma involving the extraocular tissues yields an improved prognosis compared with the diffuse form of the disease. Further investigation is necessary to determine if nodular forms of adnexal lymphoma represent early stages of diffuse extraocular or systemic disease.     

Hemangiosarcoma of the third eyelid in a cat

A case of hemangiosarcoma of the third eyelid in a 15-year-old Domestic Short-haired cat is reported. A small red mass protruding from the anterior surface of the third eyelid in the left eye was present. Only mild bilateral conjunctivitis and nuclear sclerosis were revealed on initial ophthalmic examination. After anti-inflammatory treatment, surgery and cryotherapy were performed. On histopathologic examination the mass was located just beneath the conjunctival epithelium, suggesting that the conjunctiva was the tissue of origin. The tumor showed high cellularity and was composed of pleomorphic spindle and polygonal cells arranged in interlacing bundles and solid sheets. The presence of slit-like spaces between tumor cells containing erythrocytes demonstrated the vascular differentiation. Mitotic activity was moderate, but atypical mitoses were detected. The surgical area healed uneventfully and after 7 months there was no recurrence. To the authors' knowledge, this is the first report of conjunctival hemangiosarcoma of the third eyelid in a cat.     

A case of lipogranulomatous conjunctivitis in a horse

Objective

To describe a case of lipogranulomatous conjunctivitis in a horse.

Animal Studied

A client-owned 12-year-old Standardbred gelding presenting with chronic conjunctivitis and palpebral masses.

Methods

Complete ophthalmic examination, surgical excision, histopathology, and bacterial culture of biopsy samples were performed.

Results

Upper and lower eyelids of both eyes were affected, with multiple yellow-to-white nodules on the palpebral conjunctiva, adjacent to the eyelid margin. Nodule removal was achieved via partial tarsal plate excision. Histopathological examination revealed granulomatous inflammation and large droplets of presumed free lipid in the conjunctival lamina propria. The animal was diagnosed with lipogranulomatous conjunctivitis. No postoperative ocular discomfort was observed for months; however, 3 years later, new conjunctival nodules were noticed, requiring a second surgical procedure on three of the eyelids. Transient entropion in the left lower eyelid was observed 2 months after the second surgery, and no recurrence of conjunctival nodules was observed after 18 months of follow-up.

Conclusion

To our knowledge, this is the first report of lipogranulomatous conjunctivitis in horses.     

Equine conjunctival pseudotumors

Five horses presented with unilateral pink, smooth, nonulcerated conjunctival masses with histologic features characteristic of inflammatory pseudotumors, i.e. proliferative inflammatory lesions clinically resembling true neoplasia. Although causes for the inflammatory lesions were not determined, based on the presence histologically of mononuclear (predominantly lymphocytic) inflammatory cell infiltrates and the absence of infectious agents, parasites or foreign bodies, an immune-mediated pathogenesis was suspected. Affected horses ranged from 5 to 8 years of age with no apparent breed or sex predilection. Conjunctival lesions were nodular in two cases and relatively flat and more diffuse in three cases. Third eyelid lesions were present in three cases and two affected eyes had corneal involvement. Based on findings from these five cases, the prognosis for equine conjunctival pseudotumors appears to be good when lesions are treated by partial or complete surgical excision, local administration of anti-inflammatory agents, or a combination of surgery and anti-inflammatory therapy.     

A case of conjunctival melanoma in a cat

Since 1985, 5 cases of feline conjunctival melanoma have been reported in the literature. Information on feline conjunctival melanoma epidemiological features, localizations, macroscopic features and histological features is limited. We are describing the clinical, histopathologic features and outcomes in a cat that presented clinically with a slow developing dark brown mass located under the upper eyelid of the left eye. Pertinent literature is reviewed; and the recognizable clinical features and treatment are discussed. The mass was surgically resected. Despite its size, the lesion was easily separated from underlying tissues, making possible a macroscopic complete resection that left intact the adjacent conjunctiva. The tumour histological examination has showed a pigmented melanoma lacking encapsulation, but presenting a clear zone delimiting the lesion. It was exclusively composed of epithelioid cells, and presented mild cellular anaplasia and weak mitotic activity. These features allowed it to be classified as a quite differentiated melanoma with few signs of potential malignancy. In accordance with these histologic features, no recurrence has been registered 34 months after surgery. Thus, a favorable outcome is now reported for two out of six cases of conjunctival melanoma in the cat. This report also confirms the predilection for this neoplasm to arise from the bulbar conjunctiva.     

Conjunctival-corneal intraepithelial neoplasm in an Asian elephant (Elephas maximus).

