Infectious Causes of Neoplasia in the Domestic Cat

In recent years, growing attention has been paid to the influence/role of infectious diseases in tumour development and progression. Investigations have demonstrated that some infectious organisms can have a direct role in the development of neoplasia, whereas others can predispose to neoplasia by alterations in the immune response, or by creating a pro-inflammatory environment. Feline leukaemia virus was one of the first infectious agents recognised as an oncogenic organism, and along with feline immunodeficiency virus has received the most attention. Since the discovery of this retrovirus, several other organisms have been associated with neoplastic processes in cats, these include gammaherpes virus, mouse mammary tumour virus, papillomaviruses, hepadnavirus, Helicobacter species, and the parasitic infections Platynosomum fastosum and Opisthorchis viverrini. This review summarises the findings to date.

Cutaneous Spindle Cell Squamous Cell Carcinoma in Cats: Clinical, Histological, and Immunohistochemical Study

This study describes the clinical and pathological characteristics of cutaneous spindle cell squamous cell carcinoma (SCSCC) in 18 cats. The average age of the cats was 11.8 ± 2.7 years, and all tumors were located in the facial skin, mainly affecting the pinna (13/18, 72%), followed by the periorbital area (4/18, 22%) and the dorsal muzzle (1/18, 6%). Tumors were composed of fusiform neoplastic cells with moderate atypia arranged in solid sheets or fascicles with foci of squamous differentiation. A panel of antibodies against cytokeratins, vimentin, S-100 protein, NSE, GFAP, Melan A, SMA, desmin, CD18, CD31, and p63 was used to help differentiate SCSCC from other spindle cell malignancies. SCSCCs expressed CK5/6 (17/18, 94%), AE1/AE3 (15/18, 83%), and p63 protein (18/18, 100%), but there was no immunolabeling for CK8/18. A role for sunlight exposure in the pathogenesis of the tumors was suggested by changes indicative of actinic keratosis, the location of the tumors in dorsal areas, and the absence of histomorphologic features of papillomavirus infection. Recurrence was not recorded in 14/18 cases (78%) during a follow-up period of 7 to 25 months. Three of 18 (17%) tumors recurred or led to humane euthanasia due to local progression, and one case (5%) had regional lymph node metastasis. Clinical outcome varied with cutaneous location, mitotic count, and invasion of surgical margins; thus, SCSCCs with a more aggressive behavior were located in the periorbital area (4/4 cases), had ≥14 mitoses in 10 high-power fields (2.37 mm²) (4/4 cases), and showed invasion of surgical margins (3/4 cases).

Comparative In Vitro and In Vivo Studies on Feline, Canine, and Human Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine tumor, and most human MCC cases are infected by Merkel cell polyomavirus (MCPyV). However, the underlying pathogeneses of MCC in animals remain unclear. In the present study, newly established cell lines from feline and canine MCC, a MCPyV-positive human MCC cell line, and MCC tissues from 25 cats and 1 dog were examined and compared pathologically. Feline and canine MCCs were composed of tumor cells arranged in trabeculae and solid packets. Twenty out of 25 feline MCC cases (80%) had other proliferative cutaneous lesions, such as carcinoma in situ and squamous cell carcinoma. Among the 25 feline MCC cases, tumor cells were immunopositive for cytokeratins (CKs), including CK5/6 (4/25 cases, 16%), CK7 (5, 20%), CK18 (25, 100%), CK19 (20, 80%), and CK20 (20, 80%). The tumor cells of feline MCC were also immunopositive for synaptophysin (24/25, 96%) and CD56 (22/25, 88%). The tumor cells of canine MCC were immunopositive for CK18, CK19, CK20, and synaptophysin. Cultured feline and canine MCC cells grew in adherent monolayers and exhibited diffuse cytoplasmic immunoreactivity for CKs, whereas human MCC cells grew in suspension and exhibited dot-like cytoplasmic immunoreactivity for CKs. Differences in the distribution of CKs between human and animal MCC may be attributed to cell adhesion propensities. MCPyV genes and antigen were not detected in feline or canine MCC, suggesting a different etiology from human MCC.

