Standardization of canine meningioma grading: Validation of new guidelines for reproducible histopathologic criteria

Canine meningiomas are currently graded using the human grading system. Recently published guidelines have adapted the human grading system for use in dogs. The goal of this study was to validate the new guidelines for canine meningiomas. To evaluate the inter-observer agreement, 5 veterinary surgical pathologists graded 158 canine meningiomas following the human grading system alone or with the new guidelines. The inter-observer agreement for histologic grade and each of the grading criteria (mitotic grade, invasion, spontaneous necrosis, macronucleoli, small cells, hypercellularity, pattern loss and anaplasia) was evaluated using the Fleiss kappa index. The diagnostic accuracy (sensitivity and specificity) was assessed by comparing the diagnoses obtained with the 2 grading systems with a consensus grade (considered the reference classification). The consensus histologic grade was obtained by agreement between 4 experienced veterinary neuropathologists following the guidelines. Compared with the human grading alone, the canine-specific guidelines increased the inter-observer agreement for: histologic grade (κ = 0.52); invasion (κ = 0.67); necrosis (κ = 0.62); small cells (κ = 0.36); pattern loss (κ = 0.49) and anaplasia (κ = 0.55). Mitotic grade agreement remained substantial (κ = 0.63). The guidelines improved the sensitivity in identifying grade 1 (95.6%) and the specificity in identifying grade 2 (96.2%) meningiomas. In conclusion, the new grading guidelines for canine meningiomas are associated with an overall improvement in the inter-observer agreement and higher diagnostic accuracy in diagnosing grade 1 and grade 2 meningiomas.

Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study

Simple Summary

Tumours of the mammary gland are common in humans, as in canine species. They are very heterogenous with numerous morphological variants and different biologic behaviours. In the last few decades, several efforts have been made to classify these tumours histologically and establish the level of malignancy by using histologic grading systems. However, reproducibility and diagnostic agreement of such classification and grading have been only rarely assessed. In this study, we tested the variability in diagnoses performed by 15 pathologists using the same classification and grading system. Prior to the study, pathologists agreed on guidelines regarding how to apply these systems. Pathologists worked blindly on 36 digital histologic slides of canine mammary tumours. The agreement was statistically analysed using Cohen’s kappa coefficient that, when equal to 1, indicates perfect agreement. The overall agreement in the identification of hyperplastic-dysplastic/benign/malignant lesions was substantial (kappa 0.76), while outcomes on morphological classification had only a moderate agreement (k = 0.54). Tumour grade assigned by pathologists was the least concordant and kappa could not be calculated. Although promising, the results underline that each diagnostic/grading system should be assessed and optimized for standardization and high diagnostic agreement.

Abstract

Histological diagnosis of Canine Mammary Tumours (CMTs) provides the basis for proper treatment and follow-up. Nowadays, its accuracy is poorly understood and variable interpretation of histological criteria leads to a lack of standardisation and impossibility to compare studies. This study aimed to quantify the reproducibility of histological diagnosis and grading in CMTs. A blinded ring test on 36 CMTs was performed by 15 veterinary pathologists with different levels of education, after discussion of critical points on the Davis-Thompson Foundation Classification and providing consensus guidelines. Kappa statistics were used to compare the interobserver variability. The overall concordance rate of diagnostic interpretations of WP on identification of hyperplasia-dysplasia/benign/malignant lesions showed a substantial agreement (average k ranging from 0.66 to 0.82, with a k-combined of 0.76). Instead, outcomes on ICD-O-3.2 morphological code /diagnosis of histotype had only a moderate agreement (average k ranging from 0.44 and 0.64, with a k-combined of 0.54). The results demonstrated that standardised classification and consensus guidelines can produce moderate to substantial agreement; however, further efforts are needed to increase this agreement in distinguishing benign versus malignant lesions and in histological grading.

