Imaging diagnosis--spinal cord histiocytic sarcoma in a dog

Comparison of the Clinical Characteristics of Histiocytic Sarcoma in Bernese Mountain Dogs and Flat-Coated Retrievers

Simple Summary

Histiocytic sarcoma (HS) is a malignant hematopoietic tumor. It can affect any organ in the body and, therefore, can have a broad spectrum of clinical presentations. So far, no complete overview exists of the array of clinical aspects of HS in specific dog breeds in large groups. Therefore, we investigated the clinical characteristics of HS in a population of Bernese Mountain Dogs (BMD; n = 365) and Flat-Coated Retrievers (FCR; n = 289), which are two of the most affected dog breeds. The dogs were selected from veterinary pathology services, and each dog’s clinical and diagnostic characteristics were retrospectively collected. Localized HS was reported significantly more frequently in the FCR (60.6%) than in the BMD (39.2%), and disseminated HS was recorded significantly more frequently in the BMD (60.8%) than in the FCR (39.4%). Lameness as a clinical symptom was observed more frequently in the FCR, predominant in the front legs. With blood examination, the BMD had significantly more often leukocytosis and thrombocytopenia, while no difference in the occurrence of anemia was observed. Strikingly hypercalcemia was only observed in 15 BMD and in none of the FCR in which blood examination was performed. The new information provided in this study can aid the diagnostic process and allow for prompt treatment recommendations.

Abstract

Histiocytic sarcoma (HS) is an aggressive malignant tumor of histiocytes, which can affect almost any organ in the body and is characterized by a broad array of tumor locations and clinical presentations. So far, no complete overview exists of the array of clinical aspects of HS in specific dog breeds in large groups. Therefore, we investigated the clinical characteristics of HS in a population of Bernese Mountain Dogs (BMD; n = 365) and Flat-Coated Retrievers (FCR; n = 289), which are two of the most affected dog breeds. Cases were selected from databases from different pathology services, and clinical information was retrospectively collected for each case. Localized HS was reported significantly more frequently in the FCR (60.6%) than in the BMD (39.2%), and disseminated HS was recorded significantly more frequently in the BMD (60.8%) than in the FCR (39.4%). Lameness was seen more often in FCR than in BMD, and the vast majority (78.1%) of LHS leading to lameness was located in the front legs in the FCR, while in the BMD, there was a more even distribution. BMD had significantly more often leukocytosis and thrombocytopenia, even corrected for the type of HS, than FCR. No significant difference in the frequency of anemia was recorded between BMD and FCR. In those dogs in which blood examination was performed, hypercalcemia was diagnosed in 15 BMD, while none of the FCR had hypercalcemia. The new information provided in this study can aid the diagnostic process and allow for prompt treatment recommendations.

Doxorubicin for treatment of histiocytic sarcoma in dogs: 31 cases (2003-2017)

OBJECTIVE

To evaluate the efficacy of doxorubicin for treatment of histiocytic sarcoma (HS) in dogs, whether administered as the sole treatment or as an adjunct to surgery or radiation therapy.

ANIMALS

31 client-owned dogs with localized or disseminated HS examined between 2003 and 2017.

PROCEDURES

Medical records were reviewed retrospectively, and data were collected. The Kaplan-Meier method was used to estimate time-to-progression from the date of first doxorubicin administration and survival time from initial diagnosis. Factors that could be associated with poorer outcomes with doxorubicin treatment were analyzed with log-rank tests.

RESULTS

The objective response rate (ORR) was 26%. When stratified by disease status, dogs with localized and disseminated forms experienced 43% and 21% ORRs, respectively. Median time to progression after initiating doxorubicin treatment (n = 30 dogs) was 42 days. Median survival time from initial diagnosis to death (n = 29 dogs) was 169 days. Complete responses were obtained in only 2 dogs that had localized disease and received multimodality therapy.

CLINICAL RELEVANCE

Benefits of doxorubicin administration in canine HS are modest, with a limited ORR and delay in tumor progression, and are comparable to effects attained with other single-agent regimens.

Magnetic resonance imaging findings of an intradural extramedullary hemangiosarcoma in a dog

An 11-year-old male Miniature Dachshund was referred for acute neurological deficits in the pelvic limbs. T2-weighted magnetic resonance imaging revealed that the spinal cord at the L1-2 intervertebral disc space was heterogeneously hyperintense in the sagittal plane and was mildly compressed from the ventral side by a small hypointense mass in the transverse plane. However, the lesion showed mass enhancement and severe spinal cord compression on post-contrast T1-weighted imaging. On three-dimensional myelography, a “golf tee sign” was observed around the mass. Therefore, we diagnosed an intradural extramedullary lesion. The mass was surgically removed and histologically diagnosed as a hemangiosarcoma. The “golf tee sign” observed on magnetic resonance myelography may be useful for distinguishing intradural extramedullary masses from intramedullary masses.

Diffuse leptomeningeal histiocytic sarcoma in the cerebrospinal fluid of 2 dogs

Two adult male castrated dogs were evaluated for progressive paraparesis and ataxia. Neurologic examination showed severe ataxia, delayed proprioceptive placement in the pelvic limbs, pain upon palpation of the lumbar spine as well as facial paresis in one dog, and decreased withdrawal reflex of the pelvic limbs in the other dog. Magnetic resonance imaging (MRI) in both dogs showed diffuse meningeal and intramedullary lesions. However, no evidence of a mass was found. Biopsies could not be performed safely due to the location of the lesions. Cerebrospinal fluid (CSF) examination revealed an inflammatory pleocytosis associated with increased protein concentration and numerous large atypical round cells, often multinucleated. Nuclear fragmentation, micronuclei, and rare atypical mitoses were observed. Immunocytochemistry revealed CD1(+) and CD11c(+) staining, which, in concert with the morphology confirmed the diagnosis of histiocytic sarcoma (HS). Euthanasia was elected due to poor prognosis. Histopathologic examination showed diffuse spinal and meningeal infiltration with CD18(+) neoplastic cells, without any evidence of mass formation, which completed the diagnosis of diffuse leptomeningeal HS involving the brain and the spinal cord. Canine central nervous system (CNS) HS has been seldom reported in the literature, with only isolated cases identified on CSF cytology. The cases reported here are remarkable in describing a diffuse CNS leptomeningeal HS associated with neoplastic cells in the CSF of dogs without a tumor mass. These cases emphasize the potential critical importance of CSF analysis in providing an antemortem diagnosis of neoplasia in neurologic patients.