Pathology of chronic ovine periodontitis / Patologia da periodontite crônica em ovinos

Periodontitis is an inflammatory process of infectious origin affecting the teeth and their supporting structures, causing significant economic losses and reducing animal welfare. Bacteria in the gingival biofilm are one of the main factors in initiating inflammatory lesions. Bacteria act directly on tissues or indirectly through substances that cause tissue damage. Studies on the etiopathogenesis of periodontitis in Brazilian sheep herds are scarce. The present study aimed to characterize histologically periodontal lesions of culled sheep from the Brazilian breed, Santa Inês. Periodontal lesions, such as periodontal pockets containing plant tissue and bacteria, replacement of the periodontal ligament by connective tissue and inflammatory cells, superficial pustules, hydropic epithelial degeneration, and epithelium hyperplasia, were observed. Submucosal changes were characterized by granulation tissue, edema, swelling of the endothelial cells, bacteria, and predominantly perivascular lymphoplasmacytic inflammatory infiltrate. In the alveolar bone, osteoclastic resorption and bone apposition were observed. This study revealed subacute to chronic inflammation, alveolar bone resorption, and cortical bone apposition in ovine periodontitis. Thus, these findings can contribute to the evolution of knowledge about the etiopathogenesis of ovine periodontitis and, possibly, the development of measures to control the disease.

A periodontite é um processo inflamatório de origem infecciosa que afeta os dentes e suas estruturas de suporte, causando perdas econômicas significativas e redução do bem-estar animal. As bactérias do biofilme gengival são um dos principais fatores envolvidos no início das lesões inflamatórias. As bactérias agem diretamente nos tecidos ou indiretamente por meio de substâncias que causam dano tecidual. Estudos sobre a etiopatogenia da periodontite em rebanhos ovinos brasileiros são escassos. O presente estudo teve como objetivo caracterizar histologicamente as lesões periodontais de ovinos de descarte da raça brasileira Santa Inês. Foram observadas lesões periodontais, como bolsas periodontais contendo tecido vegetal e bactérias, substituição do ligamento periodontal por tecido conjuntivo e células inflamatórias, pústulas superficiais, degeneração hidrópica epitelial e hiperplasia do epitélio. As alterações da submucosa foram caracterizadas por tecido de granulação, edema, tumefação das células endoteliais, bactérias e infiltrado inflamatório linfoplasmocitário predominantemente perivascular. No osso alveolar, observou-se reabsorção osteoclástica e aposição óssea. Este estudo revelou inflamação subaguda a crônica, reabsorção óssea alveolar e aposição de osso cortical na periodontite ovina. Assim, esses achados podem contribuir para a evolução do conhecimento sobre a etiopatogenia da periodontite ovina e para o desenvolvimento de medidas de controle da doença.

Histological and immunohistochemical evaluations of the bone marrow from femur and sternal manubrium of dogs reactive for leishmaniasis by DPP® and ELISA tests / Avaliações histológica e imunoistoquímica da medula óssea do fêmur e do manúbrio esternal de cães reagentes para leishmaniose aos testes DPP® e ELISA

As the bone marrow is one of the most organs affected by canine visceral leishmaniasis (CVL), samples from this are frequently taken for parasitological tests, with occurrence of myelodysplastic changes, with consequent anemia, leukopenia, and thrombocytopenia. Thus, this study aimed to investigate the histological and immunohistochemical changes in the bone marrow of the femur and sternal manubrium of dogs reactive for leishmaniasis by DPP® and ELISA tests. For this, thirteen canines from the epidemiological routine for CVL carried out by the Directorate of Zoonosis Surveillance of Goiânia (DVZ), GO, Brazil, were subjected to anatomopathological examination. 46.2% of bone marrow samples from the femur showed a higher proportion of the red series, and 53.9% of bone marrow of the sternal manubrium evidenced a higher proportion of the red series. Also, there were varied macrophage hyperplasia, hemosiderosis, and megakaryocytic emperipolesis. Amastigote forms of Leishmania spp. in the bone marrow of the femur and sternal manubrium to histopathological and immunohistochemical evaluations were observed, with good agreement them, but without difference in the parasite intensity between the bone marrow of these anatomical sites. It was concluded that bone marrow of the femur and sternal manubrium of dogs reactive for leishmaniasis by DPP® and ELISA tests has histological changes resulting from the disease, regardless of the parasite presence or intensity, with macrophage hyperplasia, hemosiderosis, and emperipolesis being the main medullary changes in these animals. Also, the bone marrow of the femur and sternal manubrium are useful anatomical sites for the diagnosis of CVL by direct methods.

Como a medula óssea é um dos órgãos mais acometidos pela leishmaniose visceral canina (LVC), amostras desta são frequentemente colhidas para exames parasitológicos, sendo possível a ocorrência de alterações mielodisplásicas, com consequente anemia, leucopenia e trombocitopenia. Assim, este estudo teve como objetivo investigar alterações histológicas e imunoistoquímicas na medula óssea do fêmur e manúbrio esternal de cães reativos para leishmaniose aos testes DPP® e ELISA. Para isso, 13 caninos da rotina epidemiológica para LVC realizada pela Diretoria de Vigilância de Zoonoses de Goiânia (DVZ), GO, Brasil, foram submetidos ao exame anatomopatológico. 46,2% e 53,9% das amostras de medula óssea do fêmur e do manúbrio esternal apresentaram maior proporção da série vermelha, respectivamente. Além disso, havia variados graus de hiperplasia macrofágica, hemossiderose e emperipolese megacariocítica. Formas amastigotas de Leishmania spp. na medula óssea do fêmur e do manúbrio esternal às avaliações histopatológicas e imunoistoquímicas foram observadas, com boa concordância entre essas, mas sem diferença na intensidade parasitária entre a medula óssea desses sítios anatômicos. Conclui-se que a medula óssea do fêmur e do manúbrio esternal de cães reativos para leishmaniose aos testes DPP® e ELISA apresenta alterações histológicas decorrentes da doença, independente da presença ou intensidade do parasito, sendo hiperplasia de macrófagos, hemossiderose e emperipolese as principais alterações medulares nesses animais. Além disso, a medula óssea do fêmur e do manúbrio esternal compreendem sítios anatômicos úteis ao diagnóstico de LVC por métodos diretos.

