IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF METASTATIC CEREBRAL LYMPHOMA IN A DOG

We describe histopathologically confirmed intracranial metastasis of cutaneous lymphoma. In magnetic resonance (MR) images there was a heterogeneous, contrast‐enhancing, extraaxial mass in the right parietal and piriform lobes at the level of the optic chiasm. Our MR imaging findings are consistent with reports in humans in that lymphoma masses have indistinct borders that are iso‐ to hyperintense relative to adjacent gray matter on T2‐weighted images. Our report varies from findings in humans in that the mass was extraaxial, whereas masses reported in humans are intraaxial. Contrast enhancement can be heterogeneous, as in our report, or homogeneous.     

MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL GRANULAR CELL TUMORS IN SIX DOGS

Magnetic resonance (MR) imaging characteristics of intracranial granular cell tumors (GCTs) have been previously reported in three dogs. The goal of this retrospective study was to examine a larger number of dogs and determine whether distinctive MR characteristics of intracranial GCTs could be identified. Six dogs with histologically confirmed intracranial GCTs and MR imaging were included. Tumor location, size, mass effect, T1‐ and T2‐weighted signal intensity, and peritumoral edema MR characteristics were recorded. In all dogs, GCTs appeared as well‐defined, extra‐axial masses with a plaque‐form, sessile distribution involving the meninges. All tumors were located along the convexity of the cerebrum, the falx cerebri, or the ventral floor of the cranial vault. All tumors were mildly hyperintense on T1‐weighted images, and iso‐ to hyperintense on T2‐weighted images. A moderate‐to‐severe degree of peritumoral edema and mass effect were evident in all dogs. Findings indicated that, while several MR imaging characteristics were consistently identified in canine cerebral GCTs, none of these characteristics were unique or distinctive for this tumor type alone.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF A CEREBRAL HEMANGIOBLASTOMA IN A DOG

The magnetic resonance (MR) imaging features of a cerebral hemangioblastoma in a 9‐year‐old dog are described. Imaging revealed a well‐defined contrast‐enhancing lesion of the rostral forebrain that appeared extraparenchymal. Histopathology of the excised mass showed clusters of small blood vessels interspersed with interstitial cells staining positive for neuronal specific enolase, features consistent with a cerebral hemangioblastoma; the mass also appeared intraparenchymal after further immunohistochemistry study. This neoplasm should be considered a rare differential diagnosis for intracranial masses in dogs.     

IMAGING DIAGNOSIS—MRI CHARACTERISTICS OF A FOURTH VENTRICULAR CHOLESTEROL GRANULOMA IN A DOG

A 2‐year‐old male American Bulldog experienced paroxysmal staggering, altered consciousness, and hyperesthesia. Magnetic resonance (MR) imaging enabled recognition of a fourth ventricular mass causing compression of the cerebellum and brainstem and obstructive hydrocephalus. The mass was uniformly T2‐hyperintense and predominantly T1‐hypointense. A fluid line was evident on the fluid‐attenuated inversion recovery images. A thin rim of contrast enhancement was noted. Histopathologic diagnosis was a cholesterol granuloma. We were unable to identify any other reports of a cholesterol granuloma residing in the fourth ventricle of a dog. This case report documents the clinical, diagnostic imaging, and histopathologic findings of a canine intracranial cholesterol granuloma. © 2012 Veterinary Radiology & Ultrasound.     

Gadolinium contrast medium administration does not adversely affect T2*‐weighted gradient recalled echo magnetic resonance imaging of the canine brain at 1.5 Tesla

As gadolinium‐based contrast agents are paramagnetic and have T2 shortening effects, they have the potential to adversely affect gradient recalled echo sequences. The aim of this prospective, cross‐sectional study was to evaluate the effects of gadolinium administration on T2*‐weighted sequence diagnostic quality and signal intensity when imaging the canine brain. A total of 100 dogs underwent brain magnetic resonance imaging (MRI) including pre‐ and postcontrast T2*‐weighted sequences acquired with a delay (Group A) or immediately (Group B) following gadolinium administration. Pre‐ and postcontrast images were subjectively compared. In dogs with intracranial enhancing masses, regions of interest were drawn on corresponding images and signal intensity ratios were calculated. The effect of degree and pattern of contrast enhancement, susceptibility artifacts, and time between contrast injection and T2*‐weighted sequence acquisition on signal intensity ratio was evaluated. Overall 31 dogs had contrast enhancing intracranial masses. Subjectively, there was no difference in image quality of T2*‐weighted sequences obtained before and after contrast medium administration. No significant signal intensity differences of intracranial contrast enhancing masses were found (Group A P = 0.9999; Group B P = 0.9992). Susceptibility artifacts did not differ in appearance, and there was no effect on calculated signal intensity ratio (P = 0.8142). Similarly, there was no effect of degree of enhancement or contrast heterogeneity on signal intensity ratio (P = 0.4413). No correlation was found between signal intensity ratio and the time to acquisition (P = 0.199). Administration of gadolinium‐based MRI contrast agents does not adversely affect T2*‐weighted imaging of the brain in dogs at 1.5 T even in the presence of contrast enhancing lesions.     

