Bilateral dystrophic calcinosis circumscripta in a cynomolgus macaque (Macaca fascicularis)

Uncommon Atlantoocciptal Localization of Tumoral Calcinosis in a Dog

A 5-month-old male Rottweiler dog presented with an acute upper motor neuron tetraparesis. A computed tomography study of the cervical spine revealed amorphous mineralization of the soft tissues dorsal to the articular surface of the occipital bone and atlas. The calcification extended into the vertebral canal, causing significant dorsal compression of the spinal cord. Suboccipital craniectomy and partial dorsal atlas laminectomy were performed to remove the extradural calcification. Histopathology was compatible with tumoral calcinosis. Significant clinical improvement was noted in the immediate postoperative period, and there was complete recovery with no recurrence at the last clinical follow-up 15 months postoperatively. Suboccipital craniectomy and partial dorsal atlas laminectomy allowed successful surgical resection of a dorsal craniooccipital tumoral calcinosis in this dog. The decompression resulted in resolution of clinical signs and recurrence is unlikely since there is no underlying disease.

International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Non-proliferative and Proliferative Lesions of the Non-human Primate (M. fascicularis)

The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions Project (www.toxpath.org/inhand.asp) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in most tissues and organs from the nonhuman primate used in nonclinical safety studies. Some of the lesions are illustrated by color photomicrographs. The standardized nomenclature presented in this document is also available electronically on the internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous lesions as well as lesions induced by exposure to test materials. Relevant infectious and parasitic lesions are included as well. A widely accepted and utilized international harmonization of nomenclature for lesions in laboratory animals will provide a common language among regulatory and scientific research organizations in different countries and increase and enrich international exchanges of information among toxicologists and pathologists.

CALCINOSIS CIRCUMSCRIPTA IN A COHORT OF RELATED JUVENILE AFRICAN LIONS (PANTHERA LEO)

Three juvenile, genetically related African lions (Panthera leo) were evaluated for discrete dome-shaped subcutaneous masses present over the proximal lateral metatarsal-tarsal area. The lesions measured 3-8 cm in diameter, were fluctuant to firm, nonulcerated, and attached to underlying structures. On radiographic evaluation, the lesions were characterized by well-circumscribed punctate mineralizations in the soft tissue surrounded by soft tissue swelling without evidence of adjacent bony involvement. On cut surface, the lesions were made of numerous loculi containing 2-5-mm round-to-ovoid, white-to-gray, firm structures interspersed with fibrous tissue and pockets of serosanguinous fluid. Hematology, serum biochemistry, serum thyroid screening (including total thyroxine, total triiodothyronine, free thyroxine, and free triiodothyronine), and serum vitamin D panels (including parathyroid hormone, ionized calcium, and 25-hydroxyvitamin D) were unremarkable. Histopathologic evaluation of the lesions was consistent with calcinosis circumscripta with fibroplasia, chronic inflammation, and seroma formation. An additional two genetically related lions were considered suspect for calcinosis circumscripta based on presentation, exam findings, and similarity to the confirmed cases. All masses self-regressed and were not associated with additional clinical signs other than initial lameness in two cases.

Calcinosis Circumscripta in the Digital Extensor Tendon of a Tawny Eagle (Aquila rapax)

A 9-month-old, captive-bred, female tawny eagle (Aquila rapax) presented with a nonpainful, firm, nodular structure attached to the digital extensor tendon. The mass was surgically resected without complications and was submitted for histopathologic examination. Grossly, cut surfaces of the lesion had chalky-white deposits. Histologically, the resected tissue was identified as calcinosis circumscripta. No recurrence was observed in follow-up after 6 and 12 months. To our knowledge, this is the first case of calcinosis circumscripta in a bird involving a limb extremity, similar to the presentation recognized more commonly in domestic animals. Calcinosis circumscripta should be included in the differential diagnosis list for nodular masses attached to the tendons in birds.

Tumoral Calcinosis Form of Hydroxyapatite Deposition Disease in Related Red-Bellied Short-Necked Turtles, Emydura subglobosa

Ten of 12 red-bellied short-necked turtles from a single clutch presented at 9 months of age with multiple white to tan nodules on their feet. Histologically, the nodules were composed of large periarticular deposits of mineralized crystalline material that extended into the joint spaces of interphalangeal joints and was surrounded by granulomatous inflammation and fibrosis. Crystallographic analysis determined the material to be apatite (calcium phosphate hydroxide) consistent with the tumoral calcinosis form of hydroxyapatite deposition disease (HADD). HADD has previously been described in aquatic turtles and rarely lizards and must be differentiated from gout in reptiles. A cause for the tumoral calcinosis lesions in these turtles could not be determined; however, based on previous reports in this species, a species-specific predilection, in conjunction with unknown environmental factors, is suspected. The use of the terms HADD, pseudogout (calcium pyrophosphate crystal deposition disease), and calcinosis circumscripta has been inconsistent, creating confusion in the literature.