Virtual Multiple Mini-Interviews for Veterinary Admissions.

Admissions teams are challenged to select the best applicants for their college. There is a growing emphasis on selecting applicants with personal attributes important for success in a variety of veterinary careers, but there is no clear consensus on how to best identify these individuals. A number of veterinary colleges are utilizing multiple mini-interviews (MMIs), a highly structured type of interview in this selection process. However, due to travel restrictions currently associated with COVID-19, many are now considering virtual MMIs. Long Island University (LIU) took the step to conduct MMIs virtually for its inaugural class before the pandemic restrictions occurred, largely because it hoped to reduce the cost of admission by eliminating travel costs. In this process, we encountered a unique set of challenges, the resolution of which we believe constitutes best practices for virtual MMIs. This report describes the design and execution of an MMI for LIU. We were able to interview 340 applicants in 7 days. Based on feedback from applicants as well as raters, most considered it an acceptable means of interviewing students. Both raters and applicants expressed a high degree of satisfaction with the process, and we were able to separate applicants based on MMI scores with 88% reliability.

Evaluation of endothelin-1 and MMPs-2, -9, -14 in cerebrospinal fluid as indirect indicators of blood-brain barrier dysfunction in chronic canine hypothyroidism.

Chronic canine hypothyroidism is associated with blood-brain barrier (BBB) disruption. We hypothesized that this change is mediated by endothelin-1(ET-1) and matrix metalloproteinases (MMP) -2, -9, and -14, as evidenced by increased concentrations of these proteins in cerebrospinal fluid (CSF) compared to controls. CSF from 18 dogs, 9 controls and 9 with experimentally induced hypothyroidism was collected before and 6, 12, and 18 months after induction of hypothyroidism. Concentrations of ET-1 using an ELISA kit, and for MMP-2, -9, and -14 using gelatinase zymography were measured in CSF. ET-1 was undetectable in CSF of control and hypothyroid dogs at all time-points. Constitutively expressed MMP-2 was detectable in CSF samples in all dogs at all time-points. No other MMPs were detectable in CSF. No differences in CSF concentrations of ET-1 and MMP-2, 9, and 14 were found between hypothyroid and euthyroid dogs. Therefore, ET-1 and MMP-2, 9, and 14 are unlikely to be primary mediators of BBB damage in chronically hypothyroid dogs.

Beyond NAVMEC: competency-based veterinary education and assessment of the professional competencies.

The implementation of competency-based curricula within the health sciences has been an important paradigm shift over the past 30 years. As a result, one of the five strategic goals recommended by the North American Veterinary Medical Education Consortium (NAVMEC) report was to graduate career-ready veterinarians who are proficient in, and have the confidence to use, an agreed-upon set of core competencies. Of the nine competencies identified as essential for veterinary graduates, seven could be classified as professional or non-technical competencies: communication; collaboration; management (self, team, system); lifelong learning, scholarship, value of research; leadership; diversity and multicultural awareness; and adaptation to changing environments. Traditionally, the professional competencies have received less attention in veterinary curricula and their assessment is often sporadic or inconsistent. In contrast, the same or similar competencies are being increasingly recognized in other health professions as essential skills and abilities, and their assessment is being undertaken with enhanced scrutiny and critical appraisal. Several challenges have been associated with the assessment of professional competencies, including agreement as to their definition and therefore their evaluation, the fact that they are frequently complex and require multiple integrative assessments, and the ability and/or desire of faculty to teach and assess these competencies. To provide an improved context for assessment of the seven professional competencies identified in the NAVMEC report, this article describes a broad framework for their evaluation as well as specific examples of how these or similar competencies are currently being measured in medical and veterinary curricula.

Longitudinal study of the effects of chronic hypothyroidism on skeletal muscle in dogs.