Osteoporosis in swine / Osteoporose em suínos

Forty-six pigs presented muscle weakness, hind limb paresis and paralysis, weight loss, lateral recumbency, and death in a clinical course of 7 to 10 days. Two pigs were necropsied and exhibited bone fragility, bone callus formation, and multiple fractures in the limbs, ribs, and vertebrae. Microscopically, there was a diffuse and marked decrease in thickness and number of trabeculae. These were disconnected, with a "free-floating" appearance, while the cortex of the long bones was thinned, with an increase of the cortical porosity by enlargement of Haversian canals and endosteal erosion and decreased osteoblastic activity. Flame atomic absorption spectrometry in liver samples revealed significant zinc overload (>2300ppm) and copper deficiency (<33.1ppm). In this communication, we present the first pathologic description of an outbreak of osteoporosis in pigs, and we also provide a brief review of metabolic bone diseases in pigs.

Quarenta e seis suínos apresentaram fraqueza muscular, paresia e paralisia de membros pélvicos, perda de peso, decúbito lateral e morte, com um curso clínico de 7 a 10 dias. Dois suínos foram submetidos a necropsia e exibiram fragilidade óssea, formação de calo ósseo, e múltiplas fraturas em membros, costelas e vértebras. Microscopicamente notou-se difusamente um marcado decréscimo na espessura e número de trabéculas ósseas. Essas estavam desconexas, com uma aparência de flutuação, enquanto o córtex dos ossos longos estava afinado, com um aumento da porosidade pela dilatação dos canais de Haversian, erosão endosteal e diminuição da atividade osteoblástica. Espectrofotometria por chama foi realizada em amostras de fígado, e revelou um excesso de zinco (>2300ppm) e deficiência de cobre (<33.1ppm). Neste trabalho, apresentamos a primeira descrição patológica de um surto de osteoporose em suínos, além de fornecer uma breve revisão de doenças metabólicas em suínos.

Fibrous osteodystrophy due to secondary renal hyperparathyroidism in a senile dog / Osteodistrofia fibrosa decorrente de hiperparatireodismo secundário renal em cão senil

Renal hyperparathyroidism stands out among the complications of kidney disease in dogs due to phosphorus retention with a predisposition to hypocalcemia, parathyroid hormone stimulation with mobilization of calcium from the bones, characterizing fibrous osteodystrophy, unusual in the elderly. The objective was to report it in 12-year-old Labrador with polyuria, polydipsia, and emesis for five months due to maxillary and mandibular volume increase, followed by loosely fixed teeth, and facial deformity. Blood tests showed anemia, thrombocytosis, azotemia, hypoalbuminemia and hyperphosphatemia and urinalysis showed low density, glycosuria, proteinuria, and moderate caudate and transitional epithelial cells. Oral x-rays showed loss of dental bone support and decreased bone radiopacity. Chest radiographs showed decreased density in the ribs and costochondral junction; on the other hand, organs of the cardiorespiratory system showed no changes. The electrocardiogram and echocardiogram did not show impairment. Abdominal ultrasound revealed kidneys with asymmetry, increased echogenicity of the cortical and poorly preserved cortico-medullary definition. Oral histopathology showed intense fibroplasia associated with bone reabsorption. Support therapy was instituted, but the patient died ten days after consultation. Thus, although uncommon in the elderly, fibrous osteodystrophy should be investigated in dogs with advanced-stage chronic kidney disease and, even with conservative therapies, the prognosis is unfavorable.

O hiperparatireoidismo renal destaca-se entre as complicações da doença renal em cães, pela retenção de fósforo com predisposição à hipocalcemia, estimulação de paratormônio com mobilização do cálcio dos ossos, caracterizando a osteodistrofia fibrosa, incomum em idosos. O objetivo foi relatá-la em Labrador de 12 anos com poliúria, polidipsia e vômitos há cinco meses, além de aumento de volume maxilar e mandibular seguido de dentes frouxamente fixados e deformidade facial. Os exames sanguíneos denotaram anemia, trombocitose, azotemia, hipoalbuminemia, hiperfosfatemia, urinálise, baixa densidade, glicosúria, proteinúria e moderadas células caudadas e epiteliais de transição. Pelos raios X orais, houve perda da sustentação óssea dentária e diminuição da radiopacidade óssea. As radiografias de tórax demonstraram diminuição da densidade óssea na região dos arcos costais e junção costocondral; em contrapartida, órgãos do sistema cardiorrespiratório se mostraram sem alterações aparentes. O eletrocardiograma e o ecocardiograma não incidiram comprometimento. O ultrassom abdominal revelou rins com assimetria, aumento da ecogenicidade cortical e definição corticomedular pouco preservada, e a histopatologia oral apontou intensa fibroplasia associada à reabsorção óssea. Foi instituída terapia suporte, mas o paciente veio a óbito 10 dias após a consulta. Assim, mesmo que incomum em idosos, a osteodistrofia fibrosa deve ser investigada em cães com doença renal crônica em estágio avançado, mesmo com as terapias conservadoras, o prognóstico é desfavorável.

Desordens hiperostóticas em American Bully / Hiperostotic disorders in american bully

O complexo de desordens hiperostóticas é uma condição rara e autolimitante, que tem as mesmas características histopatológicas, que cursa com proliferação óssea de caráter não neoplásico. Acomete cães jovens de raças distintas, com variabilidade quanto ao tipo de proliferação óssea e quanto aos ossos acometidos. O complexo é composto pela osteopatia craniomandibular, hiperostose da calota craniana e osteodistrofia hipertrófica. Podendo estar presente nos ossos da calota craniana, mandíbulas, coluna cervical e esqueleto apendicular. O presente relato, descreveu o quadro de uma cadela, da raça American Bully, não castrada, três meses de idade, que foi atendida com queixa de aumento de volume doloroso das mandíbulas, hiporexia e sialorreia há 15 dias, apresentando ao exame físico, amplitude de movimento diminuída e sensibilidade dolorosa da articulação temporomandibular, espessamento firme bilateral do crânio em região de fossa temporal, espessamento palpável de consistência firme das mandíbulas e crepitação respiratória. Após avaliação clínica e realização de exames complementares, chegou-se ao diagnóstico presuntivo, de complexo de desordens hiperostóticas. Foi instituído como conduta terapêutica o suporte analgésico, sendo eficaz para a manutenção das necessidades fisiológicas até a paciente alcançar a fase adulta. O prognóstico para esta paciente foi considerado bom, uma vez que não havia indícios de anquilose da articulação temporomandibular e/ou manifestações neurológicas.