Distinguishing Between Dermatologic Disorders of the Face, Nasal Planum, and Ears: Great Lookalikes in Feline Dermatology

Facial dermatitis in cats can be caused by a broad range of infectious, allergic, immune-mediated and neoplastic disorders with very different treatments and prognoses. Baseline dermatologic diagnostics (skin scrapings for mites, cytology for infection and to characterize inflammatory infiltrate, and dermatophyte culture) are required, as well as possible further diagnostics, including therapeutic trials for parasites and feeding a hypoallergenic diet, bacterial culture, and skin biopsies for histopathology in order to achieve a diagnosis. Clinical presentations of diseases affecting different parts of the feline face are presented and discussed.

Prognostic factors for cats with squamous cell carcinoma of the nasal planum following high-dose rate brachytherapy

OBJECTIVES

The aim of the study was to investigate retrospectively the prognostic impact of variables such as sex, neuter status, breed, age, number of lesions, location and size of the tumour, tumour extension beyond the nasal planum, ulceration and lymph node status, among others, in a population of cats treated with high-dose rate brachytherapy.

METHODS

This study reviews the outcome of 58 cats with cytologically and/or histologically confirmed squamous cell carcinoma of the nasal planum, treated at the Clinic Alliance (Bordeaux, France) with high-dose rate brachytherapy from 2010-2016. The total radiation dose delivered was 30 Gy, administered in two different schedules: five fractions of 6 Gy for a period of 4 days (Tuesday-Friday) or four fractions of 7.5 Gy for a period of 3 days (Tuesday- Thursday). Data were collected from cats' clinical records.

RESULTS

Complete response was achieved in 72% (n = 36) of the cats, partial response in 24% (n = 13) and 2% (n = 1) did not respond. Median progression-free survival and overall survival times were 316 and 835 days, respectively.

CONCLUSIONS AND RELEVANCE

Results indicated that sex (P = 0.045), extension of the tumour from the nasal planum to the upper lip (P = 0.015), tumour size (P = 0.015; P = 0.001), the existence of a previous treatment (P = 0.043) and the tumour response to high-dose rate brachytherapy (P = 0.038; P <0.001) are prognostic factors for cats with squamous cell carcinoma of the nasal planum following high-dose rate brachytherapy.

Clinical features and outcomes of Merkel cell carcinoma in 20 cats

The biological behaviour and prognostic factors of Merkel cell carcinoma (MCC) in 20 cats were studied. The tumours were surgically removed and histopathologically examined. The animals were 8 to 20 years old (median age: 14 years), and the tumours were predominantly located in the neck and head. Follow-up data were available in 17 cases, and 12 cats died within a year of surgery. The overall median survival time after resection was 243 days (range 16-360 days). Recurrence occurred in 11 cases, although 6 of them (55%) were found to be margin-negative. Possible metastasis occurred after the surgery in 10 cases, although 6 of them (60%) were found to be margin-negative. The histopathological features of MCC included tumour necrosis in 16 cases (80%), vascular invasion in 6 cases (38%) and high mitotic counts (median: 28.5 per high-power field). Irregular acanthosis was noted adjacent to the tumours in 9 cases (60%). Immunohistochemically, the tumour cells were positive for cytokeratin (CK) 20 and p63 in all cases, synaptophysin in 19 (95%) cases, and CK18 in 16 cases (80%). The study shows that feline MCC is associated with a poor prognosis and exhibited a strong tendency towards local recurrence, regional lymph node metastasis and distant spread.

