Sclerosing Peritoneal Mesothelioma in a Dog - A Case Report

Localized pleural mesothelioma in a dog

Malignant mesotheliomas with localized growth are extremely rare in dogs. A 9-year-old male dog presented with a localized tumour that originated from the parietal pleura and had polypoid growth in the thoracic cavity. Histological examination revealed that the tumour consisted of tubular formations with scattered cysts and minimal papillary growth pattern. Neoplastic cells were immunopositive for mesothelial markers (calretinin and Wilms' tumour gene 1) and negative for carcinoma markers (thyroid transcription factor 1 and tumour protein 63). The animal was alive with no recurrence or metastasis/dissemination 11 months after surgery. To the best of our knowledge, this is the first report of a localized mesothelioma in a dog without metastasis/dissemination and highlights the value of mesothelial markers for an accurate diagnosis.

Sclerosing encapsulating peritonitis in cats: a two-case report and literature review

Case series summary

Two castrated male domestic shorthair cats (aged 8 months [case 1] and 13 years [case 2]) were presented at the Small Animal Clinic of the Veterinary Medicine University of Vienna, Austria, both with acute vomiting and distended abdomen, as well as a history of chronic apathy, recurrent vomiting and diarrhoea. Both cats underwent invasive diagnostic procedures approximately 1 month before the diagnosis of sclerosing encapsulating peritonitis (SEP), namely an exploratory laparotomy and a bronchoscopy, respectively. Abdominal ultrasound revealed severely corrugated intestinal loops and, in case 2, the presence of peritoneal effusion. A thick and diffuse fibrous capsule around the intestine was detected and removed surgically, and biopsies were taken from the affected organs confirming the SEP. Case 1 recovered well, was discharged some days after surgery and was clinically unremarkable for the next 2 years. Case 2 showed unsatisfactory improvement directly after surgery and was euthanased a few days later, as the owner declined any further therapy.

Relevance and novel information

SEP is a very rare condition of unclear origins in cats. Here we describe the clinical and diagnostic imaging features, surgical treatment, and outcome of SEP in two cats. The results indicate that prompt diagnosis and appropriate interventions may improve the outcome.

Mediastinal Serous Cavity Mesothelioma in Two Dogs

The mediastinal serous cavity (MSC)-well documented but seldom recognized in the caudal mediastinum-is embryologically derived from the omental bursa. Mesothelioma arising from the MSC in two dogs is described. Both dogs presented with acute life-threatening hemorrhagic pleural effusion. Contrast computed tomography revealed a large solitary spherical-to-cylindrical tumor in the caudal mediastinum with variably thick, contrast-enhancing walls with lobular to frond-like proliferations that arose circumferentially and projected internally into a single, variably sized, fluid-attenuating lumen. The wall and lumen corresponded to the serous membrane and serous cavity of the MSC. Surgical exploration confirmed that both tumors arose from the mediastinum. Both had similar histologic findings, and special stains were necessary for definitive diagnosis. The tumor was nonresectable in one dog, and it was euthanized intraoperatively. The other survived 7 mo. An MSC mesothelioma should be considered a possible cause of hemothorax in dogs that may be detected on thoracic radiography and computed tomography. Differential diagnoses include esophageal foreign body or neoplasm, paraesophageal diaphragmatic hernia, MCS empyema, and pulmonary adenocarcinoma, with thoracic computed tomography helping to rule out foreign body and diaphragmatic hernia. For confirmed neoplasms, histochemistry and immunohistochemistry should be performed to differentiate between mesothelioma and pulmonary adenocarcinoma.

Ferruginous bodies resolved by synchrotron XRF in a dog with peritoneal malignant mesothelioma

Mesothelioma is a malignant tumor mainly correlated to occupational asbestos exposure. Rare reports describe its occurrence also in animals, mainly linked to asbestos in the environment. Asbestos exposure is demonstrated by the appearance of characteristic histological hallmarks: asbestos containing ferruginous bodies that are iron-based structures forming around fibers and also other dust particles. Here we present a clinical case of a suspect of mesothelioma in the peritoneum of a dog with parallel histological observation of ferruginous bodies. To possibly correlate the dog tumor to environmental exposure, we performed X-ray fluorescence (XRF) analyses at two different synchrotrons to resolve the ferruginous bodies' composition. While the histological examination diagnoses a tubulo-papillary mesothelioma, the XRF analyses show that ferruginous bodies contain Si particles, resembling formations of exogenous origin; however, the morphology is unlikely that of asbestos fibers. We speculate that the peritoneal mesothelioma of this dog could be related to environmental exposure to non-asbestos material.