Canine and feline in situ mammary carcinoma: A comparative review

Carcinoma in situ of the breast is a well-known entity in humans. In veterinary medicine, particularly in canine and feline mammary literature, there is no agreement whether the term in situ should be used to indicate a specific carcinoma histotype or the noninvasive status of a carcinoma of any histotype. Moreover, in the most recent histologic classification of mammary tumors published by the Davis-Thompson Foundation, it is suggested to abandon the term carcinoma in situ given the lack of standardized criteria defining this entity, replacing it with epitheliosis or ductal/lobular hyperplasia with severe atypia. This publication presents a critical review of the term in situ in human and veterinary medicine considering the evolution of the term over the years and its heterogeneous use by different authors, including variations in immunohistochemical markers for classification. This review aims to point out the lack of uniformity in the nomenclature and classification issues in veterinary medicine regarding the use of the term in situ, laying the ground for a process of standardization in future publications.

Comparison of harmonic shears, diode laser, and scissor cutting and suturing for caudal palatoplasty in dogs with brachycephalic obstructive airway syndrome

Traditionally, staphylectomy has been performed using scissors cutting and suturing. Alternative surgical techniques such as staphylectomy with monopolar electrocoagulation, CO₂ or diode laser, bipolar vessel sealing device and harmonic shears have also been described. The purpose of this prospective study was to compare the difference in surgical time, intraoperative haemorrhage and histological damage between staphylectomy performed with harmonic shears (HSS), diode laser (DLS) and traditional scissor 'cutting and suturing' technique with Metzenbaum scissors (SIS). Group HSS included 17 dogs, whereas Group DLS and Group SIS included 10 dogs each. Double masked histological evaluation was performed on the excised specimens. The harmonic shears resulted in the shortest surgical times (HSS 46 s, DLS 300 s, SIS 360 s; P < 0.001). There was a difference in the intraoperative haemorrhage among the three techniques; intraoperative haemorrhage did not occur in HSS and DLS groups. HSS was associated with more frequent damage involving the connective tissue (P = 0.001), muscle (P = 0.038), salivary gland tissue (P < 0.001), but less oedema was observed (P < 0.001). HSS was the fastest of the techniques evaluated for caudal elongated soft palate resection, resulting in less tissue oedema, and no intra-operative haemorrhage. These characteristics might result in reduced postoperative swelling and airway obstruction compared to other techniques.

Use of cytology for canine mammary masses and perceived diagnostic utility in four European countries

OBJECTIVES

To investigate the use of cytology of canine mammary masses and its perceived diagnostic utility in four European countries.

MATERIALS AND METHODS

The link to a web-based questionnaire was sent to veterinarians of Italy, UK, Greece and Spain. The questionnaire contained basic questions regarding the respondents' background, their general use of cytology as a diagnostic tool, the incidence of canine mammary tumours within their clinics and their use of cytology for canine mammary masses. Multiple binary and ordinal logistics models were used to evaluate associations between variables.

RESULTS

Four hundred and sixty-five veterinarians completed the survey (Italy: 114; UK: 66; Greece: 55; Spain: 230). Most veterinarians working in each country used cytology as a diagnostic tool, although only 43.0%, 54.6%, 43.6% and 36.5% used cytology for the investigation of CMMs in Italy, UK, Greece and Spain respectively. Supposing the cytology were able to correctly differentiate benign versus malignant canine mammary masses, the percentage of veterinarians using this test would increase in Italy, UK and Greece (Italy: 91.2%; UK: 93.9%; Greece: 96.4%); however, this was not reflected by veterinarians working in Spain (51.7%).

CLINICAL SIGNIFICANCE

If cytology of canine mammary masses were able to differentiate between benign and malignant, most veterinarians in Italy, UK and Greece would utilise the technique, justifying further research into the diagnostic accuracy of this test. Spanish veterinarians were significantly different and further research into why these individuals would not value the ability of cytology to differentiate between benign and malignant may be of value.

