Primary Diffuse Large B Cell Lymphoma in Kidney with Involvement of Central Nervous System and Heart in a Siamese Cat

Background: Lymphoma is the most common neoplasia in cats and usually happens in middle-aged males of European breeds, FeLV-positive test is also observed in 25% to 50% of these cases. The diagnostic of renal lymphoma is based on clinical signs, the diagnosis is based on clinical signs associated with additional tests. Histological an immunohistochemical evaluations allows the classifcation which can provide prognostic information. Central nervous system metastasis is frequently reported, but lingual and lung lobe extension were also reported. Here, we report a case of renal lymphoma with systemic involvement of heart and CNS in a cat. Case: A 3-year-old male Siamese cat presented with weight loss, emesis, anorexia, polydipsia and polyuria for at least 3 weeks. The clinical parameters were stable, but presenting pale mucosal membrane and also severe dehydration. Complete blood count and chemistry profle revealed anemia and severe azotemia. On abdominal palpation, bilateral renomegaly and irregular contours of both kidneys were also detected. The kidneys were enlarged and had irregular contours on palpation, confrmed by abdominal ultrasonography, that revealed kidneys with markedly irregular contours, and the presence of fluid with high cellularity between cortical and renal capsule (capsular fluid). An aspiration citology by fne-needle from the capsular fluid guided by ultrasound was collected and sent to cytological analysis, which suggested lymphoma. The aspirate was moderately cellular and consisted of large round cells with distinct, scant, basophilic cytoplasm, round nuclei with dense chromatin, inconspicuous nucleoli, and large amount of naked cells. On the second day of treatment the cat presented a cardiopulmonary arrest not responsive to cardiopulmonary cerebral resuscitation, died, and the owner authorized the necropsy, allowing the renal biopsy showing that the same neoplastic cells presented in kidneys were also seen in heart and central nervous system, suggesting the occurrence of primary renal lymphoma with involvement of to these tissues, and the diagnosis was high grade diffuse large cell lymphoma. And also histopathological exam diagnosed high grade diffuse large cell lymphoma. Discussion: The patient died, and the post-mortem histological analysis confrmed the diagnosis of primary diffuse large B cell lymphoma in kidney with systemic involvement of heart and central nervous system (CNS). Lymphoma is the most common renal tumor in cats, however primary feline renal tumors are rare and few reports are available at this time. Here we report the occurrence of primary renal lymphoma in a Siamese cat, and there´s no previous report of this type of lymphoma especially in this breed. More investigation is needed to evaluate the susceptibility of Siamese cat breed to the development of primary renal lymphoma. It is diffcult to determine whether the renal involvement is primary or it is a consequence of the multicenter type. In the present report the same neoplasic infltration observed in kidney was also found in central nervous system and heart. The cytology is a quickly, non-invasive, and sensitivity method for the diagnostic of lymphoma. However, the cytology do not provides the immune diagnosis of diffuse large B cell, and although it is useful for staging lymphoma, histopathology and immunohistochemistry is always necessary for classifcation and grading. Since the diagnosis, the cat of this report survived only 2 days, which reinforces the bad prognosis of renal lymphoma. The renal lymphoma should be considered as a potential cause of severe azotemia, and should be taken as the mainly differential diagnosis among neoplasias of kidneys in cats.Keywords: oncology, feline, extranodal, lymph nodes, cance