Doenças micóticas em gatos no Rio Grande do Sul

RESUMO: As enfermidades fúngicas são diagnósticos diferenciais de diversas morbidades de caráter infeccioso, degenerativo ou proliferativo neoplásico, principalmente em gatos, que é a espécie mais suscetível a estas. Este trabalho descreve os achados anatomopatológicos de doenças fúngicas em gatos no período de janeiro de 2005 a dezembro de 2015 pelo SPV-UFRGS. Foram revisados 1.274 protocolos de necropsia e encontrou-se 17 casos de micoses, correspondendo a 1,33% dos diagnósticos. Quanto às amostras provenientes de biopsias, foram verificados 2.615 protocolos e detectou-se 59 casos de doenças fúngicas, totalizando 2,25% dos diagnósticos, sendo revisados seus achados macroscópicos, microscópicos, colorações especiais e cultivo micológico. O principal diagnóstico encontrado foi esporotricose com 34 casos de biópsia e cinco de necropsia. Criptococose obteve seis diagnósticos na necropsia e 13 na biópsia. O pseudomicetoma dermatofítico possui cinco casos de biópsia e dois de necropsia. Histoplasmose obteve um diagnóstico na necropsia e dois na biópsia. Aspergilose teve dois casos diagnosticados na necropsia. Candidíase e feo-hifomicose obtiveram um caso cada. Em quatro ocasiões, não se pode identificar o agente envolvido na lesão e foram classificados conforme a alteração morfológica em: dermatite fúngica, enterite fúngica, rinite micótica e dermatite e osteomielite fúngica. Através deste trabalho, pode-se identificar que a esporotricose foi o diagnóstico de doença fúngica mais frequente em felinos, seguido da criptococose e pseudomicetoma dermatofítico.

Geno- and seroprevalence of Felis domesticus Papillomavirus type 2 (FdPV2) in dermatologically healthy cats

Background

Papillomaviruses can cause proliferative skin lesions ranging from benign hyperplasia to squamous cell carcinoma (SCC). However, asymptomatic infection is also possible. Several groups have detected Felis domesticus Papillomavirus type 2 (FdPV2) DNA in association with feline Bowenoid in situ carcinoma (BISC). Therefore, a causative connection has been suggested. However, the knowledge about FdPV2 epidemiology is limited. The aim of this study was to describe the genoprevalence and seroprevalence of FdPV2 in healthy cats.

For this purpose an FdPV2-specific quantitative (q)PCR assay was developed and used to analyse Cytobrush samples collected from 100 dermatologically healthy cats. Moreover, an ELISA was established to test the sera obtained from the same cats for antibodies against the major capsid protein (L1) of FdPV2.

Results

The genoprevalence of FdPV2 was to 98 %. Surprisingly, the quantities of viral DNA detected in some samples from the healthy cats exceeded the amounts detected in control samples from feline BISC lesions. The seroprevalence was much lower, amounting to 22 %. The concentrations of antibodies against FdPV2 were relatively low in healthy cats, whereas they were very high in control cats with BISC.

Conclusion

These observations suggest that FdPV2 is highly prevalent, even among healthy cats. However, cats that carry it on their skin mount in most instances no antibody response. It might be hypothesized that FdPV2 is only rarely productively replicating or its replication is only rarely exposed to the immune system.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-016-0776-7) contains supplementary material, which is available to authorized users.

The detection of Felis catus papillomavirus 3 DNA in a feline bowenoid in situ carcinoma with novel histologic features and benign clinical behavior

Bowenoid in situ carcinoma (BISC; papillomavirus-associated squamous cell carcinoma in situ) is an uncommon skin neoplasm of cats that can result in euthanasia because of the development of multiple lesions or because of progression to invasive squamous cell carcinoma. BISCs are currently thought to be caused by Felis catus papillomavirus 2 (FcaPV-2). The presently described cat developed a single 0.5 cm in diameter interscapular mass. Over the following 18 months, the mass doubled in size; no additional lesions developed. The mass was surgically excised and histologically diagnosed as a BISC. However, in contrast to previously reported BISCs, neither prominent thickening of the deep aspects of the follicular infundibula nor marked cell dysplasia were present. Furthermore, ~50% of the keratinocytes in the affected epidermis had prominent PV cytopathic changes that included shrunken angular nuclei and elongated basophilic cytoplasmic inclusions. As the histopathology was not typical for FcaPV-2 infection, polymerase chain reaction was performed and revealed only DNA sequences from Felis catus papillomavirus 3 (FcaPV-3). No further BISCs developed in this cat 6 months postremoval, hence surgical excision appeared to be curative. Results from this case suggest that, although FcaPV-2 appears to be the predominant cause of BISCs in cats, infection by FcaPV-3 can also cause these neoplasms. BISCs caused by FcaPV-3 appear to have unique histologic features that allow the causative PV type to be predicted. Results from this single case suggest that BISCs caused by FcaPV-3 may have a more benign clinical course than those caused by FcaPV-2.

