Ultrasonographic Appearance of Gallbladder Neoplasia in 14 Dogs and 1 Cat.

Ultrasonography is the most commonly used diagnostic imaging tool for gallbladder disease in veterinary medicine. Primary gallbladder neoplasia is an uncommon finding with variable prognosis for which no studies have been published describing their ultrasonographic appearance and diagnosis. This retrospective, multicenter, case series study examines the ultrasonographic appearance of gallbladder neoplasia with histologically or cytologically confirmed diagnoses. A total of 14 dogs and 1 cat were analyzed. All discrete masses were sessile in shape and varied in size, echogenicity, location, and gallbladder wall thickening. All studies with images showing Doppler interrogation exhibited vascularity. Cholecystoliths were an uncommon finding, being present in only one case in this study, unlike in humans. The final diagnosis of the gallbladder neoplasia was neuroendocrine carcinoma (8), leiomyoma (3), lymphoma (1), gastrointestinal stromal tumor (1), extrahepatic cholangiocellular carcinoma (1), and adenoma (1). Findings from this study indicate that primary gallbladder neoplasms have variable sonographic appearances and cytologic and histologic diagnoses.

Clinical, histopathologic, and immunohistochemical features of 13 cases of canine gallbladder neuroendocrine carcinoma.

In this retrospective descriptive study, we characterized the clinical, histologic, and immunohistochemical features of 13 cases of canine gallbladder neuroendocrine carcinoma (GB-NEC). Immunohistochemical stains for neuroendocrine (neuron-specific enolase [NSE], chromogranin A, synaptophysin) and gastrin markers were evaluated, and clinicopathologic and follow-up data were obtained for all cases. The average age at diagnosis was 8.9 y, and breeds included 6 Boston Terriers, 2 Bichon Frise, 1 Poodle, 1 English Bulldog, 1 French Bulldog, and 2 mixed-breed dogs. Boston Terriers were overrepresented in this cohort, and therefore a breed predilection is possible. Most dogs were presented with emesis and elevated liver enzyme activities: 13 of 13 had elevated alanine aminotransferase and alkaline phosphatase activities; 8 of 13 had elevated aspartate aminotransferase activity; 7 of 13 had elevated gamma-glutamyl transferase activity. Abdominal ultrasound and/or exploratory surgery revealed a gallbladder mass. All neoplasms had similar histologic features and positive immunoreactivity for NSE, chromogranin A, synaptophysin, and gastrin. Vascular invasion was noted in 8 of 13 neoplasms, and metastasis was present in 6 of 13 cases (4 hepatic and 2 pulmonary metastases). The median survival time was 3.7 y in patients who died; 5 of 8 deaths were directly attributed to the GB-NEC, 3 of which had metastatic spread. GB-NECs have the potential to metastasize; however, surgical excision may be curative in a subset of dogs.

Tumor carcinoide na vesícula biliar em cão / Carcinoid gallbladder tumor in a dog

Carcinoid is a neoplasia that arises from dispersed cells of the neuroendocrine system. This tumor is uncommon in animals, and its occurrence in the gallbladder is rare. A male Basset Hound dog's corpse was taken to the Univerdade Federal de Minas Gerais to be analyzed by the Veterinary Pathology sector, without a description of its previous history. Necropsy revealed the presence of pale oral, ocular and penile mucous membranes. The gallbladder had a thickened wall and a dilated lumen, which was filled with dark and lumpy bile. Its mucosa had a whitish-red nodule, with solid and friable areas. Microscopically, there was a focal neoplastic proliferation, which wasn't encapsulated and had imprecise limits, which cells were distributed in a solid pattern and separated by a delicate fibrovascular stroma. The neoplastic cells presented oval or round shaped nucleus, which had a chromatin predominantly loose, and one or two nucleoli. Their cytoplasm was moderately abundant, and in most of the cells it was eosinophilic, granular, and had well-defined limits. Using the Grimelius coloration, neoplastic cells' cytoplasmic granules stained brownish or black, confirming the neuroendocrine origin of the neoplasia. Based on the macroscopic and microscopic findings, the diagnosis of a gallbladder carcinoid was established.(AU)

Cholangiocarcinoma in a Free-Ranging Eurasian Brown Bear (Ursus arctos arctos) from Northern Spain.

A hepatic cholangiocarcinoma with metastases in the gallbladder, left elbow joint, adrenal glands, and lungs was observed in a female 21-yr-old free-ranging Eurasian brown bear (Ursus arctos arctos) found in the Principality of Asturias (northern Spain). Gross and histopathologic findings are described.

Chronic Inflammatory and Proliferative Lesions of the Gallbladder in Aged Pigs.

