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Cray M, Hokamp J, Abrams B, Husbands BD, Grimes JA, Gleason H, McChesney D, Casale SA, Selmic LE. Clinical Utility of Cytology from Preoperative Percutaneous Fine Needle Aspirates of Solitary Liver Masses in 220 Dogs: A Retrospective Study (2009-2019). J Am Anim Hosp Assoc 2023; 59:12-19. [PMID: 36584320 DOI: 10.5326/jaaha-ms-7283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 12/31/2022]
Abstract
When a solitary liver mass is identified in a dog, a fine-needle aspirate (FNA) is commonly employed to attempt to obtain a diagnosis. Little information is provided in the literature evaluating the sensitivity/specificity of FNA cytology for solitary liver masses. We hypothesized that liver lesion size nor the presence of cavitation would impact the success of cytological diagnosis. Medical records were obtained for 220 client-owned dogs. Inclusion criteria included preoperative abdominal imaging, percutaneous FNA of a solitary hepatic mass with cytologic interpretation by a board-certified pathologist, and a surgical biopsy or mass excision yielding a histopathological diagnosis. Six dogs (2.7%) experienced a complication after FNA, none considered severe. The agreement rate for correct cytologic diagnosis was 22.9% (49/220). Of the neoplastic masses 18.9% (35/185) were correctly diagnosed via cytology. The overall sensitivity was 60%, and the specificity was 68.6%. Neither institution (P = 0.16), lesion size (P = 0.88), cavitation (P = 0.34), or needle gauge (P = 0.20) had an association with correct diagnosis. This study demonstrates that, although there is a low risk of complications following FNA of a hepatic mass, overall success rate for correct cytologic diagnosis based on FNA was low compared to histopathologic diagnosis.
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Affiliation(s)
- Megan Cray
- From the Department of Surgery, Angell Animal Medical Center, Jamaica Plain, Massachusetts (M.C., D.M., S.A.C.)
| | - Jessica Hokamp
- From the Department of Veterinary Biosciences (J.H.), College of Veterinary Medicine, Ohio State University, Ohio
| | - Brittany Abrams
- From the Department of Veterinary Clinical Sciences (B.A., L.E.S.), College of Veterinary Medicine, Ohio State University, Ohio
| | - Brian D Husbands
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota (B.D.H.)
| | - Janet A Grimes
- From the Department of Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia (J.A.G.)
| | - Hadley Gleason
- From the Department of Veterinary Clinical Medicine, University of Illinois Urbana Champaign, Urbana, Illinois (H.G.)
| | - David McChesney
- From the Department of Surgery, Angell Animal Medical Center, Jamaica Plain, Massachusetts (M.C., D.M., S.A.C.)
| | - Sue A Casale
- From the Department of Surgery, Angell Animal Medical Center, Jamaica Plain, Massachusetts (M.C., D.M., S.A.C.)
| | - Laura Elizabeth Selmic
- From the Department of Veterinary Clinical Sciences (B.A., L.E.S.), College of Veterinary Medicine, Ohio State University, Ohio
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Sumping JC, Maddox TW, Killick D, Mortier JR. Diagnostic accuracy of ultrasonography to detect hepatic and splenic lymphomatous infiltration in dogs and cats. J Small Anim Pract 2021; 63:113-119. [PMID: 34617607 DOI: 10.1111/jsap.13438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/17/2021] [Accepted: 09/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of ultrasonography in the detection of lymphomatous infiltration of the liver and spleen in a population of dogs and cats with lymphoma. To determine if specific ultrasonographic features of the liver and spleen in dogs are associated with lymphomatous infiltration or a specific immunophenotype of multi-centric lymphoma. MATERIALS AND METHODS A blinded retrospective evaluation of ultrasonographic images of the liver and/or spleen in dogs and cats with cytologically or histologically confirmed lymphoma was performed by two board-certified veterinary radiologists. RESULTS A total of 161 animals met the inclusion criteria, comprising 132 dogs and 29 cats. Ultrasonography had a sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 16.7%, 91.0%, 55.9%, 62.5% and 55.0% for the detection of lymphomatous infiltration of the liver, and 73.1%, 93.9%, 82.6%, 93.4% and 74.7% for the spleen. In dogs, an ultrasonographically normal liver was associated with not having lymphomatous infiltration, leopard-spotted splenic parenchyma and splenomegaly were independently associated with lymphomatous infiltration and leopard-spotted splenic parenchyma was also associated with the B cell immunophenotype of multi-centric lymphoma. CLINICAL SIGNIFICANCE Ultrasonography of the spleen and liver is specific but not sensitive in the detection of lymphomatous infiltration. A leopard-spotted splenic parenchyma in dogs is highly specific for lymphomatous infiltration and in this population predicted a specific immunophenotype of multi-centric lymphoma.