An adult female Asian elephant (Elephas maximus) presented with an enlarging nasal limbal mass of the left eye. The mass was excised and the surgical bed treated with liquid nitrogen cryotherapy. Histopathologic examination of the excised tissue showed the mass to be a superficial dysplastic ocular lesion, or conjunctival intraepithelial neoplasm. A 5-yr follow-up period has passed without complications or recurrence, suggesting that as is the case in humans (Homo sapiens), excision and cryotherapy is an effective treatment for these lesions in elephants. This is the first report of any ocular neoplasia in an elephant.     

Malignant melanoma of the third eyelid in a horse

An 8‐year‐old grey Quarter Horse gelding was referred for evaluation of a rapidly growing mass associated with the third eyelid of the left eye. A pigmented mass of approximately 2 cm in diameter was palpated and visualised associated with the conjunctival lining of the nictitans. It was not possible to palpate normal nictitans deep to the base of the mass. A full dermatological examination revealed no other melanomas in common sites. Based on the size and rapid growth of the mass, surgical excision and one application of local chemotherapy was performed under general anaesthesia. Histopathology confirmed the diagnosis of malignant melanoma and the presence of clean surgical margins. There was no recurrence at 5 weeks post surgery. To our knowledge, this is the first report of a primary malignant melanoma of the third eyelid in a horse.     

Adjuvant Electrochemotherapy Increases Local Control in a Recurring Equine Anal Melanoma

A 25-year-old gelding sport horse was referred for the treatment of recurring bilateral anal amelanotic melanoma. On physical examination, the horse presented bilateral poorly delimited perianal masses that recurred 2 months after surgical excision. The owner elected the lesions to be treated with surgery combined with electrochemotherapy using the drug cisplatin. The two masses were removed, and the surgical bed was treated with electrochemotherapy. A second session was performed 3 weeks later. The horse remained disease-free for 5 months and then experienced a marginal recurrence in one side. The nodule was re-treated, and the horse remained disease-free for 2 additional months, when it died of abdominal metastases. Electrochemotherapy can be added to the current strategies to palliate recurrent melanomas in horses.     

Keratoconjunctivitis associated with Toxoplasma gondii in a dog

A 12-year-old Pug presented with a 3-mm corneal mass OD. The dog was currently being treated for keratoconjunctivitis sicca (KCS) and pigmentary keratitis OU. A superficial keratectomy followed by cryotherapy was performed OD. A histopathologic diagnosis of epithelial dysplasia and suppurative keratitis was made and the lesion resolved. Two months later, a yellow/tan conjunctival mass, diffuse chemosis and conjunctival thickening was discovered OD. Necrotizing conjunctivitis with protozoal parasites was diagnosed with histopathology. Complete blood count and a serum biochemistry panel were normal. Neospora caninum and Toxoplasma gondii titers were negative. The conjunctivitis resolved after a 6-week course of oral clindamycin. Two months later, the patient presented with a similar conjunctival mass OS. Toxoplasma gondii was confirmed as the etiologic agent with immunohistochemical staining. Repeat T. gondii titers were negative. Oral clindamycin was re-instituted. The corneal biopsy was re-reviewed and protozoal organisms were discovered. Three months later, a recurrence was suspected and oral ponazuril was initiated for 28 days. There has been no evidence of recurrence since this treatment. Ocular toxoplasmosis is rare in the dog but reports have included episcleritis, scleritis, retinitis, anterior uveitis, ciliary epithelium hyperplasia, optic neuritis and polymyositis. To our knowledge, this is the first confirmed report of toxoplasmosis causing only corneal and conjunctival disease in the dog. We hypothesize that these localized lesions may be associated with topical immunomodulating therapy for KCS. Toxoplasmosis should be considered as a differential for canine conjunctivitis and corneal disease and has the potential to manifest in one or both eyes.     

Conjunctivitis associated with a Mycoplasma-like organism in swine

A midwestern producer reported high incidence of conjunctivitis and keratoconjunctivitis in a herd of crossbred finishing swine. Complete necropsy was performed on 3 pigs with bilateral mucopurulent conjunctivitis and chemosis; other gross lesions were not seen. Mycoplasma sp was isolated from conjunctival swab specimens obtained from 1 pig; small numbers of streptococci and coagulase-negative staphylococci were isolated from conjunctival swab specimens from all 3 pigs. Neither swine influenza virus nor pseudorabies virus was isolated from conjunctival swab specimens. Histologically, the 3 pigs had chronic lymphoplasmacytic conjunctivitis with lymphofollicular hyperplasia and foci of epithelial and goblet cell hyperplasia. Ultrastructural examination of conjunctival specimens from the 3 pigs revealed large numbers of Mycoplasma-like organisms adhered to superficial conjunctival cells. Mycoplasma-like organisms also were seen in membrane-bound vacuoles in superficial conjunctival cells. Bacteria (including chlamydiae) or viruses were not seen ultrastructurally. The lymphoproliferative nature of the conjunctival lesion and the evidence of adhered and intracellular organisms suggested an etiologic role for a Mycoplasma-like organism in the disease in these pigs.     