A Retrospective Study of Clinical and Histopathological Features of 81 Cases of Canine Apocrine Gland Adenocarcinoma of the Anal Sac: Independent Clinical and Histopathological Risk Factors Associated with Outcome

Canine apocrine gland anal sac adenocarcinoma (AGASAC) is a malignant tumour with variable clinical progression. The objective of this study was to use robust multivariate models, based on models employed in human medical oncology, to establish clinical and histopathological risk factors of poor survival. Clinical data and imaging of 81 cases with AGASAC were reviewed. Tissue was available for histological review and immunohistochemistry in 49 cases. Tumour and lymph node size were determined using the response evaluation criteria in the solid tumours system (RECIST). Modelling revealed tumour size over 2 cm, lymph node size grouped in three tiers by the two thresholds 1.6 cm and 5 cm, surgical management, and radiotherapy were independent clinical variables associated with survival, irrespective of tumour stage. Tumour size over 1.3 cm and presence of distant metastasis were independent clinical variables associated with the first progression-free interval. The presence of the histopathological variables of tumour necrosis, a solid histological pattern, and vascular invasion in the primary tumour were independent risk factors of poor survival. Based upon these independent risk factors, scoring algorithms to predict survival in AGASAC patients are presented.

Value, Limitations, and Recommendations for Grading of Canine Cutaneous Mast Cell Tumors: A Consensus of the Oncology-Pathology Working Group

One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this article, the authors provide a critical review of the current literature for grading of canine cutaneous mast cell tumors, suggest guidelines for reporting, and provide recommendations for its clinical interpretation. The article mainly focuses on histologic grading, but relevant information on mitotic count and cytological grading are also discussed. This document represents the opinions of the working group and the authors but does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.

Review of Histological Grading Systems in Veterinary Medicine

Tumor grading is a method to quantify the putative clinical aggressiveness of a neoplasm based on specific histological features. A good grading system should be simple, easy to use, reproducible, and accurately segregate tumors into those with low versus high risk. The aim of this review is to summarize the histological and, when available, cytological grading systems applied in veterinary pathology, providing information regarding their prognostic impact, reproducibility, usefulness, and shortcomings. Most of the grading schemes used in veterinary medicine are developed for common tumor entities. Grading systems exist for soft tissue sarcoma, osteosarcoma, multilobular tumor of bone, mast cell tumor, lymphoma, mammary carcinoma, pulmonary carcinoma, urothelial carcinoma, renal cell carcinoma, prostatic carcinoma, and central nervous system tumors. The prognostic relevance of many grading schemes has been demonstrated, but for some tumor types the usefulness of grading remains controversial. Furthermore, validation studies are available only for a minority of the grading systems. Contrasting data on the prognostic power of some grading systems, lack of detailed instructions in the materials and methods in some studies, and lack of data on reproducibility and validation studies are discussed for the relevant grading systems. Awareness of the limitations of grading is necessary for pathologists and oncologists to use these systems appropriately and to drive initiatives for their improvement.

Biphasic Feline Mammary Carcinomas Including Carcinoma and Malignant Myoepithelioma

Feline mammary tumors are usually malignant and aggressive carcinomas. Most cases are simple monophasic carcinomas (1 epithelial population), and additional phenotyping is usually not needed. In this study, we describe 10 malignant mammary tumors from 9 female cats that had unusual histomorphology: they appeared biphasic, with 2 distinct cell populations. Initially, they were morphologically diagnosed as either carcinosarcoma (1/10) or malignant pleomorphic tumor (9/10) of the mammary gland, as the latter did not match any previously described histological subtype. Immunohistochemistry (IHC) was performed for pancytokeratin, cytokeratins 8 and 18, cytokeratin 14, cytokeratins 5 and 6, vimentin, p63, calponin, alpha-smooth muscle actin, Ki-67, ERBB2, estrogen receptor alpha, and progesterone receptor. In 7 of 10 cases, the biphasic nature was confirmed and, on the basis of the IHC results, they were classified as carcinoma and malignant myoepithelioma (4/10), ductal carcinoma (1/10), and carcinosarcoma (2/10). The other 3 of 10 cases were monophasic based on IHC. In the cases of carcinoma and malignant myoepithelioma, the malignant myoepithelial cells were 100% positive for vimentin (4/4) and variably positive for p63, calponin, and cytokeratins (4/4). These findings show that, although rare, biphasic mammary carcinomas do occur in cats. In dogs and humans, tumors composed of malignant epithelial and myoepithelial cells have a less aggressive behavior than certain simple carcinomas, and therefore, their identification might also be clinically significant in the cat.

Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture

Benign stricture is an uncommon cause of chronic small intestinal obstruction in the cat. The purpose of this retrospective case series was to describe the ultrasonographic features, histopathological findings, and clinical presentation in a group of cats with benign small intestinal stricture. Inclusion criteria were cats presenting during the period 2010-2017, and that had ultrasonography and small intestinal stricture confirmed at surgery. For each cat, clinical data and ultrasonographic findings were retrieved from the medical record, and histopathology, where available, was reviewed. Eight cats met the inclusion criteria. The location of strictures was duodenum (1/8), mid- to distal jejunum (4/8), and ileum (3/8). Ultrasonographic findings included gastric distension (8/8) and generalized (3/8) or segmental (5/8) intestinal dilation consistent with mechanical obstruction. Ingesta did not propagate beyond the strictured segment. Wall thickening was mild to moderate (3-6 mm). Normal wall layering was disrupted in all cats. Strictures were predominantly hypoechoic (7/8) and associated with hyperechoic peri-intestinal mesentery (6/8). Annular strictures (5/8) were less than 15 mm in length whereas long-segment strictures (3/8) were greater than 15 mm in length. Histopathology showed transmural disease with fibrosis and inflammation (8/8), often (6/8) extending into the bordering mesentery. The mucosa was the most severely affected layer and epithelial injury accompanied the mucosal fibrosis/inflammation. Clinical presentation reflected delayed diagnosis of chronic bowel obstruction with debilitation (8/8), marked weight loss (8/8), and prerenal azotemia (5/8). Benign fibrostenotic stricture should be considered a differential diagnosis in debilitated young cats presenting with chronic bowel disease and ultrasonographic features of intestinal obstruction.

Inter- and Intraobserver Agreement of Canine and Feline Nervous System Tumors

In routine diagnostic activity, pathologists may be confronted with nervous system tumors. The lack of clinical information, economic restrictions for additional testing, and the lack of expertise in neuropathology may render the diagnosis challenging. The goals of this study were to assess the agreement in diagnosing nervous system tumors in domestic carnivores among 4 board-certified surgical pathologists without particular expertise in neuropathology and a neuropathologist expert, and to investigate the utility of special stains frequently used in routine diagnostic laboratories. Forty-six tumors (7 cats, 38 dogs, and 1 unknown carnivore) were retrieved and 1 hematoxylin and eosin-stained slide per tumor was selected. Diagnoses (tumor type and subtype) were formulated based on histological features and available clinical information. Confidence in the diagnosis was also scored. Subsequently, a panel of histochemical and immunohistochemical stains (Gordon Sweet silver stain and immunohistochemistry for AE1/AE3, vimentin, glial fibrillary acid protein, S100, neuron-specific enolase and neurofilament) was evaluated by the pathologists, who either confirmed or changed their original diagnoses. Intraobserver and interobserver agreement and confidence in relation to diagnosis before and after analysis of special stains were assessed. The use of special stains increased the complete agreement among surgical pathologists, with regard to tumor type, from 63% to 74%. Cases with a high confidence score had a higher interobserver agreement than cases with a low confidence score. These results suggest that pathologists without expertise in neuropathology agree in the diagnosis of most nervous system tumors, and special stains available in most laboratories only slightly increase this agreement.

Prognostic significance of histopathology in canine anal sac gland adenocarcinomas: Preliminary results in a retrospective study of 39 cases

Metastatic rates and survival times of canine anal sac gland adenocarcinomas (ASGACs) vary among studies, making prognostication difficult. Little is known about the prognostic significance of histopathology of ASGACs. This retrospective study investigated associations between histological features, clinical presentation and outcome for 39 ASGACs. Most tumours were incompletely excised (62%) and had moderate to marked peripheral infiltration (74%). The predominant growth pattern was solid, tubules/rosettes/pseudorosettes and papillary in 49%, 46% and 5% of the cases, respectively. Nuclear pleomorphism was either moderate (77%) or mild (23%). Necrosis and lymphovascular invasion were present in 54% and 10% of the cases, respectively. All histological features except mitotic count and necrosis were associated with nodal metastasis at presentation. A statistically significant poorer outcome was identified for tumours with a solid growth pattern, moderate or marked peripheral infiltration, necrosis and lymphovascular invasion. These results need further validation in a larger cohort of dogs.