Pituitary Macrotumor Causing Narcolepsy‐Cataplexy in a Dachshund

Familial narcolepsy secondary to breed‐specific mutations in the hypocretin receptor 2 gene and sporadic narcolepsy associated with hypocretin ligand deficiencies occur in dogs. In this report, a pituitary mass is described as a unique cause of narcolepsy‐cataplexy in a dog. A 6‐year‐old male neutered Dachshund had presented for acute onset of feeding‐induced cataplexy and was found to have a pituitary macrotumor on magnetic resonance imaging (MRI). Cerebral spinal fluid hypocretin‐1 levels were normal, indicating that tumor effect on the ventral lateral nucleus of the hypothalamus was not the cause of the dog's narcolepsy‐cataplexy. The dog was also negative for the hypocretin receptor 2 gene mutation associated with narcolepsy in Dachshunds, ruling out familial narcolepsy. The Dachshund underwent stereotactic radiotherapy (SRT), which resulted in reduction in the mass and coincident resolution of the cataplectic attacks. Nine months after SRT, the dog developed clinical hyperadrenocorticism, which was successfully managed with trilostane. These findings suggest that disruptions in downstream signaling of hypocretin secondary to an intracranial mass effect might result in narcolepsy‐cataplexy in dogs and that brain MRI should be strongly considered in sporadic cases of narcolepsy‐cataplexy.     

IMAGING DIAGNOSIS — MAGNETIC RESONANCE IMAGING OF INTRACRANIAL INFLAMMATORY FIBROSARCOMA IN A MIXED BREED DOG

An 8‐year‐old mixed‐breed dog presented with progressive behavioral changes and altered mentation. Magnetic resonance imaging (MRI) of the brain revealed an olfactory and frontal lobe extra‐axial mass. The mass exhibited the following MRI signal intensity characteristics: T2W mixed, T1W iso‐ to hypointense, FLAIR hyperintense, and strong contrast enhancement. The mass was removed with cavitronic ultrasonic surgical aspirator (CUSA) assisted neurosurgery. Based on histopathological appearance and immunohistochemistry, the diagnosis of inflammatory fibrosarcoma was made. To our knowledge, this is the first report describing MRI characteristics of intracranial inflammatory fibrosarcoma in the veterinary literature.     

Comparison between symptomatic treatment and lomustine supplementation in 71 dogs with intracranial,space‐occupying lesions

Brain neoplasia is diagnosed in an increasing number of dogs. Consequently, there is a higher need for an effective treatment. Chemotherapy is considered in cases where surgery or radiation is not optional. The objective of this retrospective study was to evaluate the difference in median survival time (MST) of dogs with intracranial masses, treated symptomatically with corticosteroids and anti‐epileptic drugs, compared with the same symptomatic treatment supplemented with lomustine. The records of 71 dogs with intracranial masses were retrospectively evaluated. Fifteen dogs were treated symptomatically with corticosteroids and anti‐epileptics, and 56 dogs received additional therapy with lomustine. There was no statistically significant difference in MST between both groups, being 60 and 93 days, respectively. Age, duration of symptoms, intracranial localization of the mass and intra‐ or extra‐axial localization had no influence on survival time. However, female dogs survived significantly longer than male dogs.     