OBJECTIVE: To study the effects of experimentally induced hypothyroidism on skeletal muscle and characterize any observed myopathic abnormalities in dogs. ANIMALS: 9 female, adult mixed-breed dogs; 6 with hypothyroidism induced with irradiation with 131 iodine and 3 untreated control dogs. PROCEDURES: Clinical examinations were performed monthly. Electromyographic examinations; measurement of plasma creatine kinase, alanine aminotransferase, aspartate aminotransferase, lactate, and lactate dehydrogenase isoenzyme activities; and skeletal muscle morphologic-morphometric examinations were performed prior to and every 6 months for 18 months after induction of hypothyroidism. Baseline, 6-month, and 18-month assessments of plasma, urine, and skeletal muscle carnitine concentrations were also performed. RESULTS: Hypothyroid dogs developed electromyographic and morphologic evidence of myopathy by 6 months after treatment, which persisted throughout the study, although these changes were subclinical at all times. Hypothyroid myopathy was associated with significant increases in plasma creatine kinase, aspartate aminotransferase, and lactate dehydrogenase 5 isoenzyme activities and was characterized by nemaline rod inclusions, substantial and progressive predominance of type I myofibers, decrease in mean type II fiber area, subsarcolemmal accumulations of abnormal mitochondria, and myofiber degeneration. Chronic hypothyroidism was associated with substantial depletion in skeletal muscle free carnitine. CONCLUSIONS AND CLINICAL RELEVANCE: Chronic, experimentally induced hypothyroidism resulted in substantial but subclinical phenotypic myopathic changes indicative of altered muscle energy metabolism and depletion of skeletal muscle carnitine. These abnormalities may contribute to nonspecific clinical signs, such as lethargy and exercise intolerance, often reported in hypothyroid dogs.

Clinical signs, risk factors, and outcomes associated with bromide toxicosis (bromism) in dogs with idiopathic epilepsy.

OBJECTIVE: To evaluate clinical signs, risk factors, and outcomes associated with bromide toxicosis (bromism) in dogs with idiopathic epilepsy treated with potassium or sodium bromide. DESIGN: Retrospective case-control study. ANIMALS: 83 clinically ill epileptic dogs with (cases; n = 31) and without (controls; 52) bromism. PROCEDURES: Medical records were reviewed for information regarding signalment, epilepsy history, treatment, diet, clinicopathologic test results, concurrent diseases, clinical signs, and outcome. Case and control dogs were matched by the veterinary hospitals from which they were referred and by month of admission. A presumptive diagnosis of bromism was made in case dogs when treatment for primary clinical signs was limited to induction of diuresis or reduction in the dose of bromide administered, and this diagnosis was supported by serum bromide concentrations. Potential risk factors for bromism were identified via univariate and subsequent multivariate logistic regression analyses. RESULTS: Common clinical signs of bromism included alterations in consciousness, ataxia, and upper and lower motor neuron tetraparesis and paraparesis. The multivariate analysis identified bromide dose at admission to the hospital as the only factor significantly associated with bromism. In all dogs with bromism, treatment via dose reduction or facilitated renal excretion of bromide resulted in rapid clinical improvement, although breakthrough seizures happened during treatment in 8 of 31 (26%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Bromism is a clinically heterogeneous, dose-dependent neurotoxicosis that is largely reversible with treatment. Regular serial monitoring of serum bromide concentrations is recommended to optimize anticonvulsant treatment in dogs with idiopathic epilepsy.

Assessment of the use of plasma and serum chloride concentrations as indirect predictors of serum bromide concentrations in dogs with idiopathic epilepsy.

