Olfactory neuroblastoma in dogs and cats--a histological and immunohistochemical analysis

Rosettes and pseudorosettes in veterinary neuropathology

Rosettes and pseudorosettes are morphologic cell arrangements found in many neuroepithelial neoplasms in human medicine, including embryonal nervous system tumors (neuroblastoma, medulloblastoma, pineoblastoma, and retinoblastoma), non-embryonal nervous system tumors (ependymoma, astrocytoma, oligodendroglioma, and choroid plexus tumors), and other extraneural neuroepithelial neoplasms. Although these structures are also described in neuroepithelial neoplasms of domestic animals, their frequency is still poorly characterized or inconsistently documented in veterinary medicine. Furthermore, rosettes and pseudorosettes need to be interpreted with caution and within a clinical and pathologic context and should not be solely relied upon for diagnostic confirmation of a particular neoplasm. Here, we review the morphologic features and frequency of the most common types of rosettes and pseudorosettes described in neuroepithelial neoplasms of domestic animals, focusing primarily on those occurring in the nervous system and closely associated tissues.

A case of olfactory ganglioneuroblastoma in a dog: immunohistochemical comparison with olfactory neuroepithelia and olfactory neuroblastomas

In the present study, histopathological and immunohistochemical findings of olfactory ganglioneuroblastoma in a dog were compared to those of canine olfactory neuroepithelia and neuroblastomas. Olfactory ganglioneuroblastoma consists of ganglion cell-like tumor cells with Schwannian stroma and neuroblast-like tumor cells. Immunohistochemically, ganglion cell-like tumor cells were immunopositive for synaptophysin, β3-tubulin, and tyrosine hydroxylase, Schwannian stroma was immunopositive for GFAP and SOX2, and neuroblast-like tumor cells were immunopositive for OLIG2, β3-tubulin, SOX2, cytokeratin AE1/AE3, and p63. The immunohistochemical results of olfactory neuroepithelia and olfactory neuroblastomas were similar to those of neuroblast-like tumor cells. These results suggest that the ganglion cell-like tumor cells in the present case have a sympathetic neuron immunophenotype, whereas neuroblast-like tumor cells have an olfactory neuroepithelial immunophenotype.

Diagnostic immunohistochemistry of primary and secondary central nervous system neoplasms of dogs and cats

The diagnosis of primary and secondary CNS neoplasms of dogs and cats relies on histologic examination of autopsy or biopsy samples. In addition, many neoplasms must be further characterized by immunohistochemistry (IHC) for a more refined diagnosis in specific cases. Given the many investigations assessing the diagnostic and prognostic IHC profile of CNS neoplasms in the veterinary literature, it may be difficult for the diagnostic pathologist or pathology trainee to narrow the list of reliable diagnostic IHCs when facing a challenging case. Here we compile a comprehensive list of the most diagnostically relevant immunomarkers that should be utilized for the diagnostic support or confirmation of the most common primary and secondary CNS neoplasms of dogs and cats.

Olfactory neuroblastoma in a domestic cat and review of the literature

Nasal tumors account for less than 10% of all feline neoplasms, with lymphoma, followed by adenocarcinoma, and squamous cell carcinoma, the most commonly reported. Nasal neuroectodermal tumors, including olfactory neuroblastoma (ONB), are scarcely described, and their tumorigenesis is largely unknown. Here we report the cytological, histological, and immunohistochemical features of a feline ONB. We also provide a pathological review of nasal neuroendocrine neoplasms in cats. A 7-year-old Burmese cat was evaluated for sneezing, occasional epistaxis, and upper respiratory noise for 8 months. Computed tomography (CT) imaging revealed a 7 × 5 × 3 mm irregular mass effacing and expanding the nasal cavity, which extended to the nasopharynx. Cytologically, neoplastic cells were round to polygonal and had a round nucleus with finely stippled chromatin, a single small nucleolus, and abundant pale blue cytoplasm, which contained abundant fine pale pink granules. They exhibited mild cellular atypia, anisocytosis, and mild to occasionally moderate anisokaryosis. Rhinoscopic biopsies revealed a densely cellular, malignant neuroepithelial neoplasm. Cells were arranged in densely packed trabeculae and formed Homer Wright and Flexner-Wintersteiner-like rosettes, with rare mitotic figures and scant supportive fibrovascular stroma. Immunohistochemically, neoplastic cells were positive for vimentin, cytokeratin AE1/AE3, COX-2, and beta-tubulin and negative for S-100, chromogranin A, CD117, and epithelial membrane antigen (EMA). An ONB was diagnosed based on histological and immunohistochemical findings. Interestingly, and similar to nasal carcinomas, neoplastic cells diffusely neo-expressed COX-2. To the authors' knowledge, there is no previous evidence of COX-2 in feline ONB. Histopathology and immunohistochemistry are required for a definitive diagnosis of ONB.