Limbal conjunctival plaques and idiopathic eosinophilic conjunctivitis

A 4‐year‐old Welsh pony crossbred gelding was examined for acute onset of blepharospasm, epiphora and corneal oedema. Ophthalmic examination identified 2 conjunctival plaques located near the superior limbus of the left eye. The plaques did not resolve following treatment with topical triple antibiotic ointment, topical atropine ointment and oral flunixin meglumine and therefore a conjunctival biopsy was performed. Histology of the biopsy resulted in a diagnosis of eosinophilic conjunctivitis, which was treated with a topical corticosteroid ointment. Plaques resolved after 73 days of therapy but lesions did not improve with concurrent treatment with anthelmintics early in the course of therapy. Failure to identify an aetiological agent led to a diagnosis of idiopathic eosinophilic conjunctivitis. The conjunctival plaques have not recurred in the 10 months following discontinuation of therapy.     

Treatment of a recurrent ocular squamous cell carcinoma in a horse with Iridium-192 implantation

A 7-year-old Selle français gelding was presented for a recurrent conjunctival tumour on the left eye. A previous histologic analysis revealed a conjunctival squamous cell carcinoma. As it was the third recurrence after surgical excision in a 1½-year period, we decided to perform interstitial radiotherapy combined with the surgical excision. Two Iridium-192 pins were implanted in the subcutaneous fascia of the lower eyelid over the tumor site and were removed 3 days later. No postoperative adverse reactions were observed. Twelve months postoperatively, there were no signs of local recurrence. Surgical excision combined with Iridium-192 therapy appeared to be an effective treatment in this case.     

Long-term outcome of domestic ferrets treated surgically for hyperadrenocorticism: 130 cases (1995-2004)

OBJECTIVE: To determine the long-term survival rate and factors that affect survival time of domestic ferrets treated surgically for hyperadrenocorticism. STUDY DESIGN: Retrospective case series. ANIMALS: 130 ferrets with hyperadrenocorticism that were treated surgically. PROCEDURES: Medical records of ferrets surgically treated for hyperadrenocorticism were reviewed. Data recorded included signalment, duration of clinical signs prior to hospital admission, CBC values, serum biochemical analysis results, anesthetic time, surgical time, concurrent diseases, adrenal gland affected (right, left, or both [bilateral]), histopathologic diagnosis, surgical procedure, caudal vena caval involvement (yes or no), postoperative melena (yes or no), days in hospital after surgery, and whether clinical signs of hyperadrenocorticism developed after surgery. RESULTS: 130 ferrets were entered in the study (11 of 130 ferrets were admitted and underwent surgery twice). The 1- and 2-year survival rates were 98% and 88%, respectively. A 50% survival rate was never reached. Combined partial adrenal gland resection with cryosurgery had a significantly negative effect on survival time. No other risk factors were identified. Survival time was not significantly affected by either histopathologic diagnosis or specific affected adrenal gland (right, left, or bilateral). CONCLUSIONS AND CLINICAL RELEVANCE: Ferrets with adrenal gland masses that were treated surgically had a good prognosis. Survival time of ferrets with hyperadrenocorticism undergoing surgery was not affected by the histologic characteristic of the tumor, the adrenal glands affected (right, left, or bilateral), or complete versus partial adrenal gland resection. Debulking was a sufficient surgical technique to allow a favorable long-term outcome when complete excision was not possible.     

Subconjunctival nodule due to Setaria equina erratic migration in a horse: First case report

An 18‐month‐old Arabian‐English filly resident in southwest France was referred for evaluation of a conjunctival mass in the right eye (OD). A pink, solid, and mobile nodular formation, measuring approximately 1.2 × 0.8 cm was found under the superior nasal bulbar conjunctiva during an ophthalmic examination that was otherwise normal. The mass was surgically removed using a standing procedure. Cytological examination of fine‐needle aspirates from the mass revealed a mixed eosinophilic‐lymphocytic inflammation. Histological examination confirmed the dense and diffuse eosinophilic‐lymphocytic infiltrate of the mass, and it revealed several cross sections of a parasitic nematode. The morphometric diagnosis identified an immature form of a filarial worm, and molecular analysis of the mitochondrial cytochrome c oxydase subunit 1 (cox1) and 12S rRNA gene sequences led to further identification of the specimen as Setaria equina. Microfilaremia was not observed on fresh blood smears. There have been no signs of local recurrence after 18 months, nor any evidence of intraocular involvement. To the authors’ knowledge, this is the first documented case of subconjunctival setariasis due to S equina in a horse.     

