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.     

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.     

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.     

Cytologic appearance of retinal cells included in a fine‐needle aspirate of a meningioma around the optic nerve of a dog

A 6‐year‐old Wirehair Dachshund had a meningioma around the optic nerve that caused exophthalmos. A benign mesenchymal tumor was suspected based on the cytologic pattern of a fine‐needle aspirate, and a meningioma was diagnosed by histopathologic examination. In addition to the meningioma cells, the cytologic smears included groups of cells from apparently 4 layers of normal retina. In particular, uniform rod‐shaped structures in the cytologic sample could suggest rod‐shaped bacteria, but these structures were identified as cylindrical outer segments of photoreceptor rod cells. Other retinal structures recognized included pigmented epithelial layer cells with their uniquely formed pigment granules, the characteristic bi‐lobed, cleaved nuclei from the outer nuclear layer, and nerve tissue likely from the outer plexiform layer of the retina.     

Immunohistochemical features of proliferative marker and basement membrane components of two feline inductive odontogenic tumours

Feline inductive odontogenic tumour (FIOT) is a rare and interesting odontogenic neoplasm in which the odontogenic epithelium has inductive potential to form aggregated foci of dental pulp-like mesenchymal cells. Two male cats aged 11 and 10 months presented with nasal swelling and a left maxillary mass. Histopathologically, the masses consisted of non-encapsulated invasive neoplasms exhibiting proliferation of epithelial and mesenchymal components with local infiltration into the maxillary bone in both cases. The epithelial component formed islands, anastomosing strands, and solid sheets of polygonal epithelial cells. Occasionally, these cells formed circular aggregates, resembling the cap stage of odontogenesis. Type IV collagen and laminin were constantly positive around the foci of epithelial cells, and Ki-67 positive indices were extremely low; therefore, these findings consistent with the benign clinical presentation of FIOT.     

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.     

The utility of intraoperative impression smear cytology of intracranial granular cell tumors: Three cases

Two adult male dogs (a 7‐year‐old shorthaired Chihuahua and 14‐year‐old Shih Tzu) and one adult female dog (a 9‐year‐old Maltese) presented for evaluation of new‐onset seizure activity. Magnetic resonance imaging of the brain demonstrated a large, poorly marginated T2‐weighted hyperintense, and strong contrast enhancing extra‐axial mass in each case. A surgical biopsy for histopathologic evaluation was elected in all cases, and intraoperative impression smears were successfully obtained. Intraoperative cytology identified a homogenous population of round to polygonal cells with central to eccentric nuclei, coarse chromatin, and variably amphophilic to eosinophilic granular cytoplasm. Cytologic findings led to a suspected diagnosis of granular cell tumor (GCT) in all cases. Histopathologic review identified a densely cellular, unencapsulated neoplastic mass comprised of sheets of large round to polygonal cells with abundant eosinophilic cytoplasm containing numerous eosinophilic intracytoplasmic granules, confirming the diagnosis of GCT in all cases. The cases reported here are unique in that they reveal an accurate intraoperative cytologic diagnosis of a rare canine central nervous system neoplasm. Intraoperative cytology of the intracranial masses could provide clinicians with important and quick diagnostic and prognostic information; therefore, expediting decisions made intraoperatively. Further research is warranted to determine the diagnostic accuracy of intraoperative cytology for neoplasia in veterinary patients.     

Comparison of liver cytology and biopsy diagnoses in dogs and cats: 56 cases

Abstract: The results of liver cytology and corresponding biopsy specimens submitted to the Pathology Department at Angell Memorial Animal Hospital during 1998 were retrospectively reviewed to objectively assess the diagnostic value of liver cytology. A "corresponding" biopsy was defined as a biopsy specimen obtained within 1 day of the cytology specimen. Fifty-six cases were reviewed, including 25 from dogs and 31 from cats. Results were in complete agreement in 34 cases, in partial agreement in 11 cases, and in disagreement in 11 cases. Agreement occurred most often in cases of fatty change (10 cases) and neoplasia (7 cases of lymphoma and 3 cases of epithelial tumor). Disagreement was most common in cases of hepatitis (6 cases) in which inflammation was not seen in cytologic specimens. Other causes for disagreement included fibrosis (2 cases), and 1 case each of amyloidosis, hemangiosarcoma, and lymphoma. Three cytologic specimens were considered suggestive of hepatitis because of leukocytosis in the background, although clinicians were advised to compare cytologic observation to CBC results. Cytologic evaluation of the liver was useful for determining disease processes, especially when disease distribution was diffuse.     