The complex of hyperostotic disorders is a rare and self-limiting condition, which has the same histophatological characteristics, which courses with non-neoplastic bone proliferations. It affects young dogs of different breeds, with variability the bones affected. The complex is composed of craniomandibular osteopathy, calvarial hyperostotic syndrome and hypertrophic osteodystrophy. It may be present in the bones of the skullcap, jaws, cervical spine and appendicular skeleton. The present report describes the condition of a female dog, American Bully breed, entire, three months old, with a complaint of painful swelling of the jaws, hyporexia and drooling for 15 days, presenting on physical examination, reduced amplitude and pain of the temporomandibular joint, bilateral firm thickening of the skull in the temporal fossa region, palpable firm-consistent thickening of the mandibles and respiratory crackle. After clinical evaluation and complementary tests, a presumptive diagnosis of hyperostotic disorders complex was reached. It was instituted pain management as a treatment, being effective for the maintenance of physiological needs until the patient reaches the adulthood. The prognosis for this patient was considered good, since there was no evidence of temporomandibular joint ankylosis and/or neurological manifestations.

Compressive lesions in the central nervous system of cattle: a retrospective study of 50 cases in the Amazon biome / Lesões compressivas no sistema nervoso central de bovinos: um estudo retrospectivo de 50 casos no bioma amazônico

The present study gathered epidemiological and clinical-pathological information about cattle with compressive lesions in the central nervous system (CNS). The retrospective study included observations made in 50 cattle from 1998 to 2021 by reviewing the clinical records of animals with compressive lesions in the CNS treated at the Veterinary Hospital of the Veterinary Medicine Institute of the Federal University of Pará. The animals had clinical signs and were subjected to general and specific clinical examination of the nervous system. Blood samples were collected from 13 animals for complete blood counts, and cerebrospinal fluid (CSF) samples were collected from four animals for physical evaluation. Twenty-nine cattle underwent necropsy. The most affected sites were the T3-L3 (46%, 23/50), C1-C5 (22%, 11/50), C6-T2 (14%, 7/50), sacrococcygeal vertebrae, (4%, 2/50), L4-S2 (2%, 1/50), brain (8%, 4/50) and cerebellum (4%, 2/50). The age of the affected cattle ranged from 20 days to 16 years, with a higher occurrence in animals younger than 12 months (56%, 28/50). More Females were affected (58%, 29/50) than males (42%, 21/50). The clinical signs varied according to the location of the lesion and were mainly represented by ataxia, paresis or paralysis of the limbs, inability to stand and walk, postural changes, hyperesthesia in the extremities, and loss of skin sensitivity at the location of the lesion. The necropsy findings revealed changes such as abscesses in the vertebral body; intervertebral space in the medullary canal, pituitary and cerebellum; granuloma in the arch of the vertebra; fractures of the body of the vertebrae; subarachnoid haematoma; congenital bone alteration causing spinal cord compression; and spondylitis. Detailed anamnesis and clinical examination of the CNS, associated with necropsy findings, were important to determine the cause of the disease, correlate with the clinical picture and locate the affected segments of the CNS in the cattle. It is important to include these diseases in the list of differential diagnoses in cattle with nervous symptoms.

O presente trabalho reúne informações epidemiológicas e clínicopatológicas de bovinos com lesões compressivas no sistema nervoso central (SNC). O estudo retrospectivo compreendeu as observações realizadas em 50 bovinos durante os anos de 1998 a 2021, por meio da revisão dos arquivos de fichas clínicas de animais com lesões compressivas no SNC atendidos pelo Hospital Veterinário do Instituto de Medicina Veterinária da Universidade Federal do Pará. Os animais atendidos com sinais clínicos foram submetidos a exame clínico geral e específico do sistema nervoso. Foram coletadas amostras de sangue de 13 animais para realização de hemograma e amostras de líquido cefalorraquidiano de quatro animais para avaliação física. Foram submetidos à necropsia 29 bovinos. Os locais mais acometidos foram as vértebras T3-L3 (46%, 23/50), C1-C5 (22%, 11/50), C6-T2 (14%, 7/50), sacrococcígea (4%, 2/50) e L4-S2 (2%, 1/50); cérebro (8%, 4/50) e cerebelo (4%, 2/50). A idade dos bovinos afetados variou de 20 dias a 16 anos, com maior ocorrência em animais com menos de 12 meses (56%, 28/50). As fêmeas foram mais acometidas (58%, 29/50) do que os machos (42%, 21/50). Os sinais clínicos variaram de acordo com a localização da lesão e foram representados principalmente por ataxia, paresia ou paralisia dos membros, incapacidade de se levantar e de ficar em estação, alterações posturais, hiperestesia nas extremidades, além de perda da sensibilidade cutânea relacionada com a localização da lesão. Os achados de necropsia revelaram alterações como abscessos no corpo vertebral, no espaço intervertebral, no canal medular, para-hipofisário e no cerebelo; granuloma no arco da vértebra, fraturas do corpo das vértebras; hematoma subaracnoide; alteração óssea congênita causando compressão medular e espondilite. Anamnese detalhada e exame clínico do SNC, associados aos achados de necropsia foram importantes para determinar a causa da doença, correlacionar com o quadro clínico e localizar os segmentos acometidos do SNC dos bovinos. Torna-se importante incluir estas enfermidades na lista de diagnósticos diferenciais em bovinos que apresentem sintomatologia nervosa.

Hemangiossarcoma pouco diferenciado grau II em seio nasal esquerdo de cão: relato de caso / Grade II poorly differentiated hemangiosarcoma in the left nasal sinus of dog: case report