Deciduoid Peritoneal Mesothelioma in a Dog

Deciduoid mesothelioma is a rare variant of epithelial mesothelioma, up to now only described in human pathology, which bears remarkable cytomorphologic resemblance to the endometrium of pregnancy, termed decidua. A case of peritoneal mesothelioma with deciduoid features in a 10-year-old, female dog is reported. Multiple whitish-gray nodules (1-5 mm in diameter) in parietal peritoneum and mesentery were histologically composed of large, proliferating, polygonal or ovoid cells with an abundant eosinophilic, glassy cytoplasm. Immunohistochemical evaluation indicated that the neoplastic cells coexpressed cytokeratin and vimentin with strong and diffuse cytoplasmic staining, and ultrastructural analysis showed long and slender mesothelial-type microvilli; these findings confirmed the mesothelial origin of the tumor.

Cytomorphometry of serosal effusion in dogs

Cytomorphometry made on cytological slides is the quantitative method of precise analysis of cellular structures, including both cytoplasm and nucleus. The aim of this study was to describe cytomorphometric parameters of mesothelial cells in the course of benign reactive and malignant proliferation and to compare them to carcinomas and adenocarcinomas located within serosal cavities in dogs. The second aim was to evaluate applicability of cytomorphometry to diagnostics of diseases causing accumulation of effusion in serosal cavities. Cytological samples of normal and non-malignant mesothelium, mesothelioma and various carcinomas were collected from dogs. Cytomorphometry was made on the smears stained with Giemsa solution. Mean nuclear and cellular perimeter, mean nuclear and cellular area, mean nuclear and cellular diameter, and mean nuclear and cellular roundness were determined. Moreover, nuclear to cytoplasmic ratio (N/C) was calculated. The data revealed statistically significant differences for all parameters, excluding mean nuclear perimeter, between compared groups. Normal mesothelium cells and their nuclei were significantly smaller and more elongated than cells and nuclei of both benign reactive and malignant neoplastic mesothelium. Only a few differences were observed between benign reactive mesothelium cells and mesothelioma cells - mean nuclear area and mean nuclear diameter of benign reactive mesothelium cells were significantly larger and N/C ratio was higher in comparison to mesothelioma cells. Even though some significant differences were observed, considerable overlap of these cytomorphometric parameters in animals with different diseases limited practical role of these observations. Cytomorphometric analysis of cellular samples collected from dogs with proliferative processes affecting serosal cavities can be only an auxiliary method increasing accuracy of preoperative diagnosis.

Primary diffuse malignant peritoneal mesothelioma in a striped skunk (Mephitis mephitis)

A 10-year-old female striped skunk (Mephitis mephitis) was admitted with severe abdominal distension and lethargy. Cytological examination of the peritoneal fluid revealed activated mesothelial cells. At necropsy, numerous growing together, projecting, 2 to 20 mm in diameter tawny to white masses were scattered throughout the peritoneum including the mesentery, omentum and intestinal serosa. Microscopically, the tumor was composed of prominent papillo-tubular structures, and immunohistochemically, the spindle to polygonal-shaped tumor cells with nuclear polymorphism were strongly reactive for calretinin. Based on those diagnostic features, the neoplasia was diagnosed as malignant mesothelioma. This is the first case report of mesothelioma in the skunk.

Using of immunocytochemistry in differential diagnosis of neoplasms of serosal cavities in dogs

The presence of tumor within the serosal cavities, often connected with accumulation of serosal effusion, is a quite common problem in the small animal veterinary medicine. The first step in diagnosis of such cases is cytopathological examination. The aim of the present study was to evaluate the usefulness of cytology and immunocytochemistry, using commercially available antibodies (anti-cytokeratin, anti-vimentin, and anti-desmin), in differential diagnosis of malignant tumors located within serosal cavities in dogs. The final cytological diagnosis of carcinoma/adenocarcinoma, sarcoma, and mesothelioma was obtained on the basis of routine cytopathology and immunocytochemistry, and then confirmed by histopathology and immunohistochemistry. Cytoplasmic immunoreactivitiy of normal mesothelid cells and cytoplasmic immunoreactivity of hyperplastic mesothelial cells revealed constant and strong expression of all examined intermediate filaments: cytokeratin, vimentin and desmin. Application of routine cytopathology and immunocytochemistry allowed 32 neoplastic tumors to be detected: 19 cases of carcinomas/adenocarcinomas, 6 cases of sarcomas, 7 cases of mesotheliomas. Immunostaining of cytopathological samples with chosen set of antibodies: anti-cytokeratin, anti-vimentin, anti-desmin is a useful, and low invasive test for differentiation between mesotheliomas and carcinomas/adenocarcinomas in dogs.