A review of primary central nervous system neoplasms of cats

Primary central nervous system (CNS) neoplasms are uncommonly diagnosed in cats. The majority of primary feline CNS neoplasms described in the veterinary literature consist of meningioma and glioma occurring mainly in the brain and less often in the spinal cord. Although most neoplasms can be diagnosed based on routine histologic evaluation, less typical tumors need to be further characterized using immunohistochemistry. This review compiles the relevant information about the most common primary CNS neoplasms of cats available in the veterinary literature, aiming to serve as a converging source of information for the topic.

Excisional biopsy and radiotherapy for management of an olfactory neuroblastoma in an axolotl (Ambystoma mexicanum)

CASE DESCRIPTION

A 4-year-old sexually intact male leucistic axolotl (Ambystoma mexicanum) was presented with a 2-week history of dysrexia and difficulty swallowing.

CLINICAL FINDINGS

Physical examination revealed a 1-cm-diameter intraoral mass on the rostral aspect of the palate and swelling of the left nasal fossa. Local invasion into the left nasal fossa was suspected during oral examination. The lesion was marginally excised, and an incompletely excised olfactory neuroblastoma was diagnosed histologically. Five weeks later, physical examination revealed persistent erythema, delayed healing of the rostral portion of the palate, and a mild facial deformity associated with a white mass in the nasal cavity.

TREATMENT AND OUTCOME

6 weeks after excision, adjuvant electron (6-MeV) beam radiotherapy was initiated for treatment of the incompletely excised olfactory neuroblastoma and likely presence of a recurrent mass. The protocol consisted of 4 weekly fractions of 8 Gy each (total, 32 Gy) with the axolotl under anesthesia. No acute adverse radiation effects were noted following radiotherapy. The oral erythema resolved after the third session. No recurrence was observed 2 months after treatment, and the owners reported no abnormal signs at home. The axolotl died 3.5 months after radiotherapy was completed (8 months after marginal excision of the tumor) secondary to an environmental management failure. Postmortem histologic evaluation showed no evidence of neoplasia.

CLINICAL RELEVANCE

In axolotls, olfactory neuroblastoma should be considered in the differential diagnosis of intraoral palatal masses. This report describes the first application of radiotherapy for treatment of an olfactory neuroblastoma in an axolotl.

Olfactory ganglioneuroblastoma in a dog: case report and literature review

A 7-y-old, intact male Alaskan Malamute was presented with a 3-mo history of stertor and epistaxis. Computed tomography of the skull revealed generalized loss of gas throughout both nasal passages with replacement by a soft tissue mass that traversed the cribriform plate. Histopathology revealed neoplastic neuroblast cells arranged in anastomosing cords, as well as separately located aggregates of ganglion cells. Both neoplastic cell populations demonstrated immunoreactivity to MAP-2, TuJ-1, and synaptophysin. Neuroblastic cells additionally exhibited punctate immunoreactivity to MCK and CK8/18. We document here both the positive neural immunohistochemical markers for this neoplasm, as well as propose possible histomorphologic variants.