Timoma em cão. Relato de caso

Uma cadela, Dachshund, quatro anos, foi encaminhada ao H.V. da FMVZ-UNESP-Botucatu-SP com histórico de prostração, emagrecimento progressivo, anorexia, cansaço e tosse seca. Ao exame clínico observou-se apatia, secreção nasal serosa bilateral e dispnéia intensa. Radiografia torácica demonstrou efusão pleural, edema pulmonar acentuado, desvio dorsal da traquéia e possível massa mediastinal. A ultra-sonografia, após drenagem torácica, confirmou a presença de massa mediastinal, sendo classificada como neoplasia maligna de origem epitelial pela citologia aspirativa por agulha fina. O animal veio a óbito logo após o diagnóstico de neoplasia. À necropsia constatou-se massa mediastinal encapsulada, consistência macia e superfície de corte com coloração branco-acinzentada e áreas necrótico-hemorrágicas, localizada na região ântero-ventral do tórax. O exame histopatológico demonstrou células epiteliais neoplásicas, células linfóides (timócitos) com morfologia normal, vasos sangüíneos de pequeno e médio calibre, formações císticas com conteúdo eosinofílico e corpúsculos de Hassall. A imunohistoquímica apresentou positividade para citoqueratina AE1/AE3 e UCHL, confirmando o diagnóstico de timoma.A four years old Dachshund female dog was guided to the Veterinary Hospital of FMVZ-UNESP-Botucatu-SP with history of prostration, progressive weigh loss, anorexia, fatigue and drought coughs. Apathy, serous bilateral nasal discharge, intense dyspneia and lung edema were observed in the clinical exam. Thoracic X-ray showed pleural effusion and dorsal deviation of trachea and the presence of a mediastinal mass. The ultrasonography, after thoracic drainage and fine needle aspiration cytology, confirmed the presence of mediastinal mass classified as malignant neoplasm of epithelial origin. The animal died soon after the exams due to its bad clinical conditions. At necropsy mediastinal mass was located in the antero-ventral area of the thorax. It was encapsulated, with soft consistency and gray coloration with hemorragic and necrotic areas in the cut surface. The histopathology demonstrated neoplastic epithelial cells, lymphoid cells (thymocytes) with normal morphology, blood vessels of small and medium caliber, cystic formations with eosinophilic contents and Hassall corpuscles. The immunohistochemistry reaction was positive for cytokeratin AE1/AE3 and UCHL, confirming the thymoma diagnosis

Morphometric and Vascular Analyses and MMP-2 Expression in Bladders of Animals with Bovine Enzootic Haematuria

Background: Bovine enzootic haematuria is a chronic, non-infectious disease caused by the ingestion of bracken Pteridium aquilinum that contain ptaquiloside, substance responsible for the development of neoplasms in combination with bovine papillomavirus infection. Studies examining metalloproteinases have shown that these enzymes may be useful as prognostic markers and many studies have correlated the intratumoural microvessel density and incidence of metastasis in a variety of cancers, including bladder cancer. This study aimed to evaluate the urothelial morphology and vasculature and quantify the expression of the enzyme metalloproteinase-2 in the bladder lesions of bovine with enzootic haematuria.Materials, Methods & Results: Forty bladders with macroscopic lesions were subjected to routine histological processing. The material was stained using the Hematoxylin-Eosin (HE) and Weigert's resorcin-fuchsin staining methods. The morphometric analysis included the measurement of the total thickness of the urothelium. Microscopically, the lesions were differentiated as neoplastic or non-neoplastic, and the vascular changes were characterised as vascular proliferation, ectasia, dilation and thickening and the material stained using the Weigert's resorcin-fuchsin method was used to evaluate sclerosis and the vascular fibroelastosis. The metalloproteinase expression was evaluated using an anti-metalloproteinase-2 antibody. The main non-neoplastic lesions found in the urothelium included clear cell metaplasia, dysplasia, hyperplasia, haemorrhage, cystitis cystica and Brunn's nests and the neoplastic lesions were haemangioma, myxoma, transitional cell carcinoma, adenocarcinoma, in situ carcinoma and haemangiosarcoma. The urothelium measurements revealed differences between the epithelial thicknesses of bladders with and without neoplasms. The bladder vasculature evaluation revealed the frequent occurrence of different pathological aspects, such as vascular proliferation, dilation, expansion, ectasia and thickening; more severe vascular proliferation, thickening and fibroelastosis were observed in bladders with neoplasms. Metalloproteinase-2 expression was observed in the epithelial cells, fibroblasts, endothelial cells and smooth muscle cells present in the tumour tissue and was a significant increase in the expression of MMP-2 in the neoplasms of mesenchymal origin compared to the neoplasms of epithelial origin.Discussion: The presence of a large variety of non-neoplastic lesions indicates the possibility that there are other factors concomitant to BEH involved. Epithelial hyperplasia and metaplasia, for example, could be the result of damage caused by bovine papillomavirus type 2 or even an altered urine pH. Furthermore, it is believed that the bladder has the capacity to generate various types of neoplasms due to the different histological components of the bladder, thus enabling it to generate both mesenchymal and epithelial lesions. The thickness of the urothelium was greater in all the quadrants with neoplasms compared to the quadrants without neoplasms. These data revealed that it is possible to use less invasive diagnostic imaging methods to characterise bovine enzootic haematuria and to measure tumour progression based on the severity of vascular changes. The vascular proliferation and thickening were significant in bladders with neoplasms, which may be explained by the fact that tumours require an extensive vascular supply. In addition, many tumours release vascular growth factors and promote neovascularisation. The intensity of the immunostaining of metalloproteinase-2 differed among the different types of neoplasms. However, due to the diversity of the tumours, it was not possible to establish a relationship between metalloproteinase-2 expression and tumour progression