Peritoneal mesothelioma in a jaguar (Panthera onca)

A 21-yr-old female jaguar (Panthera onca) died in a zoo in Teresina, Piaui, Brazil, following a history of abdominal distension, ascites, anorexia, and dyspnea. At necropsy, a dark red, watery, blood-tinged serous fluid was present in the abdominal cavity. The peritoneum was thick with firm, yellow, villous projections. Histologically, the tumors were composed of a biphasic population of cells, which reacted to anti-cytokeratin and anti-vimentin antibodies, consistent with a biphasic benign mesothelioma of peritoneal origin. This is the first reported case of mesothelioma in a captive jaguar.

Disseminated sclerosing peritoneal mesothelioma in a dog

A 7-year-old female German Shepherd Dog was presented with multiple petechiae and ecchymoses along the ventral abdomen, flank, and on the vaginal mucosa. The clinical diagnosis was severe hemoperitoneum and presumed disseminated intravascular coagulopathy. Postmortem examination revealed a 22 cm × 15 cm × 6 cm, firm, and convoluted peritoneal mass along with hemoperitoneum, and multifocal, ill-defined, 0.5-1.5 cm in diameter, white to tan nodules in the pulmonary parenchyma. Histologically, the peritoneal mass was composed of large anaplastic cells consistent with malignant mesothelioma interspersed in abundant fibrous connective tissue. Metastasis of the neoplastic cells occurred to the brain, adrenal glands, lymph nodes, and lungs. On immunohistochemical evaluation, neoplastic cells coexpressed cytokeratin and vimentin, and were negative for cluster of differentiation (CD)18. Electron microscopy revealed numerous surface microvilli around the entire circumference of the neoplastic cells, as well as tight junctions, and desmosome-like structures. Based on test findings, a disseminated sclerosing peritoneal mesothelioma was diagnosed.

Cytokeratin and vimentin co-expression in 21 canine primary pulmonary epithelial neoplasms

Co-expression of cytokeratin and vimentin has been traditionally associated with a few select tumors. However, this phenomenon is being recognized in a wider range of tumors. Twenty-one canine primary pulmonary epithelial neoplasms were evaluated for the co-expression of cytokeratin and vimentin. The histologic pattern and grade, and an immunohistochemical grade for cytokeratin and vimentin staining, were determined for each neoplasm. Adenocarcinomas predominated, and histologically, most tumors were grade II. All of the neoplasms stained positive for cytokeratin, while only 8 (38%) stained positive for both vimentin and cytokeratin. Papillary adenocarcinomas were consistently vimentin negative. The anaplastic histologic pattern had significantly more vimentin staining than the other histologic patterns. There was no significant difference in histologic grade or grading criteria between those tumors that stained with vimentin and those that did not. The present study established that cytokeratin and vimentin co-expression occurs in canine primary pulmonary epithelial tumors at a similar frequency to human pulmonary neoplasms. Further investigation will be needed to characterize the significance of this finding, particularly with respect to prognosis.

Myocardial Adenomatoid Tumor in Eight Cattle: Evidence for Mesothelial Origin of Bovine Myocardial Epithelial Inclusions