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Affiliation(s)
- J C Sumping
- Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Cheshire, CH64 7TE, UK
| | - T W Maddox
- Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Cheshire, CH64 7TE, UK
| | - D Killick
- Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Cheshire, CH64 7TE, UK
| | - J R Mortier
- Centre Hospitalier Universitaire Vétérinaire d'Alfort, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, 94700, France
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Liffman R, Courtman N. Fine needle aspiration of abdominal organs: a review of current recommendations for achieving a diagnostic sample. J Small Anim Pract 2017; 58:599-609. [DOI: 10.1111/jsap.12709] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/21/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022]
Affiliation(s)
- R. Liffman
- Faculty of Veterinary Science; The University of Melbourne, 250 Princes Highway; Werribee Victoria 3030 Australia
| | - N. Courtman
- Faculty of Veterinary Science; The University of Melbourne, 250 Princes Highway; Werribee Victoria 3030 Australia
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Livet V, Sonet J, Saadeh D, Pillard P, Carozzo C. Needle‐tract implantation after fine‐needle aspiration biopsy of a renal cell carcinoma in a dog. VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2016-000349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Crain SK, Sharkey LC, Cordner AP, Knudson C, Armstrong PJ. Safety of ultrasound-guided fine-needle aspiration of the feline pancreas: a case-control study. J Feline Med Surg 2015; 17:858-63. [PMID: 25371007 PMCID: PMC11112200 DOI: 10.1177/1098612x14557910] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The safety of fine-needle aspiration (FNA) of the feline pancreas has not been reported. The incidence of complications following ultrasound-guided pancreatic FNA in 73 cats (pancreatic aspirate [PA] cats) with clinical and ultrasonographic evidence of pancreatic disease was compared with complications in two groups of matched control cats also diagnosed with pancreatic disease that either had abdominal organs other than the pancreas aspirated (control FNA, n = 63) or no aspirates performed (control no FNA, n = 61). The complication rate within 48 h of the ultrasound and/or aspirate procedure did not differ among the PA cats (11%), control FNA (14%) or control no FNA (8%) cats. There was no difference in rate of survival to discharge (82%, 84% and 83%, respectively) or length of hospital stay among groups. The cytologic recovery rate for the pancreatic samples was 67%. Correlation with histopathology, available in seven cases, was 86%. Pancreatic FNA in cats is a safe procedure requiring further investigation to establish diagnostic value.
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Affiliation(s)
- Sarah K Crain
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Leslie C Sharkey
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
| | | | | | - P Jane Armstrong
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
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Cordner AP, Sharkey LC, Armstrong PJ, McAteer KD. Cytologic findings and diagnostic yield in 92 dogs undergoing fine-needle aspiration of the pancreas. J Vet Diagn Invest 2015; 27:236-40. [PMID: 25776547 DOI: 10.1177/1040638715574862] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The diagnosis of pancreatic disease in small animal veterinary patients is complicated by nonspecific clinical signs and the limitations of diagnostic testing. Pancreatic cytology is a potential diagnostic tool, but safety and diagnostic yield are not well characterized in large patient cohorts. We hypothesized that pancreatic fine-needle aspiration (FNA) in dogs would frequently generate diagnostic-quality samples and subsequent adverse medical events would be uncommon. Ninety-two client-owned dogs undergoing pancreatic FNA for clinical diagnostic evaluation were identified retrospectively by a computer search for pancreatic cytology submissions. Archived slides were reviewed by a single board-certified clinical pathologist using a predetermined descriptive scheme. Medical records were reviewed for adverse events 48 hr following FNA, for concurrent procedures and diagnosis in patients with adverse events and for histology results. Diagnostic yield was calculated as the % cases in which a cytologic diagnosis could be achieved; correlation with histology or other confirmatory testing was determined when possible. Diagnostic yield was 73.5%, and the major pathologic process identified cytologically correlated with confirmatory testing in 10 out of 11 cases. There were 7 adverse events, all in dogs with significant comorbidities or undergoing other invasive procedures. Pancreatic FNA in dogs has a good diagnostic yield and a low rate of clinical complications in a large case series of dogs. Correlation of cytology and histology results was high in a limited number of cases.