Primary epithelial tumors of the gallbladder are rarely reported in animals. In this study, 9 aged pigs (6-12 years old) were histopathologically examined for gallbladder proliferative lesions. At necropsy, a large gallstone occupied the lumen of the gallbladder of 3 pigs. Histopathological examination revealed chronic cholecystitis in all 9 pigs, mucosal hyperplasia in 2 pigs, adenoma in 1 pig, and adenocarcinoma in 2 pigs. Bacilli were detected in the gallbladder lumen of 6 pigs by Warthin-Starry stain. Mucosal hyperplasia, adenoma, and adenocarcinoma were characterized by papillary projections of the mucosa with occasional acinar structures. Tumor invasion of the surrounding tissue was observed in the cases of adenocarcinoma. On Alcian blue and periodic acid-Schiff double-stained sections, the acinar structure of gallbladder mucosa in chronic cholecystitis and mucosal hyperplasia was stained in a mosaic pattern, indicating pyloric gland metaplasia. The results of immunohistochemistry revealed a CD10-positive epithelial brush border and mucin (MUC) 2-positive goblet cells in chronic cholecystitis, adenoma, and adenocarcinomas, indicating intestinal metaplasia. Immunoreactivity of MUC5 AC and cytokeratin 19 was weaker in adenoma and adenocarcinomas compared with the normal and hyperplastic gallbladder mucosa. The number of p53-positive nuclei and the Ki-67 index were higher in adenocarcinomas compared with benign lesions. These results suggest that chronic cholecystitis associated with gallstones and/or bacterial infections may contribute to metaplastic changes and development of gallbladder tumors in aged pigs. Alteration of mucin, cytokeratin, and p53 profiles in gallbladder proliferative lesions in pigs were similar to that in humans, suggesting a common pathogenesis in tumor development.

Ganglioneuromatosis of the Gallbladder in a Dog with Cholecystitis and Cholestasis.

A 2-year-old entire female mixed-breed dog was presented with signs of cholestasis. Abdominal ultrasonography revealed a gallbladder with a thickened and hyperechoic wall and luminal calculi. Exploratory laparotomy with cholecystectomy was performed and histopathological examination of the specimens from the cholecystectomy demonstrated extensive proliferation of large, prominent nerves containing ganglion cells with no atypia mainly located in the gallbladder mucosa. The neural nature of these components was confirmed by immunohistochemical labelling with antibodies specific for synaptophysin, glial fibrillary acidic protein, S100 protein and neurofilaments. Based on these findings, the lesion was diagnosed as ganglioneuromatosis. Reports of ganglioneuromatosis in animals have so far been restricted to the intestine. This is the first case of ganglioneuromatosis affecting the gallbladder in an animal in which no intestinal involvement was apparent.

Gallbladder lymphoma in a miniature dachshund.

A 7-year-old, miniature dachshund was referred for examination and treatment of persistent anorexia, deep yellow-coloured urine and leucocytosis. The clinical sign of jaundice, results from a serum biochemistry profile and ultrasonographic images suggested a biliary tract obstruction. A cholecystectomy was performed to remove the obstruction. Histopathological assessment of the resected gallbladder and partial common bile duct indicated diffuse large B-cell lymphoma. Twelve days after the initial operation, a second procedure was performed due to bile leakage into the abdominal cavity. Chemotherapy was administered twice after the second operation but discontinued, because the dog showed adverse effects. The dog is still alive 24 months after the surgery. To the authors' knowledge, this is the first description of canine gallbladder lymphoma.

Gastrointestinal small-cell lymphoma with gall bladder involvement in a cat.

A 13-year-old female spayed domestic shorthair cat presented for investigation of decreased appetite and increased serum liver enzyme concentrations. An abdominal ultrasound revealed multiple sessile hyperechoic structures along the luminal aspect of the gall bladder wall and a mildly enlarged liver with hyperechoic nodules. Cholecystectomy was performed and biopsies were obtained by laparotomy. Histopathologic examination with immunohistochemistry was consistent with a diagnosis of small-cell lymphoma of T cells within the gall bladder, liver and small intestine. Clonality testing confirmed the diagnosis. The cat remains clinically stable 23 months after institution of treatment with prednisolone, chlorambucil and ursodeoxycholic acid. This is the first report of small-cell lymphoma in the gall bladder of a cat.

Extranodal B-cell lymphoma in the urinary bladder with cytological evidence of concurrent involvement of the gall bladder in a cat.

A 15-year-old domestic shorthair cat was presented with severe haematuria, stranguria, anorexia and lethargy of 10 days' duration. Physical examination revealed a large painful urinary bladder and pain in the cranial abdomen. Abdominal ultrasound revealed severe generalised mural thickening of both the gall bladder and the urinary bladder. Lymphoma was diagnosed on cytology of urine sediment and fine-needle aspirates of the gall bladder. Despite a transitory clinical improvement and partial remission following chemotherapy, the cat was euthanased six weeks after initial presentation due to recurrent clinical signs. Post-mortem examination confirmed a B-cell lymphoma in the urinary bladder. This report is the first description of gall bladder and bladder lymphoma in a cat.

Use of color flow Doppler ultrasonography to diagnose a bleeding neuroendocrine tumor in the gallbladder of a dog.