Classificação citológica dos linfomas caninos

Os linfomas estão entre as neoplasias mais frequentes na espécie canina. Do ponto de vista etiológico, epidemiológico, clínico, morfológico e imunofenotípico, os linfomas caninos apresentam muitas semelhanças com os linfomas não-Hodgkin humanos e os esquemas de classificação destes têm sido utilizados na espécie canina. O objetivo do presente trabalho foi aplicar aos linfomas caninos as classificações de Kiel, Working Formulation e Fournel-Fleury et al. (1994), em material colhido pelo método da PAAF (Punção Aspirativa por Agulha Fina). De acordo com a Classificação de Kiel, 61,02% (36 casos) das neoplasias se enquadram como de grau alto 38,98% (23 casos) como de grau baixo. Segundo a Classificação da Working Formulation, 11,86% (sete casos) foram classificados linfomas de grau baixo, 61,02% (36 casos) de grau intermediário e 27,12% (16 casos) de grau alto. Utilizando a classificação proposta por Fournel-Fleury et al. (1994), 38,98% (23 casos) dos animais que apresentaram linfomas de grau baixo e 61,02% (36 casos) de grau intermediário ou alto. Concluindo, a PAAF é um método de diagnóstico que pode ser empregado na classificação dos linfomas caninos. A classificação que mostrou melhores resultados foi a de Kiel, que tem por característica principal a ênfase nos achados citológicos.Lymphoma is among the most frequent canine neoplasia and share many similarities with human non-Hodgkin's lymphoma in respect of etiology, epidemiology, clinical, morphological and immunophenotipical aspects. Human classification schemes have been used in canine lymphoma. The aim of this work was apply Kiel, Working Formulation and Fournel-Fleury's et al. (1994) classification in Fine Needle Aspiration (FNA) cytology matherial. According to Kiel scheme 61.02% (36 cases) were high-grade lymphomas and 38.98% (23 cases) low grade. The Working Formulation, showed 11.86% (7 cases) of low grade, 61.02% (36 cases) intermediary grade and 27.12% (16 cases) high grade. In Fournel-Fleury's protocol revealed a predominance of high-grade lymphoma, with 61.02% (36 cases) over 38.98% (23 cases) of low grade. In conclusion, FNA can be used as a diagnostic method and in canine lymphoma cytological classification. Kiel's system showed the best results, once is based on cytologic basis

Proliferação celular nos linfomas caninos

O estudo dos linfomas caninos além de abordar a classificação morfológica e imunofenotípica necessita ser ampliado para que se tenha a avaliação da cinética celular. Esta verificação só pode ser feita com segurança quando são avaliados os parâmetros que indicam a taxa de proliferação celular. No homem, estes fatores têm influência no prognóstico e no tratamento dos limfomas. Os 40 linfomas utilizados neste trabalho foram classificados de acordo com a classificação de Kiel e a imunofenotipagem utilizou CD3 (linfócitos T) e CD79a (linfócitos B). A proliferação celular foi avaliada pelos métodos de contagem dos AgNORs e Ki-67 (MIB-1) De acordo com a classificação de Kiel os linfomas de alto grau foram os mais freqüentes, a imunofenotipagem mostrou a mesma freqüência de linfomas T e B. Quando avaliada a proliferação celular houve diferença significativa entre os linfomas de alto e baixo grau tanto pelo método do AgNOR como do KI-67.(MIB-1), porém não foram estatisticamente entre os imunofenótipos Entre as neoplasias de alto grau de malignidade a média de número de NORs por núcleo de célula neoplásica foi de 1,37 ± 0,32, e nos casos de baixo grau de 0,98 ± 0,36, de acordo com o KI-67 a média do percentual de células positivas foi de 43,19% ± 19,01, e 14,09% ± 11,74 nos casos de alto e baixo grau, respectivamente.Lymphoma studies deals with morphological classification and immunophenotypic features and they have to be amplified for cellular kinetics evaluation. This evaluation can only be safely made, when the proliferative index are evaluated. In men the proliferation index have, most of the time, important influence in the neoplasia prognosis and treatment In this work it was used 40 canine lymphomas that were classified according to Kiel methods and immunophenotype was achieved with CD3 (T lymphocyte) and CD79a (B lymphocyte). Cellular proliferation was evaluated by AgNORs and Ki-67 (MIB-1) According to Kiel classification system, high grade lymphomas were more frequent and T and B lymphoma showed the same frequency.When cellular proliferation was evaluated, there was a significant difference between high grade and low grade lymphomas by AgNOR and Ki-67 (MIB-1) methods, but did not differ when comparing immunophenotype. Among high grade malignancy lymphomas the NORs medium number per cell nucleoli was 1.37± 0.32 and in low grade was 0.98± 0.36, concerning Ki-67 the positive cellular percentual was 43.19% ± 19.01, e 14.09% ± 11.74 in high and low grade, respectively