Evaluation of expression of the Wnt signaling components in canine mammary tumors via RT2 Profiler PCR Array and immunochemistry assays

The Wnt signaling pathway and its key component β-catenin have critical roles in the development of diseases such as tumors in mammals. However, little has been reported about involvement of the Wnt/β-catenin signaling pathway in canine mammary tumors (CMTs). The present study detected expression of 30 Wnt signaling pathway-related genes in CMTs; the results are potentially useful for molecular-based diagnosis of CMTs and the development of new targeted therapies. Significant upregulations of dickkopf-1 protein, secreted frizzled-related sequence protein 1 (SFRP1), frizzled 3, β-catenin, and lymphoid enhancer-binding factor 1 (LEF1) were detected in highly malignant CMTs compared to levels in normal mammary gland tissues; moreover, highly significant upregulation of WNT5A was observed in low malignancy CMTs. Downregulation was only detected for SFRP4 in malignant CMT samples. The subcellular location of β-catenin and cyclin D1 in 100 CMT samples was investigated via immunohistochemical analysis, and significantly increased expressions of β-catenin in cytoplasm and cyclin D1 in nuclei were revealed. Western blotting analysis revealed that the expression of β-catenin and LEF1 increased in in the majority of CMT samples. Taken together, the results provide important evidence of the activation status of the Wnt pathway in CMTs and valuable clues to identifying biomarkers for molecular-based diagnosis of CMT.

Small intestinal peripheral nerve sheath tumour in a cat

Case summary

A 5-year-old female spayed Chinchilla cat presented with a 4 week history of weight loss and inappetence. A thorough clinical investigation confirmed the presence of a distal jejunal mass. Histopathological and immunohistochemical analysis was consistent with a small intestinal peripheral nerve sheath tumour.

Relevance and novel information

To the best of our knowledge, this is the first reported case of a small intestinal peripheral nerve sheath tumour in a cat. This case report demonstrates the use of immunohistochemistry in differentiating this entity from other mesenchymal neoplasms. The veterinary literature available in this field is very limited and this report adds a new differential diagnosis to feline patients presenting with an intestinal mass.

Marginal resection and adjuvant strontium plesiotherapy in the management of feline eyelid malignant peripheral nerve sheath tumours: two cases

Case series summary

Two cats with a marginally resected eyelid malignant peripheral nerve sheath tumour were treated with adjuvant strontium plesiotherapy a few weeks after surgery. The dose applied in both cases was 200 Gy to the surface, in five fractions, on a Monday–Wednesday–Friday basis. The treatment aimed to achieve a clinical margin of approximately 1 cm around the surgical scar and multiple application fields were required to cover such an area. Local recurrence was not seen in either case after 1330 and 645 days, respectively.

Relevance and novel information

The majority of periocular malignant peripheral nerve sheath tumours reported in the literature recur after surgery. In the two cases described in this report the combination of surgery and adjuvant plesiotherapy has been able to provide good local control with minimal toxicity. This multimodal approach could be considered as an alternative to aggressive surgery such as enucleation or exenteration.

Prognostic Significance of Canine Mammary Tumor Histologic Subtypes: An Observational Cohort Study of 229 Cases

Histopathology is considered the gold standard diagnostic method for canine mammary tumors. In 2011, a new histologic classification for canine mammary tumors was proposed. The present study was a 2-year prospective study that validated the 2011 classification as an independent prognostic indicator with multivariate analysis in a population of 229 female dogs, identifying subtype-specific median survival times (MST) and local recurrence/distant metastasis rates. Dogs with benign tumors and carcinoma arising in benign mixed tumors all had an excellent prognosis. Dogs with complex carcinoma and simple tubular carcinoma also experienced prolonged survival. Those with simple tubulopapillary carcinoma, intraductal papillary carcinoma, and carcinoma and malignant myoepithelioma had a more than 10-fold higher risk of tumor-related death. The prognosis was even worse for adenosquamous carcinoma (MST = 18 months), comedocarcinoma (MST = 14 months), and solid carcinoma (MST = 8 months). The most unfavorable outcome was for anaplastic carcinoma (MST = 3 months) and carcinosarcoma (MST = 3 months), which also had the highest metastatic rates (89% and 100%, respectively). Adenosquamous carcinoma exhibited the highest local recurrence rate (50%). In the same canine population, the tumor diameter was recognized as a strong predictor of local recurrence/distant metastasis and an independent prognosticator of survival in the multivariate analysis. Excision margins were predictive only of local recurrence, whereas lymphatic invasion and histologic grade were predictive of local recurrence/distant metastasis and survival, although only in univariate analyses. In conclusion, this study validated the 2011 classification scheme and provided information to be used in the clinical setting and as the basis for future prognostic studies.