Malignant pilomatricoma in a soft‐coated Wheaten Terrier

Abstract: A 3‐year‐old, castrated male, soft‐coated Wheaten Terrier was presented for evaluation of mild lameness, fecal incontinence, lumbosacral pain, and lack of anal tone. Magnetic resonance imaging scan showed a large (8 × 6 × 5 cm) mass invading and expanding the pelvic bones, sacrum, and associated structures. A fine‐needle aspirate of the mass contained many neoplastic cells with high nuclear to cytoplasmic ratios and rare spindle and inflammatory cells. The neoplastic cells were 12–16 μm in diameter, round to cuboidal, basaloid in appearance, and arranged both individually and in loosely cohesive clusters with variably distinct cell borders. Given the location, signalment, and cytologic findings, differential interpretations included a primitive embryonal tumor (eg, neuroblastoma or nephroblastoma in an atypical location) or poorly differentiated carcinoma. The owner elected euthanasia due to the poor prognosis. Abnormal gross findings on necropsy included the pelvic mass and multiple firm, pale, pink‐tan nodules in the lung, which proved to be metastases. On histologic examination, the mass and nodules were composed of irregular islands, lobules, and nests of basaloid cells, which transitioned abruptly into large lakes of “ghost” cells with areas of ossification and calcification, consistent with a diagnosis of malignant pilomatricoma. This unusual presentation of a pilomatricoma adds to our knowledge of expected cytologic findings for this tumor.     

Usefulness of Ki-67 proliferation marker in the cytologic identification of liver tumors in dogs

BACKGROUND: Performing a biopsy is currently the best method of diagnosing liver disease. To reduce possible risk factors resulting from a biopsy, liver cytology can provide an alternative technique. The diagnostic accuracy of cytology for identifying liver tumors is, however, limited. The results of cytology might be improved by using immunochemistry for Ki-67, a proliferation marker, on liver cytology specimens. OBJECTIVES: The purpose of this study was to investigate the value of Ki-67 immunochemistry on liver cytologic specimens from dogs for identifying neoplastic diseases of the liver, by comparing the results to histologic findings. METHODS: Liver biopsy and cytology samples were obtained from 30 dogs with hepatic disease. All samples were evaluated by an anatomic pathologist and a cytopathologist. Parallel Ki-67 immunochemistry of histologic and cytologic samples was performed. The gradation of Ki-67 expression in histologic and cytologic samples was assessed. RESULTS: Cytologic specimens of liver tumors (n = 9) showed <50% Ki-67-positive cells. Twenty of 21 cases of non-neoplastic liver disease had no or few single Ki-67-positive cells. Using Ki-67, the diagnostic accuracy of cytologic evaluation was increased from 78% to 100% for malignant neoplasia. CONCLUSIONS: Based on the results of this study, the cytologic evaluation of liver together with Ki-67 immunochemistry can improve the diagnostic accuracy of cytology for liver neoplasia.     

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.     

Cytologic appearance of hibernoma in two dogs

Hibernomas are rare benign tumors of brown fat (adipose tissue) that have been reported in several different species. The cytologic characterization of these tumors has not been described in dogs. In this case report, we describe two dogs with hibernomas, focusing on the cytologic appearance of these unique neoplasms. Both cytologic specimens were highly cellular and predominated by vacuolated neoplastic cells with no evidence of concurrent inflammation. The cells contained a moderate to large number of variably sized cytoplasmic vacuoles, with occasional, irregularly shaped pink granular material. Most cells contained a single nucleus; however, cells displayed moderate anisokaryosis. A biopsy with histologic examination was performed in both cases, confirming the cytologic suspicion of hibernoma. Immunohistochemistry revealed that both tumors were positive for UCP1 and vimentin, and negative for cytokeratin. Hibernoma is an important differential diagnosis in dogs with conjunctival and periocular swellings that exfoliate numerous, mildly atypical, vacuolated cells.     