Hemangiossarcoma é um câncer com alto poder de malignidade e metástase, tendo origem em células endoteliais de vasos sanguíneos, é frequentemente encontrado em baço, pele e raramente em cavidade nasal de cães. Foi atendido um cão, SRD, de 13 anos, com secreção nasal hemorrágica em narina esquerda e aumento de volume dorsal ao nariz que se estendia até seio frontal, com exoftalmia de globo ocular esquerdo, tendo se instalado de forma aguda. Pela radiografia de crânio nas projeções latero-lateral obliqua e dorso ventral, observou-se lise óssea dos seios nasal, frontal e orbital. Colhido material para Citopatologia, o diagnóstico presuntivo foi osteossarcoma. A fim de se planejar o ato cirúrgico, realizou se a tomografia computadorizada de crânio, que evidenciou formação na cavidade nasal esquerda, com expansão até o osso orbital, sem acometimento de linfonodos regionais. A fim de se avaliar a hemostasia e possibilidades de tromboembolismo no pós-cirúrgico, realizou-se o tromboelastograma e o paciente tinha possibilidades de realizar trombo. Ele foi operado com sucesso, removida a maior parte da massa tumoral e utilizada a eletroquimioterapia no leito cirúrgico. O diagnóstico histopatológico foi hemangiossarcoma pouco diferenciado grau 2. O paciente recebeu tratamento com anti-coagulante nos dias seguintes, teve uma recuperação satisfatória e iniciou-se a quimioterapia adjuvante com doxorubicina após 1 mês da cirurgia, entretanto, ele apresentou quadro de sangramento difuso compatível com CID e veio a óbito. Os hemangiossarcomas são raros na cavidade nasal de cães e parece adotar um pior comportamento nesta região, quando comparado ao baço e pele, inclusive com possibilidade de síndrome para-neoplásica. O trombolestograma tem se mostrado um exame importante para avaliação do equilíbrio hemostático no controle as doenças neoplásicas.

Hemangiosarcoma is a cancer with high power of malignancy and metastasis, originating in endothelial cells of blood vessels, it is often found in the spleen, skin and rarely in the nasal cavity of dogs. A dog, SRD, 13 years old, was treated with hemorrhagic nasal discharge in the left nostril and increase in volume dorsal to the nose that extended to the frontal sinus, with exophthalmos of the left eyeball, which had been installed acutely. On the skull X-ray in the lateral oblique and dorsal-ventral projections, bone lysis of the nasal, frontal and orbital sinuses was observed. After collecting material for cytopathology, the presumptive diagnosis was osteosarcoma. In order to plan the surgical act, a computed tomography scan of the skull was performed, which showed formation in the left nasal cavity, with expansion up to the orbital bone, without involvement of regional lymph nodes. In order to assess hemostasis and possibilities of thromboembolism in the postoperative period, a thromboelastogram was performed and the patient had possibilities of having a thrombus. He was successfully operated on, removing most of the tumor mass and using electrochemotherapy in the surgical bed. The histopathological diagnosis was grade 2 poorly differentiated hemangiosarcoma. The patient received treatment with anticoagulants in the following days, had a satisfactory recovery and adjuvant chemotherapy with doxorubicin was started 1 month after surgery, however, he presented compatible diffuse bleeding. with ICD and died. Hemangiosarcomas are rare in the nasal cavity of dogs and seem to have a worse behavior in this region when compared to the spleen and skin, including the possibility of paraneoplastic syndrome. The thrombolestogram has been shown to be an important test for evaluating the hemostatic balance in the control of neoplastic diseases.

Meningeal osteosarcoma in a dog’s brain / Osteossarcoma meningeal no encéfalo de um cão

Osteosarcoma is the most common bone cancer in dogs. It has a high invasion capacity and commonly metastasizes. This neoplasia ensues mainly in the medullary canal of long bones of the appendicular and axial skeleton, rarely affecting primarily extra-skeletal sites. Primary meningeal osteosarcomas are extremely rare both in human and veterinary medicine. A male, mixed breed dog was admitted at the Veterinary Hospital with a history of over excitement, decreased neurological reflexes, and seizures. The worsening of its clinical condition led to its euthanasia and anatomopathological examination at the Veterinary Pathology Service. This report describes a primary extra-skeletal osteosarcoma of a dog’s meninges. Its clinical signs were indicative of a central nervous system disease later diagnosed by histopathological and immunohistochemical analysis.

O osteossarcoma é considerado a neoplasia óssea mais frequente em cães. Tem elevada capacidade invasiva e comumente gera metástase. Essa neoplasia é mais frequentemente observada no canal medular de ossos longos do esqueleto apendicular e axial. É raro que acometa primariamente sítios extraesqueléticos. O osteossarcoma primário meningeal é considerado extremamente raro em medicinas humana e veterinária. Um cão macho e sem raça definida foi atendido no Hospital Veterinário com histórico de excitação, diminuição dos reflexos neurológicos e desenvolvimento de quadro convulsivo. O agravamento do quadro clínico levou à eutanásia do animal e a um exame anatomopatológico pelo Serviço de Patologia Veterinária. O objetivo deste relato é descrever um caso de osteossarcoma extra-esquelético primário de meninge em um cão que apresentou quadro clínico compatível com doença originária do sistema nervoso central e que foi diagnosticado por meio das análises histopatológica e imunohistoquímica.

Meningeal osteosarcoma in a dogs brain / Osteossarcoma meningeal no encéfalo de um cão

Osteosarcoma is the most common bone cancer in dogs. It has a high invasion capacity and commonly metastasizes. This neoplasia ensues mainly in the medullary canal of long bones of the appendicular and axial skeleton, rarely affecting primarily extra-skeletal sites. Primary meningeal osteosarcomas are extremely rare both in human and veterinary medicine. A male, mixed breed dog was admitted at the Veterinary Hospital with a history of over excitement, decreased neurological reflexes, and seizures. The worsening of its clinical condition led to its euthanasia and anatomopathological examination at the Veterinary Pathology Service. This report describes a primary extra-skeletal osteosarcoma of a dogs meninges. Its clinical signs were indicative of a central nervous system disease later diagnosed by histopathological and immunohistochemical analysis.(AU)

O osteossarcoma é considerado a neoplasia óssea mais frequente em cães. Tem elevada capacidade invasiva e comumente gera metástase. Essa neoplasia é mais frequentemente observada no canal medular de ossos longos do esqueleto apendicular e axial. É raro que acometa primariamente sítios extraesqueléticos. O osteossarcoma primário meningeal é considerado extremamente raro em medicinas humana e veterinária. Um cão macho e sem raça definida foi atendido no Hospital Veterinário com histórico de excitação, diminuição dos reflexos neurológicos e desenvolvimento de quadro convulsivo. O agravamento do quadro clínico levou à eutanásia do animal e a um exame anatomopatológico pelo Serviço de Patologia Veterinária. O objetivo deste relato é descrever um caso de osteossarcoma extra-esquelético primário de meninge em um cão que apresentou quadro clínico compatível com doença originária do sistema nervoso central e que foi diagnosticado por meio das análises histopatológica e imunohistoquímica.(AU)

Pancitopenia induzida em um cão pelo uso concomitante de fármacos mielotóxicos / Pancytopenia in a dog induced by concomitant use of myelotoxic drugs