Novel Papillomaviral Sequence Detected within Epidermal Plaques in a Wolf (Canis lupus)

We describe numerous pale plaques affecting the inguinal skin of a grey wolf (Canis lupus). Histologically, these were consistent with papillomaviral plaques. Immunohistochemistry confirmed papillomavirus antigens, and partial sequencing of the L1 gene suggests this is a novel papillomavirus most-closely related to Canis familiaris Papillomavirus 5.

Electrochemotherapy with intravenous bleomycin injection: an observational study in superficial squamous cell carcinoma in cats

The aim of this study was to evaluate the efficacy and safety of electrochemotherapy (ECT) with bleomycin for treatment of squamous cell carcinoma (SCC) in cats. Between March 2008 and October 2011, 11 cats with 17 superficial SCC nodules in different clinical stages (ranging from Tis to T4), located on nasal planum (6/11), pinnae (3/11) and both locations (2/11), were included in a prospective non-randomised study. Sixteen of 17 SCC nodules were treated with ECT (15/16 with single session and in one case with two sessions); one nodule was surgically removed. Altogether, complete response (CR) was achieved for 81.8% (9/11) cats and 87.5% (14/16) nodules, lasting from 2 months up to longer than 3 years. Only 2/9 cats in which CR was initially observed, had recurrence 2 and 8 months after the ECT procedure. In the remaining two cats with highly infiltrative spread into adjacent tissues, progression of the disease was observed, despite ECT, and both were euthanased 4 and 5 months after the procedure. ECT in cats was well tolerated and no evident local or systemic side effects were observed. The results of this study suggest that ECT is a highly effective and safe method of local tumour control of feline cutaneous SCCs. It should be considered as an alternative treatment option, especially when other treatment approaches are not acceptable by the owners, owing to their invasiveness, mutilation or high cost.

Comparison of the antitumor effects of an MDM2 inhibitor, nutlin-3, in feline lymphoma cell lines with or without p53 mutation

The P53 tumor suppressor protein is a multifunctional transcription factor that prevents the malignant transformation of normal cells. In human malignancies, p53 is the most frequently altered gene and is mutated in approximately 50% of all malignancies. In contrast, p53 gene mutation has been rarely detected in feline malignancies, and most feline malignancies conceivably retain the wild-type p53 (wt-p53) gene. MDM2 negatively regulates the P53 protein by inhibiting its transcriptional activity and nuclear transport and by inducing its degradation. Inhibition of P53-MDM2 interaction stabilizes P53 protein and activates P53 pathway. Nutlin-3, a small molecule that inhibits P53-MDM2 interaction, was shown to have an antitumor effect in several human cancer cells retaining the wt-p53 gene. In the present study, we evaluated and compared the antitumor effect of nutlin-3 in 5 different feline lymphoma cell lines, of which 3 harbored wt-p53, and 2, mutated p53 (mt-p53). Treatment with nutlin-3 resulted in increased amounts of P53 protein in conjunction with augmented expression of P53-target genes in 3 feline lymphoma cell lines with the wt-p53 gene, but not in 2 feline lymphoma cell lines with the mt-p53 gene. Nutlin-3 treatment also induced G1-S and/or G2-M cell cycle arrest and apoptosis in lymphoma cell lines with wt-p53. Nutlin-3 treatment induced cell cycle arrest but not apoptosis in the cell lines with mt-p53. From these results, we concluded that nutlin-3 has an antitumor effect on feline lymphoma cell lines harboring the wt-p53 gene through accumulation and activation of P53 leading to cell cycle arrest and apoptosis. The present study suggests that inhibition of P53-MDM2 interaction using nutlin-3 may be a new therapeutic strategy for treating feline lymphoma retaining the wt-p53 gene.