The adenomatoid tumor is an uncommon benign lesion, thus far described only in humans. Adenomatoid tumors typically arise in the genital tract, exceptionally in the heart, and usually represent an incidental finding. Microscopically, they are constituted by epithelioid cells that form tubular structures and anastomosing channels within a fibrous stroma. Mesothelial origin of these lesions is suggested by their immunohistochemical characteristics. In cattle, previously reported myocardial epithelial inclusions are morphologically similar in that the cells are immunoreactive for both cytokeratins and vimentin, and bear surface microvilli. Myocardial lesions found incidentally at slaughter in 8 cattle histologically resembled the so-called bovine myocardial epithelial inclusions and had morphologic and immunohistochemical features consistent with human adenomatoid tumor. All lesions were in the left ventricular myocardium, adjacent to the epicardium, and composed of epithelioid cells that formed cords and tubules, and were immunoreactive for pan-cytokeratins, cytokeratin 5/6, vimentin, calretinin, Wilms' tumor 1 suppressor gene, and CD30 antigen. By electron microscopy, numerous long slender microvilli were associated with desmosomes and tonofibrils. The immunohistochemical and ultrastructural features were considered consistent with mesothelial origin. These lesions, corresponding to the previously described myocardial epithelial inclusions in cattle, might be considered embryologic rests and could represent the bovine counterpart of the human adenomatoid tumor.

Lipid-rich pleural mesothelioma in a dog

An 11-year-old, neutered, male Golden Retriever cross dog was euthanized following a history of recurrent pericardial effusions. At necropsy, blood-tinged pericardial and intrathoracic effusions were seen along with numerous firm to hard plaque-like masses that studded the epicardial, pericardial, mediastinal, and costal pleural surfaces. Within the right thorax, the lesions coalesced into a large mass that occupied most of the cavity. Histologically, the masses were composed of solid sheets and papillary aggregates of medium-sized polygonal cells that contained abundant vacuolated to clear cytoplasm. Some of the cytoplasmic vacuoles stained positive with oil red O. The stroma contained metaplastic trabeculae of woven and lamellar bone. Immunohistochemically, the neoplastic cells expressed vimentin, pancytokeratin, and S-100 protein. Transmission electron microscopy corroborated the presence of intracytoplasmic vacuoles and demonstrated prominent intercellular junctional complexes and apically located microvilli. These findings are consistent with a lipid-rich variant of mesothelioma. To the authors' knowledge, this is the first report of a lipid-rich mesothelioma in a dog.

Pleural mesothelioma in a nine-month-old dog

This paper reports on an unusual case of pleural epitheloid mesothelioma in a nine-month-old male, mixed breed dog. The dog was presented in-extremis and, on post mortem examination, multiple, exophytic, frequently pedunculated, yellowish-red, soft to firm masses ranging from 3 mm to 6 cm in diameter were diffusely distributed over, and attached to, the pericardial and parietal pleural surfaces. Microscopically, these masses consisted of round to partially polygonalshaped, anaplastic cells with minimal cytoplasm and hyperchromatic nuclei covering papillomatous projections or as part of more densely cellular masses. A supporting fibrovascular stroma and mitotic figures were also evident. Constituent tumour cells were labeled positively with antibodies against both vimentin and cytokeratin. In contrast, the same cells exhibited equivocal labeling with an antibody directed against calretinin antigen and did not label with antibodies against carcinoembryonic antigen (CEA) and milk fat globule-related antigen (MFGRA). Such tumours are rare in dogs, particularly in such a young animal.

Invasive epithelial mesothelioma in a dog

This report describes the gross, microscopic, and immunohistochemical features of an invasive epithelial mesothelioma in an 11-year-old neutered male Golden Retriever. The tumor involved the pericardium, pleura, mediastinum, and peritoneum and invaded into submesothelial tissues. Neoplastic cells in the thoracic fluid showed prominent features of malignancy in a background of mixed inflammatory cells and scattered erythrocytes. Histologically, the tumor consisted of nests of epithelioid cells with frequent mitotic figures and multinucleation that infiltrated submesothelial tissues. Neoplastic cells strongly coexpressed vimentin and cytokeratin intermediate filaments, which assisted in the differentiation from other epithelial tumors of nonmesothelial origin.

Peritoneal Biphasic Mesothelioma in a Dog

A 10-year-old German shepherd dog was presented with a severe abdominal distension. At necropsy, whitish and firm mass was observed in the mesentery with metastases in the pericardium and pleura. The intestinal serosa was thickened and stiff. Histologically, the tumours were composed of a biphasic population of cells, which reacted with cytokeratin, vimentin and Wilms' tumour 1 protein antibody. Ultrastructural examination revealed numerous microvilli, abundant rough endoplasmic reticulum, numerous desmosomes and bundles of microfilament. The tumour was classified as biphasic mesothelioma of peritoneal origin.