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Affiliation(s)
- Amy P Cordner
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN
| | - Leslie C Sharkey
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN
| | - P Jane Armstrong
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN
| | - Kaitlyn D McAteer
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN
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Diagnostic value of cytological analysis of tumours and tumour-like lesions of the oral cavity in dogs and cats: a prospective study on 114 cases. Vet J 2014; 205:322-7. [PMID: 25466576 DOI: 10.1016/j.tvjl.2014.10.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/12/2014] [Accepted: 10/17/2014] [Indexed: 11/22/2022]
Abstract
Neoplastic or non-neoplastic masses are common findings in the oral cavity of cats and dogs. The aim of this prospective study was to compare the results of cytological examinations of lesions of the oral cavity following fine-needle aspiration (FNA), fine-needle insertion (FNI), and impression smear (IS) with histopathological results being considered as the diagnostic gold standard. In total, 85 dogs and 29 cats were included in the study. Cases were included when histology and cytology (FNA, FNI, and/or IS) were available from the same lesion; κ-agreement and accuracy between cytological and histopathological results were calculated. Eighteen cytological specimens were excluded, with a retrieval rate of 84.2%. Of the 96 samples analysed, FNA, FNI, and IS were available from 80, 76, and 73 animals, respectively. Overall, 60/67 (89.6%) and 21/29 (72.4%) lesions were neoplastic in dogs and cats, respectively, with the remaining being non-neoplastic. For all lesions, κ-values obtained by FNA, FNI, and IS were in dogs 0.83 (95% confidence interval [CI]: 0.77-0.90), 0.87 (95% CI: 0.81-0.93) and 0.75 (95% CI: 0.67-0.84), respectively, and in cats 0.92 (95% CI: 0.87-0.96), 0.92 (95% CI: 0.88-0.97) and 0.86 (95% CI: 0.79-0.92), respectively. The diagnostic accuracies of FNA, FNI, and IS in dogs with neoplasia were 98.2%, 98.1%, and 91.8%, respectively, and in cats with neoplasia were 95.6%, 95.6% and 95.8%, respectively. In conclusion, the high agreement with histopathology suggests that cytological examinations by FNI, FNA, and IS are all appropriate methods to correctly diagnose lesions of the oral cavity in dogs and cats.
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Fine needle biopsy of abdominal organs in dogs -- indications, contraindications and performance technique. Pol J Vet Sci 2014; 16:835-42. [PMID: 24597324 DOI: 10.2478/pjvs-2013-0118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recent years have seen in both human and veterinary medicine the development of numerous techniques allowing for evaluation and classification of changes in individual organs and tissues. Despite introduction of such techniques into diagnostics as among others, CT, MRI, CEUS or elastography, biopsy is still considered a "golden standard" and it is a procedure performed in order to obtain a final diagnosis. There are many biopsy techniques, such as fine needle aspiration biopsy, core biopsy as well as methods of performing a procedure, e.g. blind biopsy, biopsy under USG control and biopsy during laparotomy. In the article usefulness of biopsy techniques in relation to diagnostics of individual abdominal organ, as well as the procedure technique, contraindication and complications are discussed.