Loss of Retinoblastoma Protein, But Not p53, Is Associated With the Presence of Papillomaviral DNA in Feline Viral Plaques, Bowenoid In Situ Carcinomas, and Squamous Cell Carcinomas

Although papillomaviral (PV) DNA is frequently present in feline cutaneous squamous cell carcinomas (SCCs), a causative association cannot be proven. Oncogenic human PVs cause neoplastic transformation by inhibiting retinoblastoma (pRb) and p53 activity. Therefore, absence of pRb and p53 immunostaining, along with increased p16 immunostaining, indicates a PV cause in some human SCCs. If PVs cause cutaneous feline SCCs, it was hypothesized that a similar immunohistochemistry profile, along with PV DNA, would be detectable. This was investigated using 5 feline viral plaques, 10 Bowenoid in situ carcinomas, 19 SCCs from ultraviolet-exposed (UV-exposed) skin, and 11 SCCs from UV-protected skin. Papillomaviral DNA was amplified by polymerase chain reaction from 30 of 45 lesions. Reduced pRb immunostaining was present in 26 of 45; increased p16 immunostaining was in 30; and p53 immunostaining was in 19. Both reduced pRb immunostaining and increased p16 immunostaining were more frequent in lesions containing PV DNA. In contrast, no association was observed between p53 immunostaining and the presence of PV DNA. SCCs from UV-protected skin more frequently contained PV DNA, reduced pRb, and increased p16 than UV-exposed SCCs. UV exposure was not associated with p53 immunostaining within the SCCs. These results suggest that feline PVs alter cell regulation by degrading pRb. Unlike oncogenic human PVs, there was no evidence that feline PVs degrade p53. These results provide further evidence that PVs may cause feline cutaneous SCCs, especially those in UV-protected skin, and they suggest a possible mechanism of this oncogenic action.

Detection of human papillomavirus DNA in feline premalignant and invasive squamous cell carcinoma

Squamous cell carcinoma (SCC) is the most common malignant cutaneous and oral neoplasm of cats. Papillomavirus (PV) DNA has been identified in a proportion of feline Bowenoid in situ carcinomas (BISCs), cutaneous SCCs and a single oral SCC, but its exact role in the pathogenesis remains unknown. In humans, it has been suggested that ultraviolet (UV) light and human PV (HPV) may act as cofactors in cutaneous SCC carcinogenesis. Little is known about the influence of UV light on PV prevalence in feline cutaneous lesions, including actinic keratosis (AK). Additionally, PV prevalence in noncutaneous feline lesions, including oral SCC, is largely not known. This study aimed to determine the presence of PV in 84 cats with premalignant and invasive SCC from cutaneous and noncutaneous sites using polymerase chain reaction and to investigate an association with UV light. Papillomaviral DNA was amplified from two of 12 cases of AK, seven of 22 BISCs, nine of 39 cutaneous SCCs and two of 35 non-cutaneous SCCs. Of the PV DNA sequenced, 50% was most similar to HPV of the genus Betapapillomavirus, while the other 50% was most similar to Felis domesticus PV type 2. Exposure to UV was not associated with an increase in PV for cutaneous SCC. The results of this study suggest that in the cat, HPV DNA may be detectible within a higher percentage of squamous lesions than previously demonstrated, UV exposure may not be a confounder for PV presence, and noncutaneous lesions may have a low prevalence of PV.