Primary ureteral leiomyosarcoma in a dog

CASE DESCRIPTION

A nearly 6-year-old female spayed Labrador Retriever was presented for acute abdominal pain and lethargy. The dog had no previous health concerns apart from occasional episodes of urinary incontinence in the 2 months prior to presentation. A retroperitoneal mass involving the right ureter was found during the investigations. Serum urea was mildly elevated, but the serum creatinine was within the normal range. No distant metastases were detected. A right ureteronephrectomy was performed. The ureteral mass was confirmed as a leiomyosarcoma and completely excised. The kidney was histologically normal. Unfortunately, during a routine 3-month postoperative assessment, a recurrent mass at the previous retroperitoneal surgical site was confirmed by biopsy to be a leiomyosarcoma. Courses of doxorubicin and chlorambucil were given, but failed to halt the progression of the recurrent mass. The dog was euthanised 5.5 months postoperatively because of poor quality of life.

CLINICAL RELEVANCE

Ureteral leiomyosarcoma should be on the differential diagnosis list for a retroperitoneal mass, possibly causing severe abdominal pain with minor clinical signs associated with the urinary tract. This dog in this reported case of ureteral leiomyosarcoma had a short survival time, despite complete surgical excision and chemotherapy, because of local recurrence.

Comparison of the use of LigaSure versus a standard technique for tonsillectomy in dogs

The principal aim of this study was to document the effectiveness of tonsillectomy in dogs using a vessel-sealing device compared with a standard technique with tonsillectomy forceps. A secondary aim of the study was to document histopathological changes of the excised tonsillar tissue in dogs with brachycephalic obstructive airway syndrome. 20 dogs were studied. The time taken to remove a tonsil using LigaSure was a mean of 44.8 seconds (sd 15 seconds, 95 per cent CI 40  to 57 seconds) and with the standard technique a mean of 305.9 seconds (sd 67 seconds, 95 per cent CI 272  to 349 seconds). Significantly less haemorrhage occurred using LigaSure compared with the standard technique. Histopathology of the tonsils was characterised by multifocal neutrophilic and lymphocytic inflammation, and 1-2 mm of heat-induced coagulation necrosis at the cut edge of LigaSure tonsils. This study shows that LigaSure is significantly faster and resulted in less bleeding than the standard technique.

Triple-negative vimentin-positive heterogeneous feline mammary carcinomas as a potential comparative model for breast cancer

BACKGROUND

Human breast cancer is a heterogeneous disease classified by molecular subtyping into luminal A, luminal B, HER2-overexpressing, basal-like, claudin-low and normal-breast like. The routinely applied and standardized immunohistochemical-based surrogates of this classification group together the last three entities as triple-negative breast cancer (TNBCs) that show the most diverse and complex heterogeneity and represent a therapeutic challenge. In the present work 156 feline mammary lesions consisting of feline mammary carcinomas (FMCs), benign neoplasms, and hyperplastic/dysplastic tissues were evaluated histologically and by immunohistochemistry for expression of basal and luminal cytokeratins (CK), vimentin, alpha-smooth muscle actin, calponin, estrogen receptor (ER) alpha (a), and progesterone receptor (PR). Thirty-seven FMCs with 27 matched non-neoplastic controls were also investigated for gene expression of ERa, ER beta, PR, and HER2.