Rare neural crest tumor in teleost species: olfactory neuroblastoma in a spotted pike-characin Boulengerella maculata

One spotted pike-characin Boulengerella maculata, managed in a public display aquarium for 7 yr, developed a small unilateral pink growth associated with the right nare. The growth eventually extended through both nares after 5 mo. B. maculata is a species of piscivorous fish that relies on visual acuity when hunting prey. The rapidly-growing bilateral tumor would have impeded vision if left untreated. The fish was managed for over 10 mo using only surgical debulking, topical liquid nitrogen, and occasional nonsteroidal anti-inflammatory medications as needed to reduce tumor size and restore sight. Diagnosis proved challenging due to superimposed inflammation, neoplasm cellular inconsistencies, and a lack of proven immunohistochemical stains or other diagnostic stains. Using tumor location and appearance, histopathology, advanced imaging, electron microscopy, special staining, and immunohistochemistry, the ultimate diagnosis confirmed olfactory neuroblastoma, or esthesioneuroblastoma. Although long-term prognosis is poor, hunting strategy of the affected species may dictate quality of life, as appetite, body condition, and behavior remained largely unchanged in this animal until time of euthanasia.

Clinical outcomes, ultrastructure and immunohistochemical features of canine high-grade olfactory neuroblastoma

Olfactory neuroblastoma (ONB) is a rare intranasal neoplasm in both dogs and humans. Similar clinical presentation and overlapping histologic and immunohistochemical features of ONB with other intranasal neoplasms can make diagnosis and treatment of intranasal neoplasia challenging. Furthermore, in part because of their rarity, there is a lack of reporting on therapeutic regimen for these neoplasms. In humans, initial debulking surgery is usually followed by radiation therapy. Here we report on the histologic, immunohistochemical, and ultrastructural characteristics of canine ONB and report on the clinical progression of cases treated with radiation therapy. In all nine canine ONB examined here, neoplastic cells were arranged in a lobular manner amidst a prominent neurofibrillary matrix and had features consistent with Grade III (high grade) ONB. The neoplastic cells demonstrated positive immunohistochemical staining for TuJ-1, a Class III beta-tubulin neuronal cytoskeletal protein, and variable staining for other markers, including chromogranin, synaptophysin, AE1/AE3 and MAP2. The longest surviving case was treated with a regimen similar to that used in humans, consisting of debulking surgery followed by definitive radiation therapy. Our study found that TuJ-1 is a useful marker for ONB and that radiation therapy, even in cases of advanced disease, may result in prolonged survival.

Oligodendrogliom mit neuronaler Differenzierung bei einem 8 Monate alten Afrikanischen Weißbauchigel (Atelerix albiventris)

Ein 8 Monate alter, männlicher Afrikanischer Weißbauchigel zeigte klinisch einen schwankenden Gang, Anurie, Inappetenz und Apathie, woraufhin die Verdachtsdiagnose Wobbly Hedgehog Syndrome gestellt wurde. Nach Exazerbation wurde der Igel euthanasiert. Der histologisch im Großhirn nachgewiesene Tumor bestand überwiegend aus mittelgroßen, ovoiden Zellen und einer in geringerer Zahl vorhandenen spindelzelligen Zellpopulation. Im Tumor fanden sich Neuropil-Inseln und extrazelluläres myxoides Material. Immunhistochemisch exprimierten die Tumorzellen sowohl oligodendrogliale (neuritic outgrowth inhibitor, Nogo-A; oligodendrocyte transcription factor, Olig-2) als auch neuronale (neuronenspezifische Enolase, NSE; microtubuleassociated protein-2a, MAP-2a; Synaptophysin) Zellmarker. Anhand der Befunde wurde die Diagnose eines Oligodendroglioms mit neuronaler Differenzierung gestellt, wobei es sich um einen bei Weißbauch - igeln bisher nicht beschriebenen Hirntumor handelt. Die bei der Obduktion festgestellte hochgradige Füllung und Dilatation der Harnblase wurde vermutlich durch eine tumorbedingte zentrale Blockade des Blasenentleerungszentrums hervorgerufen. Auch bei jungen Igeln sollte im Fall neurologischer Symptome an einen primären Gehirntumor gedacht werden. Differenzialdiagnostisch sind entzündlich-infektiöse (Tollwut, Herpes, Baylisaskariose), degenerative (Kardiomyopathie, Bandscheibenerkrankung), traumatische, alimentäre (Vitamin-B-Mangel) und metabolisch-toxische (Hitze-Kälte-Starre, hepatische Enzephalopathie) Noxen auszuschließen.