Técnica de exposição e fixação do esôfago torácico em cães

A maior parte das afecções cirúrgicas do esôfago em cães situa-se no tórax e são freqüentemente observadas na clínica de pequenos animais. No entanto, o esôfago torácico é de difícil acesso e requer técnica meticulosa. Muitas destas afecções necessitam de intervenção cirúrgica para um tratamento eficiente. Os procedimentos cirúrgicos no esôfago torácico devem ser realizados de uma maneira mais precisa do que em outros segmentos do tubo digestivo. A exclusão da mucosa esofágica da sutura força a inclusão da túnica adventícia e muscular, as quais são frágeis e esgarçam-se facilmente. O uso de pinças e fórceps deve ser evitado quando possível no manuseio do tecido esofágico. Na execução de uma esofagotomia, deve-se ter bastante cuidado para se evitar traumatismos esofágicos como laceração ou perfuração. A identificação do esôfago é facilitada pela passagem de uma sonda gástrica. O esôfago possui particularidades anatômicas e fisiológicas que requerem manipulação cuidadosa e delicada em abordagens cirúrgicas do órgão para que não haja prejuízo de cicatrização. Desta forma, resolveu-se propor nova técnica de exposição e fixação do esôfago torácico em cães. Foram realizadas toracotomias em 30 animais. O esôfago torácico foi exposto por dissecção romba do mediastino, foi elevado até a abertura da parede torácica e fixado por uma pinça hemostática, a qual foi passada por baixo do órgão com os ramos fechados. Este tipo de exposição e fixação permitiu procedimentos cirúrgicos no esôfago torácico sem manobras bruscas. Concluiu-se que a técnica cirúrgica é viável e preserva a integridade do tecido esofágico

Wound healing and colon carcinogenesis. Enhancing effects of skin wounding on development of colon tumors induced by 1,2 Dimethylhydrazine in the rat

Este estudo foi desenvolvido com a finalidade de investigar a possível influência do processo de cicatrização sobre o desenvolvimento neoplásico à distância, em um modelo experimental de carcinogênese do colon induzido pela 1,2 dimetil-hidrazina ( DMH). Ratos Wistar machos receberam injeções semanais de DMH ( 20mg/Kg, via subcutânea) ou solução salina, durante oito semanas. Na nona semana, um grupo tratado com DMH e um controle, foram submetidos à intervenção cirúrgica para retirada de um retalho cutâneo de 4cm no flanco direito, que cicatrizou por segunda intenção. Na 12ª semana, logo após o fechamento da ferida cutânea, os animais foram submetidos à eutanásia. O colon foi dividido em segmentos proximal e distal e examinado a nível macroscópico e histológico. Foram analisadas a incidência, distribuição e morfologia das lesões. O número total de tumores na mucosa do colon e o número de tumores por animal foi significantimente maior no grupo submetido à ferida cutânea do que no grupo tratado somente com DMH. O número de carcinomas pouco diferenciados foi significantimente maior no grupo com ferida cutânea do que em seu respectivo controle. Estes resultados sugerem que o processo de reparação de uma ferida cutânea favorece o desenvolvimento neoplásico em um órgão à distância, tal como o colon e que este efeito parece estar relacionado ao tipo histológico da neoplasia.This study demonstrates the tumor promoting effect at a distant site of skin wounding, in a model of colon carcinogenesis induced by 1,2 dimethylhydrazine (DMH) in the rat. Six-week-old male Wistar rats were given subcutaneous injections of DMH, 20mg/kg, or saline, once a week, for eight weeks. One week after the last DMH injection the animals received a full thickness skin wound in their dorsal skin and the wound was left open to heal by second intention. Control and DMH-treated rats, with or without skin wounds were killed at the 12th week, just after healing of the skin wound was complete. The colons were removed and divided into proximal and distal parts. Each segment was rolled as Swiss rolland processed for histology. The incidence, distribution and morphology of the colon tumors was recorded. The total number of tumors in the colonic mucosa and the number of tumors per rat was significantly higher in the skin-wounding DMH- treated group than in the unwounded group. In the histopathological analysis of the colon the number of poorly differentiated mucin-secreting carcinomas was 6-fold in the skin-wounding DMH-treated group than in the unwounded group and the majority of tumors were located near to lymphoid aggregates. The present results suggest that wound healing enhances tumor development at a distant site, such as the colon, and this effect seems to be related to tumor histology

