Adenocarcinoma pancreático em um gato / Pancreatic adenocarcinoma in a cat

Background: Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas. Due non-specificity of clinical signs in cats and the late diagnosis of the neoplasm, it is necessary to understand this disease better, to contribute for the knowledge of its early recognition and treatment. Thus, this study aims to report a case of metastatic pancreatic ductal adenocarcinoma in a cat, focusing on the main clinical aspects, diagnosis, and prognosis of this disease, in addition to the description of the presentation of peritoneal carcinomatosis. Case: A 14-year-old male neutered mixed breed cat, was referred to the Feline Medicine Service (MedFel) of the Hospital de Clínicas Veterinárias (HCV) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, with a history of hyporexia, constipation and increased abdominal volume for 3 days, besides mild difficulty in locomotion and progressive weight loss in the last 6 months. On the physical examination, the patient was alert, with a body condition score of 6/9; muscle condition score 1/4 and moderate dehydration of 7%. Popliteal lymph nodes were enlarged, and abdominal distension was evident. Around 200 mL of a slightly cloudy, straw-yellow liquid were drained from the abdominal cavity. After draining the fluid, a new abdominal palpation was performed, and there were fecal retention and a palpable mass in the right hypogastric region. The result of the cytological analysis of the fluid was consistent with a protein-rich transudate, suggesting neoplastic effusion of epithelial origin. Hematological and biochemical changes included leukocytosis due to neutrophilia, monocytosis, lymphopenia, thrombocytosis and azotemia. On abdominal ultrasound, the patient had free fluid in the abdominal cavity, and the gallbladder had discreet of biliary sludge. The intestines showed some corrugated segments with other segments lacking definition of its layers, and without peristaltic movements, suggesting intestinal neoplasia. Pancreas and adrenals were not visualized. On the chest X-ray, moderate opacification of lung fields with a diffuse interstitial pattern was observed, suggesting lung metastasis. The patient presented an acute worsening of the clinical condition and the owner requested euthanasia. The patient was referred for necropsy and based on the macroscopic and microscopic changes, the post-mortem diagnosis was metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis. Discussion: The clinical presentation of cats with exocrine pancreatic neoplasia is nonspecific, as clinical signs are common to several diseases, such as anorexia, vomiting, abdominal pain, weight loss with normal appetite, jaundice, depression, and lethargy. Complementary blood tests also do not provide data that could lead to the suspicion of pancreatic neoplastic disease. In the present case, the diagnosis of metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis was only possible post mortem. The pancreas is a difficult organ to assess adequately using most diagnostic imaging methods, so histopathology is still the method of choice for differentiating pancreatic tissue comorbidities. Therefore, exploratory laparotomy should be instituted to provide tissue samples from the pancreas and its metastases for histopathological diagnosis, whenever ultrasound or other imaging methods indicate suspicious abdominal changes. The literature reports that less than 10% of affected cats treated with complete surgical removal of the mass and chemotherapy alone will survive more than a year, and the average time for untreated cats is only 6 days. The prognosis of this disease is bad and most cats are euthanized, due to rapid clinical worsening. Therefore, diagnosis is essential to determine an adequate prognosis in advanced cases and to support therapeutic decisions or euthanasia.

Congestive heart failure in a young cat with excessive moderator bands (false tendons) in the left ventricle / Insuficiência cardíaca congestiva em um gato jovem com bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo

Left ventricular false tendons are fibrous or fibromuscular bands that transverse the ventricular cavity and have no attachment to the mitral valve in many species. In cats it is considered a congenital defect that is rarely related to clinical disease and death in adult cats. A 45 days-old mixed breed cat had a history of inappetence since birth. At the physical exam the patient was lethargic and presented restrictive dyspnoea. At necropsy, there were marked ascites, hydrothorax, hepatomegaly with enhanced lobular pattern (nutmeg liver), and the lungs were markedly diminished (compressive pulmonary atelectasis). The heart was enlarged due to marked dilation of the cardiac chambers. Moreover, multiple slightly whitish and irregular cord-like structures were connecting the posterior papillary muscle to the interventricular septum (excessive moderator bands /left ventricular false tendons) at the left ventricle. Microscopically, these structures were characterized by a marked proliferation of fibrous connective tissue intermixed with Purkinje cells and well-differentiated cardiomyocytes lined by a single layer of endocardium. This study described a case of excessive moderator bands (left ventricular false tendons) in a young cat associated with congestive heart failure and death.