B‐cell lymphoma with Mott cell differentiation in two young adult dogs

Abstract: Two young adult dogs with gastrointestinal signs were each found to have an intra‐abdominal mass based on physical examination and diagnostic imaging. On exploratory laparotomy, small intestinal masses and mesenteric lymphadenopathy were found in both dogs; a liver mass was also found in dog 1. Cytologic and histologic examination of intestinal and liver masses and mesenteric lymph nodes revealed 2 distinct lymphoid cell populations: lymphoblasts and atypical Mott cells. With Romanowsky stains, the atypical Mott cells contained many discrete, clear to pale blue cytoplasmic inclusions consistent with Russell bodies that were positive by immunohistochemistry for IgM and CD79a in both dogs and for IgG in dog 2. The Mott cells and occasional lymphoblasts stained strongly positive with periodic acid‐Schiff. Using flow cytometric immunophenotyping in dog 1, 60% of peripheral blood mononuclear cells and 85% of cells in an affected lymph node were positive for CD21, CD79a, IgM, and MCH II, indicative of B‐cells. With electron microscopy, disorganized and dilated endoplasmic reticulum was seen in Mott cells in tumors from both dogs. Antigen receptor gene rearrangement analysis of lymph node and intestinal masses indicated a clonal B‐cell population. Based on cell morphology, tissue involvement, and evidence for clonal B‐cell proliferation, we diagnosed neoplasms involving Mott cells. To the authors' knowledge, this is the second report of Mott cell tumors or, more appropriately, B‐cell lymphoma with Mott cell differentiation, in dogs. More complete characterization of this neoplasm requires further investigation of additional cases. This lymphoproliferative disease should be considered as a differential diagnosis for canine gastrointestinal tumors.     

Hepatic AA amyloidosis in a cat: cytologic and histologic identification of AA amyloid in macrophages

A 3‐year‐old, spayed female, Domestic Shorthair cat presented with anorexia, lethargy, vomiting, probable hemoabdomen, and multiple masses on the right lateral liver lobe. Clinicopathologic and imaging abnormalities included anemia, azotemia, icterus, and hepatomegaly with hypoechoic masses. On cytologic evaluation of a fine‐needle aspiration of a liver mass there was abundant extracellular pink‐ to purple‐colored material between hepatocytes. The amorphous material was stained with direct fast scarlet (DFS), and green birefringent areas were observed under polarized light, confirming the presence of amyloid. A unique finding on the cytologic smear were macrophages containing amorphous and fibrillar amyloid‐like protein. Histopathologic examination using H&E and Congo red staining confirmed amyloid deposits within the space of Disse, along the sinusoids, portal tracts, blood vessel walls, and within the cytoplasm of macrophages. Immunohistochemical staining with anti‐AA amyloid antibodies further confirmed the presence of AA amyloid. To the author's knowledge, this is the first report of the cytologic finding of AA amyloid protein within macrophages and DFS stain detection of amyloid on a cytologic smear.     

Use of multi‐detector computed tomographic angiography in the diagnosis of a parapharyngeal aneurysm in a 6‐week‐old foal

Multidetector‐row computed tomographic contrast angiography (MDCTA) is routinely employed to investigate vascular masses in human patients but, to date, the use of this technique to investigate an aneurysmal mass has not been reported in an equine case. The potential of MDCTA to investigate a right‐sided parapharyngeal mass in a 6‐week‐old Thoroughbred foal was therefore investigated. A 4‐slice helical computed tomography scanner was used on a superficial, firm, ovoid mass yielding arterial blood on fine needle aspiration. MDCTA enabled identification of the vessels involved thus assisting in forming a diagnosis based on the morphology of the lesion and aided surgical planning. Histology confirmed the presence of mural thrombus and calcification within the smooth muscle wall consistent with a true aneurysm. MDCTA provided additional information to conventional imaging in this case of vascular masses of the head and neck. The technique therefore has the potential to improve diagnosis and assist in the management of such lesions.     

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.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF ODONTOGENIC NEOPLASMS IN DOGS