Background: The indiscriminate use of drugs is an issue in Veterinary Medicine, as it has serious consequences for theanimals. Many drugs are myelotoxic and cause a decrease in the production of blood cells, which may be irreversible insome cases. The present work reports a case of pancytopenia induced by the concomitant use of myelotoxic drugs (estrogen, metamizole and phenobarbital) in a dog and describes findings on myelotoxicity, hematological alterations andtreatment success.Case: A 7-year-old Lhasa Apso bitch was referred to the Veterinary Hospital of Federal University of Paraná, Curitibacampus, with hematuria and a history of treatment with phenobarbital [2 mg/kg twice a day (bis in die, BID)], metamizole[25 mg/kg 3 times a day (ter in die, TID)], and use of estrogen hormone (estradiol cypionate). At physical examination, theanimal was normohydrated and exhibited normal palpable lymph nodes, pale mucous membranes, galactorrhea, and a bodytemperature of 36°C. A complete blood count including reticulocyte count and a total plasma protein (TPP) exam wererequested. The results revealed pancytopenia (18% hematocrit, 1,400 total leucocytes/µL, and 22,000 reticulocytes/µL).An abdominal ultrasound exam did not detect any relevant alterations. In view of the results obtained, medullary aplasiawas suspected. A bone marrow aspiration was performed. A myelogram revealed a decrease in cellularity (erythrocyticand granulocytic hypoplasia), with presence of rare erythroid and granulocytic precursors. The diagnosis was medullaryaplasia. The animal was treated, and the evolution of the hematological alterations was monitored. The treatment consistedof administration of erythropoietin (100UI/kg subcutaneously every 48 h), prednisone (2 mg/kg BID), Leucogen (3 mg/kg BID), interferon (0.2 IU/kg BID) and Eritrós Dog Tabs [1 tablet once a day (semel in die, SID)]. After 5 days of treatment, the...

Pancitopenia induzida em um cão pelo uso concomitante de fármacos mielotóxicos / Pancytopenia in a dog induced by concomitant use of myelotoxic drugs

Background: The indiscriminate use of drugs is an issue in Veterinary Medicine, as it has serious consequences for theanimals. Many drugs are myelotoxic and cause a decrease in the production of blood cells, which may be irreversible insome cases. The present work reports a case of pancytopenia induced by the concomitant use of myelotoxic drugs (estrogen, metamizole and phenobarbital) in a dog and describes findings on myelotoxicity, hematological alterations andtreatment success.Case: A 7-year-old Lhasa Apso bitch was referred to the Veterinary Hospital of Federal University of Paraná, Curitibacampus, with hematuria and a history of treatment with phenobarbital [2 mg/kg twice a day (bis in die, BID)], metamizole[25 mg/kg 3 times a day (ter in die, TID)], and use of estrogen hormone (estradiol cypionate). At physical examination, theanimal was normohydrated and exhibited normal palpable lymph nodes, pale mucous membranes, galactorrhea, and a bodytemperature of 36°C. A complete blood count including reticulocyte count and a total plasma protein (TPP) exam wererequested. The results revealed pancytopenia (18% hematocrit, 1,400 total leucocytes/µL, and 22,000 reticulocytes/µL).An abdominal ultrasound exam did not detect any relevant alterations. In view of the results obtained, medullary aplasiawas suspected. A bone marrow aspiration was performed. A myelogram revealed a decrease in cellularity (erythrocyticand granulocytic hypoplasia), with presence of rare erythroid and granulocytic precursors. The diagnosis was medullaryaplasia. The animal was treated, and the evolution of the hematological alterations was monitored. The treatment consistedof administration of erythropoietin (100UI/kg subcutaneously every 48 h), prednisone (2 mg/kg BID), Leucogen (3 mg/kg BID), interferon (0.2 IU/kg BID) and Eritrós Dog Tabs [1 tablet once a day (semel in die, SID)]. After 5 days of treatment, the...(AU)

Osteopatia craniomandibular em cães sem raça definida / Craniomandibular osteopathy in mixed breed dogs

Background: Craniomandibular osteopathy (CMO) is a degenerative, osteopetrotic, and self-limiting bone disease that is rare in the canine species. The most affected bones and joints are the branches of the mandible, tympanic bulla, and temporomandibular joint (TMJ) with generalized thickening of the bone trabeculae, increased lines of bone cementation, and bone proliferation. The aim of the present study was to evaluate 2 cases of CMO in mixed-breed dogs belonging to the same litter sent to the Laboratório Regional de Diagnóstico, Faculdade de Veterinária, Universidade Federal de Pelotas (LRD / FV / UFPel). Cases: Three dogs (mixed-breed, 2 females and 1 male) belonging to the same litter presented at eight months of age with increases in volume and pain in the face, difficulties in moving the jaw, anorexia, and sialorrhea. The 2 bitches were euthanized and sent to LRD / FV / UFPel for necropsy. The animals underwent radiography of the left and right lateral and dorsoventral lateral projections in the imaging sector of the Hospital de Clínicas Veterinária (HCV) at UFPel. During the necropsy, fragments of organs from the abdominal and thoracic cavities, as well as the central nervous system and head bones, were collected and fixed in 10% buffered formalin. The tissue samples were cleaved, processed routinely, embedded in paraffin, cut into sections of 3 µm thickness, and stained using hematoxylin and eosin (HE). The bone fragments were decalcified in a 50/50 solution of 8% hydrochloric acid and 8% formic acid and subsequently cleaved and stained with HE. The head and jaw of one of the canines were dissected and subjected to maceration in water at room temperature. Radiographic examination of the 2 remaining animals showed irregular and exuberant bone proliferation in the mandible and temporomandibular region. In the tympanic bullae, occipital bone, and zygomatic process, thickening of the structures was observed with increased opacity. On necropsy, the canines were cachectic with marked muscle atrophy and increased volume of the mandibular branches and head bones, in addition to marked edema in the adjacent subcutaneous tissue. The regional lymph nodes were enlarged, and in one of the animals, bilateral lesions in the femurs were also observed. In the head subjected to biological maceration, areas of bone proliferation and rarefaction were observed, with increased volume and destruction of the TMJ. On histopathological evaluation of the ventral portion of the mandibular bodies, a network of bony trabeculae was observed, composed of a chondroid matrix with different degrees of mineralization. The cortical portion of the bones exhibited loss of lamellar compactness, with greater spread of the bone trabeculae. The bone trabeculae were perpendicular to the long axis of the cortical of the mandible and were distributed in the medullary spaces, presenting some dense foci of inflammatory infiltrates composed predominantly of neutrophils, lymphocytes, and plasma cells. Discussion: The breeds most predisposed to developing CMO are West Highland White Terrier and Scottish Terrier; however, the disease has also been described in other non-Terrier breed. Nevertheless, there are no descriptions in the literature of mixed-breed dogs, with this report being the first of CMO in mixed-breed dogs. The bones most frequently affected in CMO are those of the head. In Terrier dogs, the TMJ is also affected. In the cases of this study, severe CMO occurred, affecting both the head bones and TMJ, and in 1 of the canines, it also affected the femurs. Although CMO has not previously been reported in mixed-breed dogs, the condition can seriously affect these animals, and differential diagnosis should always be made.(AU)