Falsos tendões são bandas fibrosas ou fibromusculares que atravessam a cavidade do ventrículo esquerdo, sem ligação com a valva mitral, em várias espécies. Nos gatos, a alteração é considerada um defeito congênito que raramente está relacionada com alterações clínicas e morte em gatos adultos. Um gato de 45 dias de idade, sem raça definida e com histórico de inapetência desde o nascimento foi encaminhado para atendimento veterinário. Ao exame físico apresentou letargia e dispneia restritiva. À necropsia, havia acentuada ascite, hidrotórax, hepatomegalia com evidenciação do padrão lobular (fígado noz-moscada) e os pulmões apresentavam-se acentuadamente diminuídos (atelectasia pulmonar compressiva). O coração apresentava acentuada dilatação das câmaras cardíacas. Em ventrículo esquerdo, havia numerosas estruturas brancacentas semelhantes a cordas conectando o músculo papilar ao septo interventricular (bandas moderadoras excessivas/falsos tendões). Microscopicamente, estas estruturas apresentavam acentuada proliferação de tecido conjuntivo fibroso, além de células de Purkinje e cardiomiócitos bem diferenciadas revestidas por uma única camada de endocárdio. O objetivo deste trabalho é descrever um caso de bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo de um gato jovem com insuficiência cardíaca congestiva e morte.

Congestive heart failure in a young cat with excessive moderator bands (false tendons) in the left ventricle / Insuficiência cardíaca congestiva em um gato jovem com bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo

ABSTRACT: Left ventricular false tendons are fibrous or fibromuscular bands that transverse the ventricular cavity and have no attachment to the mitral valve in many species. In cats it is considered a congenital defect that is rarely related to clinical disease and death in adult cats. A 45 days-old mixed breed cat had a history of inappetence since birth. At the physical exam the patient was lethargic and presented restrictive dyspnoea. At necropsy, there were marked ascites, hydrothorax, hepatomegaly with enhanced lobular pattern (nutmeg liver), and the lungs were markedly diminished (compressive pulmonary atelectasis). The heart was enlarged due to marked dilation of the cardiac chambers. Moreover, multiple slightly whitish and irregular cord-like structures were connecting the posterior papillary muscle to the interventricular septum (excessive moderator bands /left ventricular false tendons) at the left ventricle. Microscopically, these structures were characterized by a marked proliferation of fibrous connective tissue intermixed with Purkinje cells and well-differentiated cardiomyocytes lined by a single layer of endocardium. This study described a case of excessive moderator bands (left ventricular false tendons) in a young cat associated with congestive heart failure and death.

RESUMO: Falsos tendões são bandas fibrosas ou fibromusculares que atravessam a cavidade do ventrículo esquerdo, sem ligação com a valva mitral, em várias espécies. Nos gatos, a alteração é considerada um defeito congênito que raramente está relacionada com alterações clínicas e morte em gatos adultos. Um gato de 45 dias de idade, sem raça definida e com histórico de inapetência desde o nascimento foi encaminhado para atendimento veterinário. Ao exame físico apresentou letargia e dispneia restritiva. À necropsia, havia acentuada ascite, hidrotórax, hepatomegalia com evidenciação do padrão lobular (fígado noz-moscada) e os pulmões apresentavam-se acentuadamente diminuídos (atelectasia pulmonar compressiva). O coração apresentava acentuada dilatação das câmaras cardíacas. Em ventrículo esquerdo, havia numerosas estruturas brancacentas semelhantes a cordas conectando o músculo papilar ao septo interventricular (bandas moderadoras excessivas/falsos tendões). Microscopicamente, estas estruturas apresentavam acentuada proliferação de tecido conjuntivo fibroso, além de células de Purkinje e cardiomiócitos bem diferenciadas revestidas por uma única camada de endocárdio. O objetivo deste trabalho é descrever um caso de bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo de um gato jovem com insuficiência cardíaca congestiva e morte.

Congestive heart failure in a young cat with excessive moderator bands (false tendons) in the left ventricle / Insuficiência cardíaca congestiva em um gato jovem com bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo

Left ventricular false tendons are fibrous or fibromuscular bands that transverse the ventricular cavity and have no attachment to the mitral valve in many species. In cats it is considered a congenital defect that is rarely related to clinical disease and death in adult cats. A 45 days-old mixed breed cat had a history of inappetence since birth. At the physical exam the patient was lethargic and presented restrictive dyspnoea. At necropsy, there were marked ascites, hydrothorax, hepatomegaly with enhanced lobular pattern (nutmeg liver), and the lungs were markedly diminished (compressive pulmonary atelectasis). The heart was enlarged due to marked dilation of the cardiac chambers. Moreover, multiple slightly whitish and irregular cord-like structures were connecting the posterior papillary muscle to the interventricular septum (excessive moderator bands /left ventricular false tendons) at the left ventricle. Microscopically, these structures were characterized by a marked proliferation of fibrous connective tissue intermixed with Purkinje cells and well-differentiated cardiomyocytes lined by a single layer of endocardium. This study described a case of excessive moderator bands (left ventricular false tendons) in a young cat associated with congestive heart failure and death.(AU)