Odontogenic neoplasms are locally invasive oral tumors in dogs. The purpose of this retrospective study was to describe CT characteristics for varying histopathologic types of canine odontogenic neoplasms. A board‐certified veterinary radiologist who was unaware of histologic findings reviewed and scored imaging studies. A total of 29 dogs were included in the study. Twenty‐three of these dogs had concurrent dental radiographs. The most common CT characteristics for all tumor types were a direct association with or in the region of multiple teeth in 96.4% (27/28), contrast enhancement in 96.3% (26/27), alveolar bone lysis in 93.1% (27/29), and mass‐associated tooth displacement in 85.2% (23/27). Mass‐associated cyst‐like structures were identified in 53.6% (15/28) and were only present in tumors containing odontogenic epithelium. Canine acanthomatous ameloblastomas (n = 15) appeared as extra‐osseous (10/15) or intra‐osseous (5/15) masses. Intra‐osseous canine acanthomatous ameloblastomas were more likely to have mass‐associated cyst‐like structures and were subjectively more aggressive when compared with extra‐osseous canine acanthomatous ameloblastomas. Amyloid‐producing odontogenic tumors (n = 3) had subjectively uniform CT imaging characteristics and consisted of round soft tissue and mineral attenuating masses with multiple associated cyst‐like structures. Fibromatous epulides of periodontal ligament origin (n = 4) were contrast enhancing extra‐osseous masses that were rarely referred for CT examinations and 25% (1/4) were not visible with CT. Other odontogenic tumors were less represented or had more variable CT imaging characteristics. Mass‐associated tooth destruction was appreciated more often with dental radiographs and extra‐oral tumor extension was identified more often with CT.     

Primary extracranial nasopharyngeal meningioma in a dog

An 8‐year‐old Labrador Retriever was presented for inspiratory efforts with stertor. A rhinoscopy and a magnetic resonance imaging scan were performed and revealed a naso‐pharyngeal mass. The mass was identified in the nasopharynx without meningeal extension. This mass was both T1‐ and T2‐hyperintense, compared to normal brain parenchyma without significant postcontrast enhancement. The mass was surgically removed and the histologic diagnosis was a mesenchymal tumor. Immunohistochemistry with antibodies was conducted and consistent with an extracranial meningioma. To the authors’ knowledge, this is the first case report documenting a primary extracranial nasopharyngeal meningioma in a dog.     

Parotid salivary gland carcinoma in a geriatric horse

This case report describes a geriatric gelding with a 2 month history of fast‐growing masses within the parotid and submandibular regions. The horse was dyspnoeic on presentation and upper airway endoscopy revealed partial airway obstruction at the level of the pharynx, secondary to a space‐occupying mass. Cytological evaluation of multiple fine‐needle aspirates obtained from the masses were suggestive of salivary gland neoplasia, therefore the horse was subjected to humane euthanasia. A computed tomographical scan was obtained post mortem and revealed a large multi‐lobulated mass involving both guttural pouches, resulting in 80% occlusion of the naso‐ and oropharynx. Histopathology confirmed a parotid salivary gland carcinoma (papillary‐cystic type). Salivary gland tumours are extremely rare in horses, with only a few cases reported in the literature. Treatment of these malignancies proves to be challenging, requiring complete parotidectomy or surgical debulkment, in combination with adjunctive therapy.     

Pancreatic mixed acinar-endocrine carcinoma in a dog

A 10.5‐year‐old crossbreed dog was presented with a history of hypoglycaemic episodes and elevated serum insulin concentration. A pancreatic mass was removed at surgery along with an enlarged draining lymph node. An unresectable hepatic nodule was also present. Immunohistochemistry confirmed the pancreatic and lymph node masses as functional mixed acinar‐endocrine carcinoma, previously unreported in domestic species. Persistent hypoglycaemia and hyperinsulinaemia post‐operatively was highly suggestive of the hepatic mass being a functional metastasis. The dog was managed on prednisolone and remained asymptomatic 9 months post‐operatively. This tumour type has only been rarely reported in human patients and may highlight the need for more rigorous immunohistochemical staining of pancreatic masses in veterinary species to identify the prevalence of this tumour type.     

IMAGING DIAGNOSIS—MALIGNANT PERIPHERAL NERVE SHEATH TUMOR PRESENTING AS AN INTRA‐AXIAL BRAIN MASS IN A YOUNG DOG

A 3‐year‐old Labrador retriever was presented with acute onset seizures. Magnetic resonance imaging demonstrated an intra‐axial mass affecting the right temporal lobe of the brain. Surgical resection and histopathological findings were most consistent with a malignant peripheral nerve sheath tumor. After initial recovery, deterioration 3 months post surgery prompted euthanasia. Post‐mortem revealed a mass protruding from the ventral surface of the temporal lobe, encroaching upon the optic chiasm and invading the brain. Histopathology findings were again consistent with malignant peripheral nerve sheath tumor. Although rare, this tumor should be included as a possible differential diagnosis for intra‐axial brain masses in dogs.