Inflammatory myofibroblastic tumour in the nasal cavity of a dog

A 4·5‐year‐old, female neutered Leonberger was presented with a 2‐month history of sneezing, nasal discharge and epistaxis. A presumptive diagnosis of nasal aspergillosis was made based on a suspected (fungal) granuloma on rhinoscopic examination and fungal hyphae on cytological examination. A poor response to targeted therapy was observed and computed tomography 16 months after initial presentation revealed a progressive, locally invasive mass lesion. Histopathological and immunohistochemical analysis of deep surgical biopsies revealed a spindle cell population and a plasma cell rich inflammatory infiltrate, with diffuse expression of vimentin, supporting a diagnosis of inflammatory myofibroblastic tumour. Complete resolution of the nasal discharge and reduced sneezing frequency was reported 9 months post‐surgical debridement via rhinotomy. To the authors’ knowledge, this is the first report of IMT in the nasal cavity of a dog. IMT should be considered when presented with a nasal mass lesion, particularly if histopathological features and clinical course are inconsistent.     

Temporary regression of locally invasive polypoid rhinosinusitis in a dog after photodynamic therapy

A 5‐year‐old male cross‐breed dog with chronic rhinosinusitis was presented. Computed tomography (CT) revealed opacities consistent with soft tissue or fluid in the left nasal cavity and frontal sinus. A diagnosis of chronic rhinosinusitis with myxomatous polyps was based on the histology of biopsy samples, so prednisolone treatment was administered for 1 month. Although the clinical signs slightly improved, no changes were observed on the CT images. At 8 months after the initial presentation, the dog was treated with antivascular photodynamic therapy (PDT) using benzoporphyrin derivative monoacid ring A and, 11 days later, CT revealed remarkably decreased soft tissue opacity; the facial swelling and sneezing also resolved. Three additional sessions of PDT were performed at 114, 210, and 303 days after the first PDT because of recurrence of clinical signs. The disease was well controlled for approximately 10 months by antivascular PDT.     

Suture exostosis with concurrent nasal septum chondrosarcoma in a horse

A 15‐year‐old Hanoverian mare presented with a 10‐day history of facial swelling in the right maxillary and frontal regions, left epiphora and intermittent right epistaxis. Radiographs revealed suture exostosis of both nasofrontal sutures and a deviated and thickened nasal septum. Computed tomography (CT) of the skull revealed exostosis of the nasolacrimal sutures and ducts bilaterally of both nasofrontal sutures and of the right zygomatocomaxillary and lacrimomaxillary sutures. The mid‐to‐caudal aspect of the nasal septum was thickened and had multiple well demarcated hypoattenuated regions within the septum. Histological examination of biopsies taken from the right nasofrontal suture and the nasal septal mass revealed suture exostosis and nasal septum chondrosarcoma. The horse was treated with rest and anti‐inflammatories. The facial swelling and left epiphora were improved at 7 months telephone follow‐up. This report is the first to describe a nasal septum chondrosarcoma in a horse. Additionally, we suggest that the suture exostosis may have developed due to an alteration of the biomechanics of the skull sutures secondary to the septal tumour.     

Intranasal malignant melanoma in a dog

A 10-year-old, female Newfoundland-cross dog was presented for evaluation of chronic intermittent unilateral epistaxis, nasal stertor, and sneezing. Nasal magnetic resonance imaging revealed a 3 x 5-cm mass in the left nasal cavity. Histopathological evaluation of nasal biopsies determined that the mass was a malignant melanoma. The mass was surgically resected and treated with bilateral opposed photon-beam radiation. This is the first report to describe the presentation, diagnosis, and treatment of an intranasal malignant melanoma in a dog.     

Retrobulbar pigmented peripheral nerve sheath tumor in a dog

A 1‐year‐old male castrated Pug was referred for unilateral exophthalmos unresponsive to oral antibiotic and anti‐inflammatory therapy. Clinical findings included exophthalmos of the left eye with lateral strabismus, resistance to retropulsion, and an elevated nictitans. Hematologic and biochemical analyses were within normal limits. Findings following computed tomography (CT) of the head included an expansile retrobulbar soft tissue mass with bony lysis extending into the left nasal cavity and nasopharynx. Ultrasound‐guided fine‐needle aspirates and biopsy samples obtained via rhinoscopy were nondiagnostic. Palliative exenteration was elected; the patient was euthanized 13 weeks following exenteration due to development of neurologic signs and perceived poor quality of life. The histopathologic diagnosis was a malignant pigmented peripheral nerve sheath tumor.     