Metastatic pancreatic polypeptide‐secreting islet cell tumor in a dog

Abstract: A 14‐year‐old female spayed Golden Retriever was presented to the University of Florida's Veterinary Medical Center with history of lymphoplasmacytic gastroenteritis, intermittent vomiting, watery diarrhea, and weight loss for over a year. CBC, biochemical profile, and urinalysis were within reference intervals. Abdominal ultrasonographic examination revealed mesenteric and jejunal lymphadenopathy and hyperechoic hepatic nodules. Cytologic examination of the enlarged lymph nodes revealed loosely cohesive cells with moderate nuclear pleomorphism and rare punctate eosinophilic cytoplasmic granules. The cytologic interpretation was metastatic neuroendocrine neoplasia. On surgical exploration, a mass was detected in the right lobe of the pancreas. Histologic evaluation determined the mass to be an islet cell tumor. Approximately 98% of cells were positive by immunolabeling for pancreatic polypeptide (PP), and only rare cells were positive for insulin or somatostatin. All cells were negative for glucagon, gastrin, vasoactive intestinal polypeptide, protein gene product 9.5, synaptophysin, and chromogranins A and B. Pancreatic tumors that primarily produce PP are rare in dogs, and this is the first report of both the cytologic and histologic features of an islet cell tumor predominantly secreting PP. Clinical signs for these tumors are typically absent or nonspecific; signs may include watery diarrhea, as noted in this dog, although the diarrhea may have resulted from lymphoplasmacytic gastroenteritis. Additional case studies are needed to further characterize the cytomorphologic features and clinical presentation of PP‐secreting islet cell tumor, or polypeptidoma, in dogs.     

A true "triphasic" pattern: thoracolumbar spinal tumor in a young dog

An 8-month-old male Bernese Mountain Dog was referred with a history of hindlimb weakness that progressed to paresis on the right side. An intradural mass was detected in the spinal canal at the level of the 2nd and 3rd lumbar vertebrae. During surgical removal, 2 small fragments of the mass were prepared for cytologic examination by the squash technique. Cytologic examination revealed 3 different cell types: mesenchymal (stromal) cells, epithelial cells, and small undifferentiated hyperchromatic cells. On the basis of location and the triphasic cytologic pattern, a diagnosis of spinal nephroblastoma (thoracolumbar spinal tumor of young dogs) was made; histologic examination of the mass confirmed the cytologic diagnosis. To our knowledge, this is the first report of a triphasic pattern in a cytologic sample; recognizing this pattern is an important aid in reaching a definitive cytologic diagnosis.     

Carcinoma in the urinary bladder of a cat: cytologic findings and a review of the literature

Percutaneous fine needle aspiration biopsy (FNAB) was used to diagnose a urinary bladder carcinoma in an aged cat. The cytologic appearance of specimens collected initially was similar to that reported for canine transitional cell carcinoma. However, impression smears of the tumor made at necropsy 7 weeks later consisted predominantly of atypical squamous epithelial cells compatible with squamous cell carcinoma. Histologically, the malignancy was noted to have intermixed areas of abnormal squamous and transitional cell proliferation. The neoplasia was interpreted as a transitional cell carcinoma with extensive transformation to squamous cell carcinoma. This report examines the use and limitations of FNAB in the diagnosis of feline urinary bladder carcinoma and the incidence and behavior of these tumors in the cat.     