Falsos tendões são bandas fibrosas ou fibromusculares que atravessam a cavidade do ventrículo esquerdo, sem ligação com a valva mitral, em várias espécies. Nos gatos, a alteração é considerada um defeito congênito que raramente está relacionada com alterações clínicas e morte em gatos adultos. Um gato de 45 dias de idade, sem raça definida e com histórico de inapetência desde o nascimento foi encaminhado para atendimento veterinário. Ao exame físico apresentou letargia e dispneia restritiva. À necropsia, havia acentuada ascite, hidrotórax, hepatomegalia com evidenciação do padrão lobular (fígado noz-moscada) e os pulmões apresentavam-se acentuadamente diminuídos (atelectasia pulmonar compressiva). O coração apresentava acentuada dilatação das câmaras cardíacas. Em ventrículo esquerdo, havia numerosas estruturas brancacentas semelhantes a cordas conectando o músculo papilar ao septo interventricular (bandas moderadoras excessivas/falsos tendões). Microscopicamente, estas estruturas apresentavam acentuada proliferação de tecido conjuntivo fibroso, além de células de Purkinje e cardiomiócitos bem diferenciadas revestidas por uma única camada de endocárdio. O objetivo deste trabalho é descrever um caso de bandas moderadoras excessivas (falsos tendões) em ventrículo esquerdo de um gato jovem com insuficiência cardíaca congestiva e morte.(AU)

Hemangiossarcoma na língua de um gato / Hemangiosarcoma in a cat’s tongue

Background: Hemangiosarcoma is a primary malignant neoplasm of vascular endothelial cells, common in dogs and uncommon in cats. It is characterized by being aggressive and presenting high metastatic behavior. It corresponds to 0.5% to 2% of all feline neoplasms, with more reports in shorthaired cats aged between 8 and 12.2 years old, with no predisposition for sex or breed. Among the diagnostic methods, histopathological and immunohistochemical exams stand out because they are more accurate, since the result of fine-needle aspiration biopsy is usually hidden by blood contamination. This report aims to describe a case of a hemangiosarcoma in a cat’s tongue. Case: A 9-year-old, female, shorthair cat with a history of weight loss, lethargy, chewing difficulty with the evolution of three months and two-day oral bleeding was attended. Physical examination revealed blood in the oral cavity, enlargement, and darkening of the tongue surface, normalized oral and ocular mucous membranes, estimated dehydration of 7%, a rectal temperature of 38.8OC, and pulmonary and cardiac auscultation without changes. The cat was hospitalized, and euthanasia was elected. Cytological and histopathological exams of the tongue were requested, which revealed a neoplastic proliferation of endothelial cells expanding and replacing the muscular layer of the tongue, forming primitive vascular structures filled with a large number of red blood cells and supported by a delicate fibrovascular stroma. There were moderate anisocytosis and anisocariosis and rare figures of mitosis. Immunohistochemical examination showed the expression of von Willebrand factor, smooth muscle vimentin, and actin in the cytoplasm of neoplastic cells, and negative staining for pancitokeratin. Discussion: According to the results of cytological, histopathological and immunohistochemical

Hemangiossarcoma na língua de um gato / Hemangiosarcoma in a cats tongue

Background: Hemangiosarcoma is a primary malignant neoplasm of vascular endothelial cells, common in dogs and uncommon in cats. It is characterized by being aggressive and presenting high metastatic behavior. It corresponds to 0.5% to 2% of all feline neoplasms, with more reports in shorthaired cats aged between 8 and 12.2 years old, with no predisposition for sex or breed. Among the diagnostic methods, histopathological and immunohistochemical exams stand out because they are more accurate, since the result of fine-needle aspiration biopsy is usually hidden by blood contamination. This report aims to describe a case of a hemangiosarcoma in a cats tongue. Case: A 9-year-old, female, shorthair cat with a history of weight loss, lethargy, chewing difficulty with the evolution of three months and two-day oral bleeding was attended. Physical examination revealed blood in the oral cavity, enlargement, and darkening of the tongue surface, normalized oral and ocular mucous membranes, estimated dehydration of 7%, a rectal temperature of 38.8OC, and pulmonary and cardiac auscultation without changes. The cat was hospitalized, and euthanasia was elected. Cytological and histopathological exams of the tongue were requested, which revealed a neoplastic proliferation of endothelial cells expanding and replacing the muscular layer of the tongue, forming primitive vascular structures filled with a large number of red blood cells and supported by a delicate fibrovascular stroma. There were moderate anisocytosis and anisocariosis and rare figures of mitosis. Immunohistochemical examination showed the expression of von Willebrand factor, smooth muscle vimentin, and actin in the cytoplasm of neoplastic cells, and negative staining for pancitokeratin. Discussion: According to the results of cytological, histopathological and immunohistochemical…(AU)