Computer tomographic imaging in 4 dogs with primary nasal canine transmissible venereal tumor and differing cellular phenotype

Primary nasal canine transmissible venereal tumor (CTVT) without genital affection is uncommon. The aim of this report was to describe the primary nasal CTVT findings and CT staging in 4 dogs with different cytological phenotypes. Three male dogs and 1 bitch were evaluated for their chronic histories of sneezing, snoring, mucopurulent nasal discharge and nasal deformation. Cytological examination of nasal secretions suggested CTVT, confirmed by histopathological examination and LINE‐1/c‐myc. Males had the plasmacytoid phenotype of CTVT, and the bitch had the lymphocytoid phenotype. CTVT were staged based on the CT findings using modified Adams staging system. The bitch was classified as stage 1, 2 males were classified as stage 3 and 1 male as stage 4. All dogs had a complete tumoral remission after chemotherapy. Plasmacytoid phenotype was identified in cases with most important damage of the nasal cavity. However, the cytological type did not affect the response to chemotherapy.     

Intranasal hemangiosarcoma in a dog

Magnetic resonance (MR) was conducted for an 8-year-old, intact male Spitz with sneezing, serous discharge and epistaxis from the left nasal cavity. MR imaging showed a nasal cavity-occupied mass of iso-intensity on T1WI , high-intensity on T2WI and markedly enhanced on contrast-enhanced T1WI at parts of rostal to medial ocular angle in the left cavity. After Surgery and intraoperative radiation, the mass was diagnosed intranasal hemangiosarcoma by histopathology. Although the dog showed the finding, which suggested recurrence after the treatment ending, about 30 months later, it maintained good conditions without evidence of metastasis.     

Outcome of a dog undergoing definitive‐intent intensity‐modulated radiation therapy for an intranasal ganglioneuroma

An 11‐year‐old intact male Shiloh Shepherd was presented for evaluation of epistaxis, decreased nasal airflow, and destructive caudal nasal lesion identified using CT. Histopathologic evaluation of the nasal mass was consistent with a ganglioneuroma. The dog was treated with 10 × 4.2 Gy using IMRT technique. Post radiation therapy (RT), improvement in clinical signs were noted. Tumor progressed in size based on CT evaluation at 49 days, 3, and 6 months post‐treatment. A grade 2 oral mucositis was the only RT side effect noted. Radiation therapy as described above was completed without evidence of high‐grade radiation toxicities and has potential to improve clinical signs but failed to induce tumor response.     

COMBINATION OF COMPUTED TOMOGRAPHIC IMAGING CHARACTERISTICS OF MEDIAL RETROPHARYNGEAL LYMPH NODES AND NASAL PASSAGES AIDS DISCRIMINATION BETWEEN RHINITIS AND NEOPLASIA IN CATS

Feline nasal diseases are a diagnostic challenge. The objective of this retrospective, cross‐sectional study was to determine whether computed tomography (CT) imaging characteristics of the medial retropharyngeal lymph nodes (MRPLN), alone or in combination with CT imaging characteristics of the nasal passages, could aid in differentiation between rhinitis and nasal neoplasia. Cats were recruited from record archives at two veterinary facilities during the period of 2008–2012. Selection criteria were presentation for chronic nasal discharge, contrast‐enhanced CT of the head that included the MRPLN, and rhinoscopic nasal biopsy resulting in diagnosis of rhinitis or neoplasia. For each CT scan, two board‐certified veterinary radiologists recorded MRPLN size, attenuation, heterogeneity, contrast‐medium enhancement, margination, shape, presence of a lymph node hilus, perinodal fat, turbinate lysis, paranasal bone lysis, and nasal mass. Both readers were unaware of patient information at the time of CT interpretation. Thirty‐four cats with rhinitis and 22 cats with neoplasia were included. Computed tomographic characteristics significantly associated with neoplasia included abnormal MRPLN hilus (OR 5.1), paranasal bone lysis (OR 5.6), turbinate lysis (5.6), mass (OR 26.1), MRPLN height asymmetry (OR 4.5), and decreased MRPLN precontrast heterogeneity (OR 7.0). The combined features predictive of neoplasia were a nasal mass with abnormal hilus (OR 47.7); lysis of turbinates/paranasal bones with abnormal MRPLN hilus (OR 16.2). Findings supported the hypothesis that combining CT features of the nasal passages and MRPLN aided in differentiating rhinitis from neoplasia in cats.     