Fractal dimension of canine mammary gland epithelial tumors on cytologic smears

BACKGROUND: Fractal geometry is a tool that can be used for describing, modeling, analyzing, and processing irregular and complex figures. Past investigations in medicine have revealed that fractal analysis could also be applied in tumor pathology to characterize irregular boundaries of the nuclei of tumor cells. OBJECTIVE: The aim of this study was to define whether the fractal dimension parameter could be used on cytologic specimens to differentiate benign from malignant canine mammary gland epithelial tumors. METHODS: The fractal dimension of nuclear surface was determined by computer-assisted morphometry on Hemacolor-stained cytologic smears obtained by fine needle aspiration of normal canine mammary gland epithelial cells, and cells in mammary adenomas, tubulopapillary carcinomas, solid carcinomas, and anaplastic carcinomas. Data were analyzed by Mann-Whitney U test. RESULTS: Significant differences (P <.001) were observed in mean fractal dimension among all tumor types and in comparison with normal canine mammary gland epithelial cells (except for the fractal dimension between solid carcinomas and anaplastic carcinomas). CONCLUSION: The morphometric parameter, fractal dimension, could help in the diagnostic discrimination between benign and malignant canine mammary gland epithelial tumors on cytologic specimens.     

Subcutaneous embryonal rhabdomyosarcoma in a dog: cytologic, immunocytochemical, histologic, and ultrastructural features

Abstract: A subcutaneous mass on the left antebrachium of an 11‐year‐old intact female English Pointer dog was evaluated presurgically by cytologic examination and immunocytochemical staining. The sample consisted of discrete, variably sized, markedly pleomorphic neoplastic cells that expressed vimentin with diffuse cytoplasmic staining, desmin with focal paranuclear staining, and myoglobin with diffuse cytoplasmic staining, consistent with a diagnosis of rhabdomyosarcoma. Lymphocytic and histiocytic markers were negative. Aspirates of the enlarged ipsilateral prescapular lymph node were positive for metastatic disease. Surgical excision of the tumor and lymph node were followed by histologic and electron microscopic examination. Histomorphologic appearance of neoplastic cells from the mass and the lymph node paralleled cytologic findings; the histologic diagnosis was round cell variant of embryonal rhabdomyosarcoma. By ultrastructural evaluation, cells contained numerous mitochondria and masses of cytoplasmic tangled myofilaments, features typical of rhabdomyoblasts. The dog received doxorubicin (30 mg/m²) every 3 weeks for 5 treatments. Local recurrence developed 6 months after resection but was not treated. Despite a guarded prognosis and untreated local recurrence, the dog was still alive 18 months after surgery. Cytologic evaluation and immunocytochemical staining were pivotal for the presurgical diagnosis of rhabdomyosarcoma.     

Immunocytochemical study of Ki-67 as a prognostic marker in canine mammary neoplasia

Background: Canine mammary tumors are challenging for clinicians and pathologists because of complex histologic classification, low specificity of cytologic diagnosis, and unpredictable biological behavior. In histologic specimens, expression of tumor proliferation marker Ki‐67, a nuclear nonhistone protein, has been shown to have prognostic value for canine mammary tumors and to correlate with malignancy and low survival rates. Objective: The objective of this study was to measure the proliferation index of canine mammary tumors by immunochemical detection of Ki‐67 in cytologic specimens and to determine its relationship to clinical and pathologic variables and patient outcome. Methods: Spontaneous mammary tumors from 31 female dogs were surgically excised. Imprint specimens for cytologic evaluation were wet‐fixed in ethanol; histologic specimens were prepared routinely. Immunostaining was performed with the PH 177 monoclonal antibody against Ki‐67; proliferation index was graded from negative to +++. Dogs were followed for 18 months. Multivariate logistic regression analysis was used to determine correlations between immunocytochemical results, tumor and clinical variables, and patient outcome. Results: Ki‐67 proliferation indices in cytologic specimens were significantly lower for nonmalignant tumors than for malignant tumors. High index values of Ki‐67 were positively correlated with metastasis, death from neoplasia, low disease‐free survival rates, and low overall survival rate. With the exception of 4 specimens for which cellularity was insufficient, positive expression of Ki‐67 in cytologic specimens correlated with that of histologic specimens. Conclusions: The prognostic value of the Ki‐67 index in canine mammary tumors by using wet‐fixed cytology imprint specimens was similar to that observed previously for histologic specimens. Immunocytochemical detection of Ki‐67 could improve the accuracy and value of cytology by providing safe and rapid information about malignancy and patient outcome.