RESULTS

A large group of hormone receptors (HRs)-negative aggressive carcinomas - that did not overexpress HER2 - could be distinguished from the less aggressive (10.8%) and benign (8%) HRs + tumors, that showed bilineage (luminal and myoepithelial) differentiation. Immunohistochemical evaluations of cytoplasmic filaments indicated that HRs- FMCs are vimentin+, CK14+, and CK5_6+ carcinomas that may resemble the TNBCs (basal like/claudin low) described in women. The identification of luminal and myoepithelial progenitors within the mammary ductal system suggested potential cells/sites of origin of these tumors. A diffuse and never previously described CKs/vimentin luminal cell co-expression was detected in the non-neoplastic ducts, indicating a potential bilineage progenitor.

CONCLUSIONS

These results indicate and potentially explain the high incidence of triple-negative, vimentin + aggressive tumors in cats that may used to elucidate some of the challenging features of TNBCs in women.

The dog as a natural animal model for study of the mammary myoepithelial basal cell lineage and its role in mammary carcinogenesis

Basal-like tumours constitute 2-18% of all human breast cancers (HBCs). These tumours have a basal myoepithelial phenotype and it has been hypothesized that they originate from either myoepithelial cells or mammary progenitor cells. They are heterogeneous in morphology, clinical presentation, outcome and response to therapy. Canine mammary carcinomas (CMCs) have epidemiological and biological similarities to HBCs, are frequently biphasic and are composed of two distinct neoplastic populations (epithelial and myoepithelial). The present study evaluates the potential of CMCs as a natural model for basal-like HBCs. Single and double immunohistochemistry was performed on serial sections of 10 normal canine mammary glands and 65 CMCs to evaluate expression of cytokeratin (CK) 8/18, CK5, CK14, α-smooth muscle actin (SMA), calponin (CALP), p63 and vimentin (VIM). The tumours were also evaluated for Ki67 and human epidermal growth factor receptor (HER)-2 expression. A hierarchical model of cell differentiation was established, similar to that for the human breast. We hypothesized that progenitor cells (CK5(+), CK14(+), p63(+) and VIM(+)) differentiate into terminally-differentiated luminal glandular (CK8/18(+)) and myoepithelial (CALP(+), SMA(+) and VIM(+)) cells via intermediary luminal glandular cells (CK5(+), CK14(+) and CK8/CK18(+)) and intermediary myoepithelial cells (CK5(+), CK14(+), p63(+), SMA(+), CALP(+) and VIM(+)). Neoplastic myoepithelial cells in canine complex carcinomas had labelling similar to that of terminally-differentiated myoepithelial cells, while those of carcinomas-and-malignant myoepitheliomas with a more aggressive biological behaviour (i.e. higher frequency of vascular/lymph node invasion and visceral metastases and higher risk of tumour-related death) were comparable with intermediary myoepithelial cells and had significantly higher Ki67 expression. The majority of CMCs examined were negative for expression of HER-2. The biphasic appearance of CMCs with involvement of the myoepithelial component in different stages of cell differentiation may help to define the role of myoepithelial cells in the mammary carcinogenetic process and the heterogeneous nature of basal-like HBCs.

Prognostic evaluation of feline mammary carcinomas: a review of the literature

A large number of studies have investigated feline mammary tumors in an attempt to identify prognostic markers and generate comparative analyses with human breast cancer. Nevertheless, a retrospective base of assessments and the lack of standardization in methodology and study design have caused weakness in study results, making comparison difficult. We examined feline mammary tumor publications and evaluated postulated prognostic parameters according to the recently published "Recommended Guidelines for the Conduct and Evaluation of Prognostic Studies in Veterinary Oncology." Using these criteria, we determined with statistically significant reliability that prognostic parameters for feline mammary tumors are tumor grading and lymph node/lymphovascular invasion. Furthermore, tumor subtype, size, and staging are worthy of further standardized investigation. We present statistical significance for each studied parameter as well as its relevance to disease progression and survival. Our evaluation suggests that marker expression (ie, Ki67, HER2, ER) may provide relevant information applicable for therapeutic predictions; however, consensus efforts and protocol standardization are needed. We identify and discuss major points of concern--such as sample preservation and selection, standardization of immunohistochemical protocols, and evaluation of results--to provide support for subsequent reliable analyses.