Direct approach to the nasal cavity through a bone flap for the treatment of a large nasal cyst

A 21‐year‐old Warmblood mare was referred to the Equine Department, Vetsuisse Faculty, University of Zurich, because of recurrent unilateral nasal discharge 3 months after partial removal of a large cyst from the left maxillary and frontal sinuses. Endoscopic, radiographic and computed tomographic examinations showed that the remnant of the cyst, which originally had extended from the left maxillary and frontal sinuses into the left nasal cavity, had expanded and was obliterating the left middle nasal meatus. A direct surgical approach to the cyst through the left nasal and maxillary bones rostral to the facial crest was chosen, which allowed evaluation and removal of the entire cyst. Endoscopic examination 3 days post operatively showed no remnants of the cyst, and the mare was discharged in good health. Re‐examination one year later showed no recurrence of the cyst.     

Idiopathic osseous hyperplasia of the nasal turbinates in a Welsh terrier

A three-year-old Welsh terrier was presented with a 6-month history of progressive stertor, exercise intolerance and sneezing which was unresponsive to symptomatic treatment. A large calcified mass occupying the entire rostral right nasal cavity was defined with computed tomography. The mass was completely removed via a dorsal rhinotomy. Histopathological examination of the mass revealed osseous hyperplasia of the nasal turbinates. The excision led to complete resolution of clinical signs and there has been no recurrence 18 months after surgery.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHY FINDINGS IN A CASE OF METASTATIC OVARIAN ADENOCARCINOMA IN A DOG

A 5‐year‐old female entire German Shepherd presented for otitis and lethargy. An incidental abdominal mass was identified on examination. Ultrasound examination (US) identified a heterogeneous left ovarian mass. Computed tomography (CT) was performed for surgical planning and staging. The reproductive tract was removed en bloc and submitted for histopathology. Multiple small (1–5 mm) nodules identified at coeliotomy on the surface of the liver, spleen and peritoneum were biopsied. The lesions were not visible on CT nor US on review. This is the first case report of the CT findings of ovarian papillary adenocarcinoma with carcinomatosis.     

Successful medical treatment of an orbital osteoma in a dog

A 6‐year‐old neutered male German Shepherd‐mixed breed with a 2‐month history of bilateral conjunctival hyperemia, epiphora, and a firm, slowly progressive swelling of the medial canthal region of the left eye (OS) was examined. Ophthalmic examination OS revealed a firm and smooth mass, extending from the medial canthus toward the medial orbital wall. Indirect ophthalmoscopy revealed indentation of the nasal part OS, which corresponded to the position of the orbital mass. Orbital neoplastic diseases were the main differential considerations. Computerized tomography revealed a bony smooth orbital mass without bone destructive features. Biopsy was performed, and histologic features were suggestive of osteoma. Systemic nonsteroidal anti‐inflammatory (NSAID) drugs resulted in complete mass regression and absence of clinical signs for 5 years following initial diagnosis. This report describes the first case of canine orbital osteoma, which was responsive to NSAIDs.     

Nasal infestation by Linguatula serrata in a dog in the UK: a case report

A two‐year‐old, female neutered, cross‐breed dog imported from Romania was diagnosed with nasal infestation of Linguatula serrata after she sneezed out an adult female. The dog was presented with mucopurulent/sanguinous nasal discharge, marked left‐sided exophthalmia, conjunctival hyperaemia and chemosis. Computed tomography and left frontal sinusotomy revealed no further evidence of adult parasites. In addition, there was no evidence of egg shedding in the nasal secretions or faeces. Clinical signs resolved within 48 hours of sinusotomy, and with systemic broad‐spectrum antibiotics and non‐steroidal anti‐inflammatory drugs. Recommendations are given in this report regarding the management and follow‐up of this important zoonotic disease.     

Tritrichomonas foetus and Mycoplasma felis coinfection in the upper respiratory tract of a cat with chronic purulent nasal discharge

A 5‐year‐old indoor male neutered Siamese cat was presented with clinical signs of sneezing and chronic bilateral purulent nasal discharge. Multiple nasal cavity swabs were submitted for bacterial cultures, Mycoplasma felis‐DNA qPCR, and cytology. M felisqPCR was positive and cytomorphologic diagnosis was severe, acute, purulent, rhinitis with intralesional protozoal microorganisms consistent with a Trichomonas spp. Nested PCR (nPCR) confirmed the diagnosis of Tritrichomonas foetus. Systemic therapy with doxycycline for M felis and metronidazole for T foetus was started with remission of clinical signs within 2 weeks; however, symptoms relapsed shortly after therapy was discontinued. This study represents the first documented case of T foetus associated with chronic nasal discharge in a cat, which supports the hypothesis that T foetus can live in the nasal cavity. It is also the first reported case of M felis and T foetus coinfection, which indicates that with mycoplasmal feline upper respiratory tract infections, T foetus should be considered as a coinfecting agent.     