Sarcoide equino: aspectos clínicos, etiológicos e anatomopatológicos

Equine sarcoid is the most frequent cutaneous neoplasia among equidae. Its clinic behaviour is locally aggressive due to its infiltrative capacity as well as being resistant to different forms of therapy. Morphologically, equine sarcoid is a predominantly fibrous tissue neoplasia, originally fibroblastic and without metastasis, often showing the involvement of epidermis, thus being recognized as a biphasic tumor. In its clinical presentation, several types and subtypes of equine sarcoids are recognized, being described as hidden, verrucous, fibroblastic, malignant and mixed. Etiology of equine sarcoid is related to infection through BPV1 and BPV2, however this neoplasia must be considered as a tumor which is induced by virus, with a wide range of resulting manifestations of interactions between the etiologic agent, the environment and the host genome. The objective of this article is to draw an updated panel over the epidemiologic, clinical-pathological and etiologic characteristics of the equine sarcoid.La sarcoidosis equina es la neoplasia cutánea mas frecuente entre los caballos. Su comportamiento clínico es localmente agresivo debido a su capacidad de infiltración, además de ser refractario a diferentes formas de terapias. Morfologicamente, la sarcoidosis equina es una neoplasia predominantemente del tejido fibroso, con origen fibroblástico, sin metástasis, lo que demuestra muy frecuentemente el envolvimiento de la epidermis, y puede ser reconocido como un tumor bifásico. En su presentación clínica son reconocidos varios tipos y subtipos, siendo descritos los tipos oculto, verrugoso, nodular, fibroblástico, maligno y mixto. La etiología de la sarcoidosis equina está relacionada a la infección con PVB1 y PVB2, sin embargo, esta neoplasia debe ser considerada como un tumor inducido por virus con una gran variedad de manifestaciones resultantes de interacciones entre el agente etiológico, el ambiente y el genoma del húsped. El objetivo de este artículo es trazar un panel actualizado sobre las características epidemiológicas, clínico-patológicas y etiológicas del sarcoide equino.O sarcoide equino é a neoplasia cutânea mais frequente entre os equídeos. Seu comportamento clínico é localmente agressivo devido à sua capacidade infiltrativa, além de ser refratário a diferentes formas de terapias. Morfologicamente, o sarcoide equino é uma neoplasia predominantemente de tecido fibroso, com origem fibroblástica, não metastatizante, que mostra muito frequentemente o envolvimento da epiderme, podendo ser reconhecido como um tumor bifásico. Na sua apresentação clínica são reconhecidos vários tipos e subtipos, sendo descritos os tipos oculto, verrucoso, nodular, fibroblástico, maligno e misto. A etiologia do sarcoide equino esta relacionada à infecção pelos PVB-1 e PVB-2, porém esta neoplasia deve ser considerada como um tumor induzido por vírus com uma variedade ampla de manifestações resultantes de interações entre o agente etiológico, o ambiente e o genoma do hospedeiro. O objetivo deste artigo é traçar um painel atualizado sobre as características epidemiológicas, clínico-patológicas e etiológicas do sarcoide equino

Comparative susceptibility and pathogeny of Nelore and Holstein-Friesian calves to the experimental infection of Haemonchus placei (Place, 1893)

Two groups of Holstein-Friesian and Nelore calves, five animals each, about nine months old, received, by oral route, 1,000 infective larvae (L-3) per kg of body weight of Haemonchus placei. Blood samples were collected by venipuncture, at weekly intervals, from one week before, to eight weeks after infection. Hematological studies comprised the hematocrit, differential leukocyte counts, hemoglobin, fibrinogen and plasma protein determinations. Parasitological examinations covered weekly fecal egg counts (EPG) and worm burden counts at necropsy. Samples of the abomasal mucosa were submitted to gross examination and histopathological studies. Both groups had increasing EPG after the fifth week, with Holstein calves showing higher counts than the Nelore. Holstein calves had anemia and hipoproteinemia from the third week post-infection to the end of the experiment, whereas Nelore calves showed no significant differences in those, parameters. Holstein calves had significantly larger worm counts than the Nelore. The gross and histopathological lesions in the abomasum at necropsy were very similar, although macroscopically they look more apparent in the Holstein group. These results showed that Holstein calves are more susceptible to the infection and pathogenic effects of H. placei than Nelore calves