Long-term control of olfactory neuroblastoma in a dog treated with surgery and radiation therapy

BACKGROUND

Olfactory neuroblastoma is a rare malignancy of the nasal cavity in dogs that is thought to arise from specialised sensory neuroendocrine olfactory cells derived from the neural crest.

CASE REPORT

An 8-year-old dog was presented for reclusiveness and pacing. On CT and MRI, a contract-enhancing mass was disclosed within the rostral fossa, extending caudally from the cribriform plate into the left nasal sinus. Surgical excision was performed and the diagnosis was histological grade III (Hyams grading scheme) olfactory neuroblastoma. Based on human CT criteria this was high stage (modified Kadish stage C). Surgical excision was incomplete and was followed by curative-intent radiation therapy using a linear accelerator to a total dose of 48 Gy.

CONCLUSION

The dog survived 20 months after diagnosis. Although olfactory neuroblastoma is a rare tumour in dogs, aggressive local therapy may allow for prolonged survival, even when the tumour is advanced.

How Behavioral Changes Can Indicate Serious Cerebral Pathology: A Case Report of Concomitant Olfactory Neuroblastoma and Distemper Virus Encephalitis in a Swiss Shepherd Dog

Behavioral alterations in dogs are not easy to understand and cure. The situation is more difficult when an encephalitis due to Canine Distemper Virus (CDV) and a concomitant olfactory neuroblastoma are present. This case report deals with the story of a 5-year-old Swiss shepherd dog with behavioral changes, seizures, epistaxis and ataxia. Following clinical and laboratory exams, a suspected diagnosis of CDV infection was hypothesized, and a therapy based on Ω-interferon was administered. Every supporting therapy failed and the worsening of the clinical conditions led to the euthanasia of the patient. A neoformation in the right frontal lobe was found post mortem. Histopathology and immunohistochemistry investigation showed a non-suppurative demyelinating encephalitis, suggestive of CDV infection, and a desmoplastic epithelioid olfactory neuroblastoma. To the best of authors’ knowledge, this is the first clinical pathological report of a non-suppurative encephalitis due to CDV infection and olfactory neuroblastoma in a dog.

Disseminated peripheral neuroblastoma in a Rhodesian Ridgeback dog

CASE REPORT

A 4-year-old neutered male Rhodesian Ridgeback dog with right-sided Horner's syndrome, bilateral laryngeal paralysis, neck pain and bilateral hindlimb ataxia was euthanased following deterioration of its neurological status. Necropsy examination revealed an off-white retropharyngeal neoplastic mass (100 × 30 × 30 mm) attached to the base of the skull on the right side and macroscopic nodular metastases in the spleen and three vertebral bodies (C6, C7 and T6), including a nodule attached to the dura at C7. Histological evidence of neuroblastic tumour was detected in these macroscopic lesions, a regional lymph node, bone marrow of a femur and all 15 vertebral bodies (C1-T8) examined, including the three with macroscopic metastases, and in the lumens of small blood vessels in the lungs and liver. Ganglion cell differentiation was detected only in the primary retropharyngeal mass, one splenic nodule and the C7 dural nodule. Neoplastic cells were immunoreactive to neurofilament protein (ganglion cells only), vimentin and synaptophysin, and were negative for S100 protein, GFAP, CD3 and Pax5.

CONCLUSION

The diagnosis was disseminated peripheral neuroblastoma, differentiating subtype (International Neuroblastoma Pathology Classification), with likely primary involvement of the right cranial cervical ganglion. This appears to be the first report of neuroblastoma in a dog with widespread occult haematogenous metastasis to bone marrow.