Nasal vascular hamartoma in a Domestic Shorthair cat

A nasal mass in a Domestic Shorthair cat was causing facial deformity, sneezing and intermittent epistaxis. Biopsy samples obtained previously had been non-diagnostic. Computed tomography images revealed an irregular, contrast-enhancing mass occupying a large portion of the righthand side of the nasal cavity. Previously described criteria for malignancy were not present. A ventral surgical approach combined with temporary, ipsilateral, common carotid arterial occlusion provided excellent access for debulking the lesion and collecting samples for histopathology. A nasal vascular hamartoma was diagnosed and clinical signs resolved postoperatively. This is the first documentation of this abnormality in the cat. Hamartomatous abnormalities should be included on the list of differential diagnoses for feline nasal mass lesions. The prognosis for hamartomatous lesions postoperatively is good, in keeping with their limited propensity for growth after maturity.     

Resection of the incisive bone and rostral maxillae for removal of an ossifying fibroma in an 18‐year‐old Warmblood gelding

A 510 kg, 18‐year‐old Warmblood gelding used for high level dressage was presented with a 6 week history of a growing mass at the rostral aspect of the incisive bone. Radiographic examination of the maxillae showed an osteolytic lesion between the left maxillary central and intermediate teeth spreading caudally into the hard palate. Biopsy of the mass was consistent with an aggressive oral fibrosarcoma. Diagnostic work‐up ruled out metastatic lesions. An amputation of the incisive bone and part of the rostral maxillae was performed with the intent of removing the mass in healthy margins. However, the neoplastic tissue extended to the rostral aspect of the ventral nasal conchae and a resection in healthy margins was not performed to avoid surgical complications due to communication with the nasal conchae. After surgery, the horse's appetite and food uptake were not impaired and cosmetic appearance was excellent. Active drains were used in order to prevent any submucosal collection of fluids. Histopathological examination of the surgical margins of the removed maxillae confirmed the presence of tumoural tissue. Even though excision of the tumour was not complete, no macroscopic local recurrence was reported post operatively at 36 months' follow‐up. Based on histological re‐evaluation of the removed tissue and the absence of recurrence a definitive diagnosis of ossifying fibroma was made.     

Four cats with fungal rhinitis

Fungal rhinitis is uncommon in the cat and cases of nasal aspergillosis-penicilliosis have been rarely reported. Signs of fungal rhinitis include epistaxis, sneezing, mucopurulent nasal discharge and exophthalmos. Brachycephalic feline breeds seem to be at increased risk for development of nasal aspergillosis-penicilliosis. Computed tomography (CT) imaging and rhinoscopy are useful in assessing the extent of the disease and in obtaining diagnostic samples. Fungal culture may lead to false negative or positive results and must be used in conjunction with other diagnostic tests. Serological testing was not useful in two cats tested. The cats in this study were treated with oral itraconazole therapy. When itraconazole therapy was discontinued prematurely, clinical signs recurred. Hepatotoxicosis is a possible sequel to itraconazole therapy.     

Nasal infection with Scedosporium apiospermum in a dog

CASE HISTORY: A 2-year-old female Siberian Husky was presented with a 6-month history of sneezing and mucous discharge from the right nostril. CLINICAL FINDINGS: Reduced airflow through the right nostril was evident. Radiographs showed subtle loss of detail of turbinates within the right nasal chamber. Rhinoscopy revealed swollen and erythematous turbinates and a white mass within the caudal aspect of the right nasal cavity. Histopathologically, there was a heavy mixed inflammatory infiltrate in the submuscosa of the right turbinate, and the presence of fungal hyphae and spores in the white mass. A heavy growth of Scedosporium apiospermum was cultured from the mass. DIAGNOSIS: Chronic rhinitis of the right nasal cavity and infection with S. apiospermum. CLINICAL RELEVANCE: This is the first reported case of S. apiospermum isolated from the nasal cavity of a dog in New Zealand. Fungal culture is necessary to differentiate this fungus from Aspergillus spp.