Multiple dermoid sinuses of type Vb and IIIb on the head of a Saint Bernard dog

Dermoid sinus, a congenital malformation of neural tube development, has been reported in humans and several animal species including dogs. It is typically found in the dorsal midline and commonly occurs in the Rhodesian Ridgeback breed. A case of multiple dermoid sinuses in the fronto-occipital region is described. An 11-month-old, intact female Saint Bernard dog was presented with a 2 day history of discharge from a large irregular subcutaneous mass in the fronto-occipital region. The dog was otherwise healthy. The dog had two circular skin lesions (approximately 4 × 4 and 4 × 2 cm diameter) surrounded by multiple irregular elevated masses. The masses had multiple small openings on the skin surface with tufts of hair protruding from the apertures. The masses were surgically removed, and the diagnosis of multiple dermoid sinuses was confirmed by histological examination. Histopathological examination showed multiple, variably sized, spherical to tubular cysts expanding the dermis and subcutis. Cysts were filled with hair shafts and lamellar keratin and were lined by a stratified squamous epithelium. Sebaceous and apocrine gland adnexal structures were also observed. To the best of our knowledge, this is the first reported case of multiple dermoid sinuses of two different types in the head of a Saint Bernard dog.

A Retrospective Study of Those Histopathologic Parameters Predictive of Invasion of the Lymphatic System by Canine Mammary Carcinomas

The aim of the present study was to determine which histopathologic parameters of primary canine mammary carcinomas (CMCs) could predict metastatic spread via the lymphatic system. A modification of the World Health Organization classification was applied to 245 CMCs. In addition to tumor subtype, neoplastic infiltration of the surrounding mammary stroma, vasculogenic mimicry, and micropapillary pattern were evaluated, and 2 histologic grading systems were used for each sample. A statistical analysis was undertaken to determine the relationship between these histopathologic parameters and the detection of lymphatic vessels invasion (LVI) and regional lymph node metastases (RLM). To compare the predictive value for lymphatic spread of the 2 histologic grading systems, the Akaike information criterion was measured. The classification into tumor subtypes was significant ( P < .01) in predicting the risk of LVI and RLM. Peripheral infiltration, vasculogenic mimicry, and micropapillary pattern were found in 170 of 245 (69.4%), 32 of 245 (13.1%), and 54 of 245 (22.0%) CMCs. The presence of peripheral infiltration was significantly associated ( P < .001) with both LVI and RLM, and a similar relation ( P < .05) was found for the micropapillary pattern. Vasculogenic mimicry was not predictive of invasion of the lymphatic system. Both histologic grading systems were significant predictors ( P < .001) of the risk of LVI and RLM. The grading system that included a more rigorous evaluation of the neoplastic mitotic activity had the lower Akaike information criterion values, thus indicating a better predictive ability. The study confirms the significant prognostic role for the modified World Health Organization classification of CMCs and the prognostic value of additional histopathologic parameters.

Classification and grading of canine mammary tumors

Mammary neoplasms are the most common neoplasm in female dogs. Two histologic classification systems for canine mammary tumors and dysplasias have been published: the first in 1974 and a modification in 1999. This article provides a brief overview of the two histologic classification systems. Since the publication of the second system, several new histologic subtypes of canine mammary neoplasms have been described. These have been incorporated into the proposed new classification system. This article also compares the grading systems for canine mammary carcinomas and their use for prognosis, along with the histologic classification.

Development, anatomy, histology, lymphatic drainage, clinical features, and cell differentiation markers of canine mammary gland neoplasms

Mammary neoplasms are the most common neoplasm in female dogs. This article describes the embryologic development, normal anatomy, and histology of the canine mammary gland from the onset of first estrous and the changes that occur in the mammary gland during the estrus cycle. The clinical features of canine mammary gland tumors and their relation to prognosis are discussed, including age, hormones, breed, diet, and obesity. Additional clinical prognostic factors including clinical presentation, tumor size, and lymph node status at the time of presentation are discussed in relation to diagnosis and tumor staging. Immunohistochemical evaluation of the cell differentiation markers of the normal and neoplastic canine mammary gland is described and compared with similar studies in humans; the ways these markers may be used to assist with the prognosis of canine mammary neoplasms are discussed.