Magnetic resonance imaging features of esthesioneuroblastoma in three dogs and one cat

OBJECTIVE

Esthesioneuroblastoma is a rare malignant intranasal tumor that originates from the olfactory neuroepithelium of the upper nasal cavity, and can destroy the cribriform plate and expand into the neurocranium. Descriptions of the magnetic resonance features of esthesioneuroblastomas in animals are scarce. The objectives of this study were to report the magnetic resonance imaging features of esthesioneuroblastomas in order to determine distinct imaging characteristics that may help distinguish it from other intracranial tumor types.

MATERIAL AND METHODS

Magnetic resonance images of four patients with confirmed esthesioneuroblastomas were reviewed and compared with previously reported cases.

RESULTS

The esthesioneuroblastomas appeared as oval-shaped, solitary lesions in the caudal nasal cavity that caused osteolysis of the cribriform plate and extended into the brain in all cases. Signal intensity was variable. Contrast enhancement was mild and varied from homogeneous to heterogeneous. A peripheral cystic component was found in two patients and was reported in only one previous case. Mass effect and white matter edema were marked to severe. Osteolysis of facial bones and extension into the facial soft tissues or retrobulbar space were not present in any of the cases, although this has been reported in the literature.

CONCLUSION

A definitive diagnosis of esthesioneuroblastoma based on signal intensity or contrast behavior was not possible. Nevertheless, the presence of a mass in the caudal nasal cavity with extension into the neurocranium seems to be a feature highly suspicious of esthesioneuroblastoma. In contrast to other extra-cranial lesions, the extra-cranial mass was relatively small and destruction of facial bones seems to be rare.

A retrospective study of skull base neoplasia in 42 dogs

This study describes the prevalence and distribution of 42 cases of skull base neoplasia in dogs between 2000 and 2014. The average age of affected individuals was 9.5 years, and there was no sex or breed predisposition. The most common skull base neoplasms were meningioma (25 cases) and pituitary adenoma (9 cases). Less common tumors included craniopharyngioma (2 cases), nerve sheath tumor (2 cases), and 1 case each of pituitary carcinoma, meningeal oligodendrogliomatosis, presumed nasal or sinonasal carcinoma, and multilobular tumor of bone. All neoplasms caused some degree of compression of adjacent structures. The distribution of the tumors was greatest in the sellar region ( n = 18), followed by the paranasal region ( n = 12), caudal cranial fossa ( n = 10), central cranial fossa ( n = 1), and rostral cranial fossa ( n = 1).

Metastasizing Esthesioneuroblastoma in a Dog

A 7-year-old Afghan hound presented with a history of disorientation, loss of vision, and seizures. Magnetic resonance imaging helped identify a mass at the level of the main olfactory bulb that compressed and displaced adjacent tissues in the cribriform plate into the nasal cavity and nasopharynx. Bony structures were osteolytic. After removing almost 80% of the mass, the tumor recurred a few months later. Due to severe respiratory distress and subsequent to an ultrasound diagnosis of a liver tumor, the dog was euthanized. In addition to the nasal mass, a single nodule in the liver and multiple nodules in the lung were present. All masses had similar cell morphology and were diagnosed as metastasizing esthesioneuroblastoma. The neoplastic cells expressed neuron-specific enolase and chromogranin A, and a few cells within the nasal mass were positive for cytokeratin. This is the first description of a canine esthesioneuroblastoma with distant metastases.

Of mice and men: olfactory neuroblastoma among animals and humans

Olfactory neuroblastoma (ONB) is a rare tumour of nasal cavity and paranasal sinuses that arises from the olfactory neuroepithelium and has unpredictable clinical course. As the sense of smell is phylogenetically one of the first senses and olfactory neuroepithelium is evolutionary conserved with striking similarities among different species, we performed an extensive analysis of the literature in order to evaluate the similarities and differences between animals and humans on the clinical, morphological, immunohistochemical, ultrastructural and molecular level. Our analysis revealed that ONB was reported mainly in mammals and showed striking similarities to human ONB. These observations provide rationale for introduction of therapy modalities used in humans into the veterinary medicine. Animal models of neuroblastoma should be considered for the preclinical studies evaluating novel therapies for ONB.