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Linderman MJ, Brodsky EM, de Lorimier LP, Clifford CA, Post GS. Feline exocrine pancreatic carcinoma: a retrospective study of 34 cases. Vet Comp Oncol 2012; 11:208-18. [DOI: 10.1111/j.1476-5829.2012.00320.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. J. Linderman
- The Veterinary Oncology and Hematology Center; Norwalk; CT; USA
| | - E. M. Brodsky
- The Veterinary Oncology and Hematology Center; Norwalk; CT; USA
| | | | | | - G. S. Post
- The Veterinary Oncology and Hematology Center; Norwalk; CT; USA
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Wypij JM. Getting to the point: indications for fine-needle aspiration of internal organs and bone. Top Companion Anim Med 2011; 26:77-85. [PMID: 21596347 DOI: 10.1053/j.tcam.2011.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 02/28/2011] [Indexed: 11/11/2022]
Abstract
The technique of fine-needle biopsy (fine-needle aspiration or fine-needle fenestration) for cytologic evaluation can be extended to many sites beyond the traditional lymph node and skin. Intra-abdominal, intrathoracic, and bone lesions can be easily and rapidly evaluated cytologically. Percutaneous fine-needle aspiration and fine-needle fenestration are useful, accurate, and inexpensive techniques with a rapid turnaround time, and outpatient applicability. For most pets, these minimally invasive techniques do not require anesthesia or analgesia. Although risks are inherent with any invasive procedure, complications are uncommon even with visceral and intrathoracic fine-needle biopsy. Attention to appropriate technique and close patient monitoring minimize the morbidity and improve the diagnostic utility. The low cost, low risk, minimal invasiveness, and high diagnostic yield make fine-needle biopsy particularly attractive to clients. In combination with ultrasound guidance and newer staining techniques, these diagnostic procedures are invaluable to the veterinary clinician.
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Affiliation(s)
- Jackie M Wypij
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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Skeldon N, Dewhurst E. The perceived and actual diagnostic utility of veterinary cytological samples. J Small Anim Pract 2009; 50:180-5. [DOI: 10.1111/j.1748-5827.2008.00701.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Frank JD, Reimer SB, Kass PH, Kiupel M. Clinical outcomes of 30 cases (1997-2004) of canine gastrointestinal lymphoma. J Am Anim Hosp Assoc 2007; 43:313-21. [PMID: 17975213 DOI: 10.5326/0430313] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In 30 cases of canine gastrointestinal lymphoma, each case was localized to the stomach, small intestine, large intestine, or two or more sites. Treatments consisted of surgery alone (n=4), surgery with chemotherapy (n=8), chemotherapy alone (n=15), or supportive care (n=3). Four dogs died, 24 were euthanized, and two are currently alive. Median survival time for all cases was 13 days. In both surviving dogs, the site of lymphoma was the large intestine. Canine gastrointestinal lymphoma is a severe disease that warrants a poor to grave prognosis. However, cases of colorectal origin may have longer survival times.
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Affiliation(s)
- Joseph David Frank
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, Michigan State University, East Lansing, Michigan 48824-1314, USA
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Batchelor DJ, Bright SR, Ibarrola P, Tzannes S, Blackwood L. Long-term survival after combination chemotherapy for bilateral renal malignant lymphoma in a dog. N Z Vet J 2006; 54:147-50. [PMID: 16751846 DOI: 10.1080/00480169.2006.36627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
CASE HISTORY A 6-year-old, entire male Flat-coated Retriever was presented with a history of lethargy, polydipsia and seizures. Clinical chemistry had shown marked azotaemia. CLINICAL FINDINGS AND DIAGNOSIS Radiography and ultrasonography revealed bilateral renomegaly, and cytology of fine needle aspirates from the kidneys was diagnostic of malignant lymphoma. The dog was treated with a modified high-dose cyclophosphamide-, vincristine-, and prednisolone-based chemotherapy protocol, achieved remission, and returned to normal quality of life. Survival time was 346 days from the time of diagnosis. CLINICAL RELEVANCE Malignant lymphoma in the kidneys of dogs has been considered to carry a uniformly poor prognosis. Long-term remission after medical treatment has not previously been reported. The favourable outcome in this case illustrates the limitations of clinical staging in determining the outcome for individual patients.
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Affiliation(s)
- D J Batchelor
- Small Animal Hospital, Department of Clinical Veterinary Science, University of Liverpool, Crown St, Liverpool, L7 7EX, United Kingdom.
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