Conjunctival malignant melanoma in a horse

A case of malignant melanoma originating from the conjunctiva of a horse is reported. The tumor exhibited locally aggressive behavior as evidenced clinically by recurrence following two treatment episodes including surgical excision on each occasion and one application of cryotherapy. The orbit was subsequently exenterated and histologically malignant conjunctival melanoma was confirmed. Histopathologic features included variable pigmentation with amelanotic sites demonstrating marked cellular and nuclear pleomorphism with high numbers of mitotic figures. Cords of neoplastic cells invaded the sclera and cornea. Following exenteration, the horse exhibited no recurrence of the tumor for five years before being lost to follow-up. To our knowledge, this is the first report of primary malignant conjunctival melanoma in a horse.     

Conjunctival lipid granulomas in a cat

A 12-year-old, neutered male cat was examined because of a persistent serous ocular discharge from the left eye. Three, pale cream, 1-4 mm lesions were detected in the palpebral conjunctivae of the left eye. The surgical excision of the lesions resulted in complete resolution of the epiphora. Histological examination confirmed that the lesions were lipid granulomas but the aetiology and pathogenesis of them were not determined. No disease conditions which result in primary or secondary hyperlipoproteinaemia were detected.     

Unilateral orbital lacrimal gland abscess in a horse

A 20-year-old Thoroughbred gelding presented for evaluation of a periorbital dorsal swelling of the left eye that had been intermittently present for 3 months. Upon ocular examination, a firm, non-painful swelling was identified under the upper eyelid in the region of the orbital lacrimal gland, and was noted to extend anteriorly from underneath the dorsal orbital rim. Ultrasonographic examination revealed a mixed echogenic mass along the dorsal orbital rim that followed the contour of the globe. CT scan showed a moderately contrast enhancing mass that was contiguous with the eyelid. Differential diagnoses included neoplasia, inflammatory lesions such as a granuloma, foreign body or abscess. Surgical exploration and excision of the mass revealed a lobular structure with a purulent center. Histopathology identified the mass as the orbital lacrimal gland with concurrent severe dacryoadenitis. Culture of the purulent center of the mass revealed beta-hemolytic Staphylococcus aureus. The patient was maintained on supportive care and antibiotic treatment based on sensitivity postoperatively. No recurrence was reported 40 months later. This paper aims to identify bacterial dacryoadenitis as a cause for unilateral periorbital swelling in the horse. Differential diagnoses for this presentation, as well as successful surgical management are discussed. To the author's knowledge, this is the first case of bacterial dacryoadenitis and subsequent abscessation of the orbital lacrimal gland in the horse.     

Nasal and ocular amyloidosis in a 15-year-old horse

Localized nasal, conjunctival and corneal amyloidosis was diagnosed in a 15-year-old pony with nasal and conjunctival masses and severe dyspnoea. Multiple swellings had been evident in the nostrils for at least two years and had gradually increased in size before presentation due to dyspnoea and exercise intolerance. Surgical debulking of the masses was performed and histological examination revealed large amounts of extracellular, hyaline, eosinophilic, Congo red positive material in the lamina propria of the nasal mucosa. A tentative diagnosis of localized nasal amyloidosis was made. The treatment relieved the clinical signs, however, the nasal masses recurred and bilateral conjunctival, papillary masses developed. The horse was euthanized. Nodular nasal and papillary conjunctival masses consisting of rubbery, grey to yellow tissue were found at necropsy. At the limbus this tissue infiltrated and expanded the cornea. The masses consisted of amyloid and moderate infiltrates of T lymphocytes and B lymphocytes were present in the tissue. No predominance of either cell type was observed and no distinct neoplastic mass could be identified. Ultrastructural examination of the nasal mucosa and cornea confirmed the presence of abundant extracellular deposits of non-branching fibrils ranging from 9–11 nm in diameter consistent with amyloid. Immunohistochemistry of amyloid revealed no labelling for AA amyloid, and no peptides representing serum amyloid A (SAA) were detected by microscopic laser dissection and subsequent mass spectrometry. Peptides from immunoglobulin kappa-like light chains were detected and are suggestive of AL amyloidosis, however the results were inconclusive and a final identification of the amyloid protein could not be made.Nasal amyloidosis is a clinical entity of localized amyloid deposits in the horse. Localized amyloidosis involving the conjunctiva of the horse is previously described in only seven cases and the present case is the first case of combined, localized nasal and corneal amyloidosis in the horse. In several reported cases surgical excision has provided clinical improvement and return to normal levels of exercise, while medical treatment has had no effect. The present case however, shows that rapid recurrence and progression of nasal amyloidosis to involve ocular tissues can occur and lead to recurrent respiratory obstruction.

Electronic supplementary material

The online version of this article (doi:10.1186/s13028-014-0050-6) contains supplementary material, which is available to authorized users.     

Neodymium:yttrium-aluminum-garnet laser-assisted excision of progressive ethmoid hematomas in horses: 20 cases (1986-1996)

OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.