Osteosarcoma of the hard palate in a dog - case report / [Osteossarcoma em palato duro de cão - relato de caso]

The osteosarcoma (OSA) is the most diagnosed primary bone cancer in canine patients. This work reports a case of a canine, six years old, mongrel, female, intact, with an OSA in the hard palate. Physical examination detected a firm mass in the palate. Thoracic radiographs, hematological and biochemical exams, histopathological exams and computed tomography were requested. A chondroblastic OSA was diagnosed and the tumor was characterized by immunohistochemistry. There was never evidence of metastasis in this case. The treatment consisted of the combination of conventional chemotherapy, metronomic chemotherapy, and palliative care, aiming at greater survival and well-being of the patient since surgical excision was not possible due to the location and extension of the tumor. Osteogenic sarcomas of the hard palate are rarely seen and described in the literature. In this article we present a characterization of the osteosarcoma with uncommon localization in the hard palate.(AU)

O osteossarcoma (OSA) é a neoplasia óssea primária mais diagnosticada em pacientes caninos. Este trabalho relata o caso de um canino, com seis anos de idade, sem raça definida, fêmea, não castrado, apresentando OSA em região de palato duro. Ao exame clínico, constatou-se uma massa de consistência firme em região palatina. Além do exame clínico, foram solicitadas radiografias torácicas, exames hematológicos e bioquímicos, exames histopatológicos e tomografia computadorizada. Fora então dado o diagnóstico de OSA condroblástico, e o tumor foi caracterizado pela imuno-histoquímica. Não foram observadas evidências de metástases nesse caso. O tratamento instituído consistiu na combinação de quimioterapia convencional, quimioterapia metronômica e cuidados paliativos, almejando maior sobrevida e bem-estar do paciente, uma vez que a excisão cirúrgica não foi possível devido à localização e à extensão do tumor. Neste artigo, apresentou-se uma caracterização do osteossarcoma com localização incomum no palato duro.(AU)

Mesenchymal Stem cells in the context of canine atopic dermatitis: A Review / Células-tronco mesenquimais no contexto da dermatite atópica canina: uma revisão

Canine atopic dermatitis (CAD) is a chronic inflammatory skin disease and has a high frequency among dermatological diseases. The interaction of genetic factors, skin and environmental conditions affect the expression of the disease, developing a complex pathology. Current multimodal treatment has numerous adverse effects and variations in its efficacy and safety, demonstrating the need to develop safe and effective therapeutic resources for patients with CAD. Mesenchymal stem cells (MSCs) are multipotent cells, with special characteristics, such as self-renewal, immunomodulatory properties, and de-differentiation, making them useful for several clinical problems. The discovery of the immunosuppressive effect of MSCs on T cells has opened the potential for new perspectives with its use as a therapeutic agent for immune diseases, such as CAD. The scarce number of research using the MSC as a treatment for CAD result in the lack of knowledge about the benefits and possible protocols to be followed for the use of this cell therapy. In this review, we highlighted the clinical studies and potential biological mechanisms of MSC-based cell therapy effects attenuating canine atopic dermatitis compared to conventional treatment, which might lead to a safe improvement of the animals clinical condition in a short period without causing adverse effects.(AU)

A dermatite atópica canina (DAC) é uma doença inflamatória crônica da pele e tem alta frequência entre as doenças dermatológicas. A interação de fatores genéticos, pele e condições ambientais afetam a expressão da doença, desenvolvendo uma patologia complexa. O tratamento multimodal atual apresenta inúmeros efeitos adversos e variações em sua eficácia e segurança, demonstrando a necessidade de desenvolver recursos terapêuticos seguros e eficazes para pacientes com DAC. As células-tronco mesenquimais (CTM) são células multipotentes, com características especiais, como auto renovação, propriedades imunomoduladoras e desdiferenciação, tornando-se úteis para diversos problemas clínicos. A descoberta do efeito imunossupressor das CTMs sobre as células T abriu o potencial para novas perspectivas com sua utilização como agente terapêutico para doenças imunológicas, como a DAC. O escasso número de pesquisas utilizando o MSC como tratamento para DAC resulta no desconhecimento dos benefícios e dos possíveis protocolos a serem seguidos para a utilização dessa terapia celular. Nesta revisão, destacamos os estudos clínicos e os potenciais mecanismos biológicos dos efeitos da terapia celular baseada em MSC que atenuam a dermatite atópica canina em comparação com o tratamento convencional, podendo levar a uma melhora segura da condição clínica do animal em um curto período, sem causar efeitos adversos.(AU)