Epidermal growth factor receptor expression is predictive of poor prognosis in feline cutaneous squamous cell carcinoma

The aim of this study was to investigate epidermal growth factor receptor (EGFR) expression in feline cutaneous squamous cell carcinoma (FC-SCC) and assess its prognostic role. Nineteen formalin-fixed paraffin-embedded excisional biopsies of FC-SCC were tested for EGFR expression using immunohistochemistry (IHC). Relationships between EGFR expression and histopathological parameters (differentiation, mitotic activity), disease-free interval (DFI) and overall survival (OS) at 24 months were further investigated. Fourteen of 19 tumours (73.7%) were positive for EGFR, with great variation in intensity and proportion of labelled cells. EGFR expression was not correlated with tumour differentiation or mitotic activity. Nine cats (47.4%) died of tumour-related causes. Patients with EGFR-positive tumours had a significantly worse outcome (P=0.0217), with decreased DFIs (P=0.0075) and survival times (P=0.0391). These data suggest that EGFR expression carries a negative prognostic significance in FC-SCC. EGFR inhibitors in association with conventional treatments may improve outcome for the subgroup of cats with EGFR-positive tumours.

Increased p16CDKN2A Protein Within Feline Cutaneous Viral Plaques, Bowenoid In Situ Carcinomas, and a Subset of Invasive Squamous Cell Carcinomas

Cutaneous viral plaques and bowenoid in situ carcinomas (BISCs) in cats are thought to be caused by papillomavirus (PV) infection. There is evidence that PVs may also cause some feline invasive squamous cell carcinomas (ISCCs). Human oncogenic PVs degrade retinoblastoma (RB) protein, impairing cell cycle control. Loss of RB function also increases p16CDKN2A protein (p16), and increased p16 immunoreactivity within a human oral ISCC indicates that the neoplasm was caused by PV infection. In the present study, p16 immunoreactivity was evaluated in 14 feline viral plaques, 14 BISCs, 7 non–solar-induced ISCCs, 11 solar-induced ISCCs, and 14 trichoblastomas. Increased p16 was present within all viral plaques, BISCs, and non–solar-induced ISCCs. In contrast, little p16 immunoreactivity was visible in the solar-induced ISCCs or trichoblastomas. PV DNA was consistently amplified from viral plaques, BISCs, and non–solar-induced ISCCs. However, just 5 solar-induced ISCCs and 1 trichoblastoma contained PV DNA. Given that both increased p16 immunoreactivity and PV DNA were present within viral plaques, BISCs, and non–solar-induced ISCCs, all 3 may be caused by PV infection. This suggests that feline non–solar-induced ISCCs may develop as a result of neoplastic progression from viral plaques and BISCs. Whether PVs promote this progression is unknown; however, evidence from this study suggests the PV that is associated with viral plaques and BISCs is able to disrupt the p16–RB pathway and therefore could have oncogenic potential. Immunohistochemical detection of p16 appears to be a useful technique to investigate the role of PVs in feline skin disease.

Multicentric Squamous Cell Carcinoma In Situ Associated With Papillomavirus in a Ferret

A 6-year-old castrated male ferret presented with multiple black and tan proliferative skin lesions. Histologically, the lesions were characterized by multifocal plaques of irregular epidermal hyperplasia and full-thickness dysplasia, with loss of normal epithelial stratification, loss of nuclear polarity, and rare eosinophilic intranuclear inclusion bodies in the superficial layers of the epidermis. Immunohistochemical staining with a monoclonal antibody against papillomaviruses was strongly immunoreactive. Ultrastructurally, large numbers of hexagonal viral particles approximately 50 nm were observed within the nuclei of dysplastic superficial keratinocytes. To the authors' knowledge, this is the first report of a ferret multicentric squamous cell carcinoma in situ associated with papillomavirus.

Papillomavirus-Associated Cutaneous Neoplasia in Mammals

For humans, strong evidence indicates that some mucosal papillomavirus (PV) types cause genital and oral neoplasia, and weaker evidence suggests that some cutaneous PVs may cause cutaneous squamous cell carcinomas (SCC). For nonhuman species, strong evidence supports a causal role of PVs in the development of feline and equine sarcoids. Likewise, PVs are believed to cause cutaneous SCCs in rabbits, western barred bandicoots, and some rodents. Furthermore, some evidence suggests that PVs may influence the development of both feline and canine cutaneous SCCs. This review discusses the evidence that PVs cause human cutaneous SCCs and the proposed mechanisms for this action. It then reviews preneoplastic and neoplastic skin diseases that are associated with PV infection in nonhuman mammals.