CASE DESCRIPTION: A 13-year-old neutered female Keeshond-cross was evaluated because of a history of melena, anemia, hematemesis, vomiting, and high serum liver enzyme activities over a 1.5-year period. CLINICAL FINDINGS: Abdominal ultrasonography revealed a hyperechoic mass in the gallbladder. In the gallbladder mass itself, a distinct linear blood flow pattern was detected by use of color flow Doppler ultrasonography. TREATMENT AND OUTCOME: A cholecystectomy was performed, and clinical signs resolved. Samples of the mass were examined histologically and immunohistochemically, and findings supported a diagnosis of neuroendocrine tumor of the gallbladder. CLINICAL RELEVANCE: Tumors of the biliary tree are a potential source of blood loss into the gastrointestinal tract. Color flow Doppler ultrasonography in conjunction with conventional grayscale ultrasonography may be useful in evaluation of the gallbladder in dogs. When echogenic material is detected in the gallbladder, it is important to evaluate the region for blood flow.

Neuroendocrine carcinoma of the liver and gallbladder in a cow.

A 15-year-old Limousin-cross cow was presented for examination with neurological signs and serum biochemical changes consistent with liver disease. Necropsy revealed enlargement of the liver with multifocal firm, depressed, pale, circumscribed lesions throughout the parenchyma. Within the gallbladder there were exophytic and villiform mucosal masses. Microscopically, hepatic structure was displaced by neoplastic cells forming trabeculae, nests and rosettes. There was transmural infiltration of the gallbladder by similar cells. The histological pattern of growth of the neoplastic cells, the presence of silver-stained cytoplasmic granules within these cells and the immunohistochemical demonstration of chromogranin A supported the diagnosis of neuroendocrine carcinoma. Bovine liver and gallbladder neuroendocrine carcinomas are rare and this is the first detailed documentation of the disease in the United Kingdom.

Gallbladder adenocarcinomas in two captive African lions (Panthera leo).

Gallbladder adenocarcinomas in two captive African lions (Panthera leo), an 18-yr-old male and a 17-yr-old female, are described in this report. Grossly, both lions had hemoperitoneum with thickened and sclerotic gallbladder walls. Histopathologically, the male's tumor was well differentiated and the female's was poorly differentiated with multinucleate giant cells. Both tumors were highly invasive and involved the gallbladder serosa. The male also had a tumor in the liver, and the female's tumor had disseminated to the serosal surfaces of abdominal organs. In both cases, neoplastic cell cytoplasm stained diffusely for cytokeratin AE-1/AE-3 and cytokeratin 7 and granularly for lysozyme on immunohistochemical staining.

A carcinoid tumor in the gallbladder of a dog.

A cholecystectomy was performed on a 10-year-old spayed female mixed-breed dog with chronic weight loss, persistently increased liver enzyme activities, and cholecystomegaly identified by ultrasonographic examination. A subsequent diagnosis of a biliary carcinoid was made based on a neuroendocrine-type histologic pattern, cytoplasmic argyrophilia by Grimelius staining, immunopositivity for chromogranin A, and the ultrastructural finding of cytoplasmic secretory granules in neoplastic cells. Extrahepatic biliary carcinoid tumors are rare tumors of humans and have not been documented in domestic animals.

Adenoma of the gallbladder in a chimpanzee (Pan troglodytes).

A 37-yr-old chimpanzee (Pan troglodytes) died due to bacterial meningoencephalomyelitis. At necropsy, a mass was observed in the fundus of the gallbladder. Histopathologic examination resulted in a diagnosis of adenoma, the first diagnosis of a primary spontaneous neoplasm in the gallbladder of a non-human primate.

Porcelain gallbladder associated with primary biliary adenocarcinoma in a dog.

A 9-year-old spayed female Poodle was admitted because of vomiting of 3 weeks' duration, lethargy, and anorexia. Palpation of the cranial portion of the abdomen elicited signs of pain. Principal laboratory abnormalities included mild segmented neutrophilia, lymphopenia, high serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase activities, and hyperbilirubinemia. Radiography revealed foamy appearing areas of mineral opacity in the region of the gallbladder. Ultrasonographically, a hyperechoic structure with acoustic shadowing was seen in the same region, and extrahepatic bile ducts were distended. Cholecystectomy was performed. The gallbladder wall felt thicker than normal and was bluish-white. Multiple choleliths were found in the gallbladder and extrahepatic bile ducts. Histologic examination revealed chronic proliferative lymphoplasmacytic cholecystitis with mineralization and a well-differentiated adenocarcinoma of the gallbladder neck. A diagnosis of porcelain gallbladder was made. The dog recovered without complications and was healthy 14 months after surgery. To our knowledge, porcelain gallbladder has not been reported in dogs. In human patients, it is defined as intramural mineralization of the gallbladder commonly associated with gallbladder neoplasia. Early recognition is important for appropriate surgical treatment.

Cholecystadenocarcinoma in a cat.

A malignant neoplastic process originating from gall bladder epithelium was diagnosed in a 14-year-old, spayed female, domestic shorthair cat. The tumor produced widespread pulmonary and lymphatic metastases. The clinical and pathological manifestations are described. Neoplasia arising from the gall bladder epithelium is rarely reported in animals.