Central nervous system infiltration in acute lymphoblastic leukemia in a dog

Background: Acute lymphoblastic leukemia (ALL) is a malignant neoplasia in which there is proliferation of lymphoid progenitor cells in the bone marrow, blood, and extramedullary sites. This disorder has a fast and progressive development; in dogs, cases of infiltration of ALL cells in the central nervous system (CNS) are uncommon and rare. Diagnosis can be achieved with the help of the clinical history and physical, radiographic, hematological, myelographic, and cerebrospinal fluid (CSF) tests in patients with or without neurological clinical signs. The present report aims to describe a case of ALL and the presence of lymphoblasts in the CSF of a dog with neurological clinical signs. Case: An 8-year-old Lhasa Apso dog was examined at the Veterinary Hospital of Universidade Federal do Paraná, Curitiba campus. At the physical examination, the animal exhibited apathy and paralysis of pelvic limbs, which progressed to tetraplegia. Abdominal palpation revealed presence of hepatosplenomegaly and absence of lymphadenomegaly. No alterations were observed in radiographs of the cervical, thoracic or lumbar spine. A complete blood count revealed presence of non-regenerative anemia (hematocrit = 22%), extreme lymphocytosis (185,229 cells/µL), lymphoblasts at a level of 72% (133,364 cells/µL), and thrombocytopenia (66,000 platelets/µL). The biochemical tests revealed increased alkaline phosphatase (859 IU/L). The levels of alanine aminotransferase, creatinine, urea, total protein, albumin, and globulin were normal. The diagnosis of ALL was achieved with the help of a myelogram. The myelogram findings included 39% of mature lymphocytes and 59% of lymphoblasts exhibiting large size, spherical shape, poorly delimited borders, with a high nucleus/cytoplasm ratio, marked cytoplasmic basophilia, and 2 to 3 evident nucleoli; metarubricytes (1%) and promyelocytes (0.6%) were also observed. The CSF contained an increased number of nucleated cells (27 cells/µL) comprising lymphocytes (43%), macrophages (33%), and segmented neutrophils (24%). Of the 11.6 lymphocytes per µL of CSF, 8.1 were lymphoblasts, which indicates infiltration of ALL cells in the CNS. The animal died one day after collection of bone barrow and CSF. Discussion: Relevant alterations observed in this case included the neurological signs caused by the infiltration of neoplastic cells in the CNS, severe leukocytosis and lymphocytosis, with large amounts of lymphoblasts in the blood and predominance of lymphoblasts in the bone marrow, which are alterations typically found in ALL. The animal also exhibited non-regenerative anemia and thrombocytopenia, which were secondary to infiltration of leukemic cells in the bone marrow. The CSF exhibited pleocytosis (27 cells/ µL), and 30% of the cells observed were lymphoblasts. Lymphoblast infiltration in the CNS of leukemic dogs is rare, and other studies have reported absence of neurological signs or neurological signs different from those observed in the present study. CSF analysis in indicated in cases of leukemia to assess leukemic cell infiltration in the CNS. In the case reported here, the plasma level of alkaline phosphatase was increased (859 IU/L) as a consequence of hepatomegaly and hepatic cholestasis. ALL is a very aggressive, proliferative neoplasia, and the resulting lymphoblasts infiltrated the CNS of the animal. In cases of ALL, performing complete blood count, myelogram, and CSF analysis is indicated whether the patients exhibit neurological signs or not.(AU)

Enxerto pediculado de omento maior como adjuvante no tratamento de osteomielite de tíbia em cão - relato de caso / [Greater omentum pedicle flap as adjunctive treatment of tibial osteomyelitis in a dog - case report]

A osteomielite é um desafio terapêutico em ortopedia, capaz de retardar ou mesmo impedir a consolidação óssea. O omento, há anos, tem sido empregado como alternativa em diferentes procedimentos cirúrgicos, por sua capacidade, entre outras, de angiogênese, sendo aplicado na ortopedia veterinária quando há o risco de não união óssea. Neste caso, um cão Fila Brasileiro foi submetido à realização de enxerto com retalho pediculado de omento maior, após osteomielite resistente presente em osteossíntese de fratura múltipla de tíbia aberta grau II. Durante 16 dias, manteve-se a comunicação do retalho, mas, diante do risco de peritonite, o pedículo foi seccionado. Numa sequência de intervenções cirúrgicas, após 89 dias, houve cicatrização óssea e remissão da osteomielite, mesmo na presença de bactérias multirresistentes. Neste relato, o omento foi efetivo como terapia adjuvante no tratamento da osteomielite e garantiu o retorno da função do membro.(AU)

Osteomyelitis is a therapeutic challenge in orthopedics, capable of delaying or even preventing bone healing. The omentum has been used in different surgical procedures as an alternative for its capacity, among others, of angiogenesis, being applied in veterinary orthopedics, when there is a risk of non-union of bone. In this case, a Brazilian row dog was submitted to grafting with pedicle flap of greater omentum, after resistant osteomyelitis present in open fracture osteosynthesis of open tibia grade II. For 16 days the communication of the flap was maintained, but at the risk of peritonitis, the pedicle was sectioned. In a sequence of surgical interventions, after 89 days, there was bone healing and remission of osteomyelitis, even in the presence of multi-resistant bacteria. In this report, the omentum was effective as adjuvant therapy in the treatment of osteomyelitis and guaranteed the return of limb function.(AU)

Enterococcus faecalis causes osteitis deformans in aGolden Lancehead snake (Bothrops insularis): a case report / Enterococcus faecalis causa osteíte deformante em uma serpente Jararaca-ilhoa (Bothrops insularis): relato de caso

Osteitis deformans (Paget's disease) is a chronic bone disorder characterized by excessive osteoclast-mediated bone resorption followed by new bone formation. The present paper reports this condition in an 18-year-old captive golden lancehead (Bothrops insularis) from Brazil. This patient initially exhibited anorexia and swelling in the middle third of the spine associated with locomotor disability. For diagnosis, radiography, ultrasound, computed tomography, cytology, and microbiological culture were performed. Diagnostic imaging showed bone changes, vertebral fusion, and bone proliferation. Cytology revealed blood cells how toxic heterophiles, reactive monocytes, young red blood cells, and polychromasia compatible with an infectious process. A bacterial culture identified an ampicillin-susceptible strain of Enterococcus faecalis. Antibiotic treatment was promptly started, but the snake died 25 days later. Histopathologically, the bone tissue showed a generalized thickening of the vertebral trabeculae. For the first time, the presence of E. faecalisassociated with the development of osteitis deformans in snakes was presented.(AU)

Osteíte deformante (Doença de Paget) é um distúrbio ósseo crônico caracterizado por reabsorção óssea excessiva mediada por osteoclastos, seguida por nova formação óssea. O presente trabalho relata essa condição em uma serpente jararaca-ilhoa (Bothrops insularis) do Brasil de 18 anos. O paciente apresentou inicialmente anorexia e um inchaço no primeiro terço médio da coluna associado com a incapacidade locomotora. O diagnóstico foi estabelecido com o apoio de radiografia, ultrassonografia, tomografia computadorizada, citologia e cultura microbiológica. O diagnóstico por imagem mostrou alterações ósseas, fusão de vértebras e proliferação óssea. A citologia mostrou células sanguíneas como heterófílos tóxicos, monócitos reativos, células sanguíneas jovens e policromasia compatíveis com um processo infeccioso. A cultura bacteriana identificou uma cepa de Enterococcus faecalis suscetível à ampicilina. O tratamento com antibióticos foi iniciado imediatamente, mas a serpente morreu 25 dias depois. Histopatologicamente, o tecido ósseo mostrou um espessamento generalizado das trabéculas vertebrais. Portanto, foi demonstrado pela primeira vez a presença de E. faecalis associada ao desenvolvimento de osteíte deformante em uma serpente.(AU)

Enterococcus faecalis causes osteitis deformans in aGolden Lancehead snake (Bothrops insularis): a case report / Enterococcus faecalis causa osteíte deformante em uma serpente Jararaca-ilhoa (Bothrops insularis): relato de caso

Osteitis deformans (Paget's disease) is a chronic bone disorder characterized by excessive osteoclast-mediated bone resorption followed by new bone formation. The present paper reports this condition in an 18-year-old captive golden lancehead (Bothrops insularis) from Brazil. This patient initially exhibited anorexia and swelling in the middle third of the spine associated with locomotor disability. For diagnosis, radiography, ultrasound, computed tomography, cytology, and microbiological culture were performed. Diagnostic imaging showed bone changes, vertebral fusion, and bone proliferation. Cytology revealed blood cells how toxic heterophiles, reactive monocytes, young red blood cells, and polychromasia compatible with an infectious process. A bacterial culture identified an ampicillin-susceptible strain of Enterococcus faecalis. Antibiotic treatment was promptly started, but the snake died 25 days later. Histopathologically, the bone tissue showed a generalized thickening of the vertebral trabeculae. For the first time, the presence of E. faecalisassociated with the development of osteitis deformans in snakes was presented.(AU)

Osteíte deformante (Doença de Paget) é um distúrbio ósseo crônico caracterizado por reabsorção óssea excessiva mediada por osteoclastos, seguida por nova formação óssea. O presente trabalho relata essa condição em uma serpente jararaca-ilhoa (Bothrops insularis) do Brasil de 18 anos. O paciente apresentou inicialmente anorexia e um inchaço no primeiro terço médio da coluna associado com a incapacidade locomotora. O diagnóstico foi estabelecido com o apoio de radiografia, ultrassonografia, tomografia computadorizada, citologia e cultura microbiológica. O diagnóstico por imagem mostrou alterações ósseas, fusão de vértebras e proliferação óssea. A citologia mostrou células sanguíneas como heterófílos tóxicos, monócitos reativos, células sanguíneas jovens e policromasia compatíveis com um processo infeccioso. A cultura bacteriana identificou uma cepa de Enterococcus faecalis suscetível à ampicilina. O tratamento com antibióticos foi iniciado imediatamente, mas a serpente morreu 25 dias depois. Histopatologicamente, o tecido ósseo mostrou um espessamento generalizado das trabéculas vertebrais. Portanto, foi demonstrado pela primeira vez a presença de E. faecalis associada ao desenvolvimento de osteíte deformante em uma serpente.(AU)

Mieloma múltiplo em felino / Multiple myeloma in a feline

Background: Multiple myelomas (MM) are malignant neoplasms originating in the bone marrow plasmacytes, and are characterized by the presence of persistent hyperglobulinemia. Although they are rarely found in domestic animals, the canine species is most affected. In felines, they represent less than 1% of hematopoietic neoplasms, and mainly occur in older animals aged 10-12 years. The aim of the present study was to report a case of multiple myeloma, with extramedullary plasmocytosis in a feline. Case: A 3-year-old feline, female, mixed breed, with a history of apathy, anorexia, halitosis, and vomiting was referred to the Laboratório Regional de Diagnóstico (LRD) at the Universidade Federal de Pelotas (UFPel). Oral examination revealed a cyanotic oral mucosa and ulcerative lesions on the gingiva. The necropsy showed generalized lymphadenomegaly, splenomegaly, and hemorrhagic diathesis. Organ fragments were collected and fixed in 10% buffered formalin. After 48 h, the samples were cleaved, embedded in paraffin, and stained using the routine hematoxylin and eosin technique. Selected sections were subjected to immunohistochemistry (IHC) using the streptavidin-biotin method. The CD79a, CD138, CD3, and MUM1 antibodies were used. Histopathological evaluation of the bone marrow revealed hypercellularity with predominant round pleomorphic cells (90%), which presented an eccentric basophilic nucleus and abundant eosinophilic cytoplasm. The same neoplastic cells infiltrated the gingival mucosa, lymph nodes, spleen, liver, kidneys, heart, lungs, and brain. The IHC showed positive immunostaining for MUM1 and CD138 antibodies. Discussion: The diagnosis of MM in the present study was based on histopathology and by IHC. According to the literature, the presence of neoplastic plasmocytes in the bone marrow (>20%)...

Mieloma múltiplo em felino / Multiple myeloma in a feline

Background: Multiple myelomas (MM) are malignant neoplasms originating in the bone marrow plasmacytes, and are characterized by the presence of persistent hyperglobulinemia. Although they are rarely found in domestic animals, the canine species is most affected. In felines, they represent less than 1% of hematopoietic neoplasms, and mainly occur in older animals aged 10-12 years. The aim of the present study was to report a case of multiple myeloma, with extramedullary plasmocytosis in a feline. Case: A 3-year-old feline, female, mixed breed, with a history of apathy, anorexia, halitosis, and vomiting was referred to the Laboratório Regional de Diagnóstico (LRD) at the Universidade Federal de Pelotas (UFPel). Oral examination revealed a cyanotic oral mucosa and ulcerative lesions on the gingiva. The necropsy showed generalized lymphadenomegaly, splenomegaly, and hemorrhagic diathesis. Organ fragments were collected and fixed in 10% buffered formalin. After 48 h, the samples were cleaved, embedded in paraffin, and stained using the routine hematoxylin and eosin technique. Selected sections were subjected to immunohistochemistry (IHC) using the streptavidin-biotin method. The CD79a, CD138, CD3, and MUM1 antibodies were used. Histopathological evaluation of the bone marrow revealed hypercellularity with predominant round pleomorphic cells (90%), which presented an eccentric basophilic nucleus and abundant eosinophilic cytoplasm. The same neoplastic cells infiltrated the gingival mucosa, lymph nodes, spleen, liver, kidneys, heart, lungs, and brain. The IHC showed positive immunostaining for MUM1 and CD138 antibodies. Discussion: The diagnosis of MM in the present study was based on histopathology and by IHC. According to the literature, the presence of neoplastic plasmocytes in the bone marrow (>20%)...(AU)