BACKGROUND: Bromide (BR) administration causes pseudohyperchloremia when plasma or serum chloride (Cl-) concentrations are determined with commonly available automated analytical assays. In humans receiving BR, it has been previously demonstrated that the plasma Cl- concentration is a useful indirect estimator of the measured BR concentration. OBJECTIVE: The objective of this study was to determine if the magnitude of pseudohyperchloremia seen in epileptic dogs treated with BR could be used as a predictor of the measured serum BR concentration. METHODS: Plasma and serum Cl- concentrations, analyzed by ion-specific electrode (ISE) and colorimetric techniques, and serum BR concentrations, determined using the gold-trichloride assay, were simultaneously determined in 88 blood samples from dogs with idiopathic epilepsy that were treated with BR. RESULTS: For all methods used to quantify Cl- concentrations, there were significant (P < .0001) linear relationships between BR and Cl- concentrations. Linear relationships between BR and Cl- concentrations were significantly different (P < .0001) between blood samples from dogs obtained during routine therapeutic monitoring and those obtained during emergency hospital admissions. Calculated 95% prediction intervals for future values of BR using measured Cl- concentrations contained considerable error. Plasma Cl- values determined with ISE generally provided the best prediction of serum BR concentrations. Agreement between the measured BR and Cl- using all Cl- assay techniques was moderate, but was statistically significant only when Cl- was assayed in plasma using one ISE method. CONCLUSIONS: The pseudohyperchloremia observed in epileptic dogs receiving BR is an inadequate indirect estimator for the measured BR concentration, although in certain clinical situations identified through construction of a clinical decision tree, the measured Cl- value can be used to guide general therapeutic decisions regarding alterations in BR therapy. Optimal tailoring of BR therapy in dogs with idiopathic epilepsy should be based on results of therapeutic monitoring of BR concentrations.

Cerebrospinal fluid from a 10-year-old dog with a single seizure episode.

A cerebrospinal fluid sample collected from the cerebellomedullary cistern of a 10-year-old Shetland Sheepdog with a recent history of seizures was submitted for fluid analysis and cytologic examination. Key findings included a total nucleated cell count of 520/microL (reference interval 0-5 cells/microL), with a predominance of mononuclear cells, a protein concentration of 51.8 mg/dL (reference interval 0-35 mg/dL), and a glucose concentration of 44.7 mg/dL (reference interval 52-105 mg/dL). There was marked atypia of the mononuclear cells, with abundant eosinophilic cytoplasm, marked anisocytosis and anisokaryosis, occasional binucleated cells, mitotic figures, and rare erythrophagia. The cytologic interpretation was marked, monocytoid-rich, mixed cell pleocytosis with cellular atypia worrisome for neoplasia. In addition to histiocytic neoplasia, differentials included granulomatous meningoencephalomyelitis, necrotizing meningoencephalitis, and granulomatous inflammation. The dog did not respond to anti-inflammatory and anticonvulsive therapy. At necropsy, a mass involving the meninges and subtending the neuropil of the right temporal lobe of the cerebrum was found. Histologically, the mass was composed of large, bizarre histiocytic cells with multinucleated forms and numerous mitotic figures. Using immunochemistry on cytologic and histologic samples, the pleomorphic histiocytic cells were positive for CD1c, CD11ad, CD45, lysozyme, and vimentin, and were negative for CD3, CD4, CD79a, CD90, and pancytokeratin. These findings supported a diagnosis of primary CNS malignant histiocytosis of dendritic antigen-presenting cell (CD1c+) origin. To our knowledge, this is only the third reported case of primary CNS histiocytic sarcoma in dogs, and the first to demonstrate strong immunochemical evidence for dendritic antigen-presenting cell origin.

The effects of epidural deracoxib on the ground reaction forces in an acute stifle synovitis model.

OBJECTIVE: To evaluate the efficacy of epidurally administered deracoxib to mediate the signs of a sodium urate crystal-induced stifle synovitis in dogs, and to compare the efficacy of epidural versus subcutaneously administered deracoxib. STUDY DESIGN: Experimental, randomized, blinded, placebo-controlled modified cross-over design. ANIMALS: Random source, adult, mixed breed dogs (n = 24; 14 males, 10 females). METHODS: Sodium urate crystals were used to create a stifle synovitis model to evaluate the efficacy of deracoxib. Dogs were divided into 4 groups: 3 mg/kg epidural deracoxib, 1.5 mg/kg epidural deracoxib, 3 mg/kg subcutaneous deracoxib, and a placebo (vehicle for deracoxib). Force plate and subjective evaluations were made at time 0, 2, 4, 8, 12, and 24 hours post-treatment. Repeated measures ANOVA with Bonferroni-corrected post hoc comparisons was used to determine significant treatment effects. RESULTS: Peak vertical force (PVF) and vertical impulse (VI) were both significantly higher in deracoxib treated dogs compared with placebo. For 3 mg/kg epidural and subcutaneous deracoxib, PVF and VI were significantly greater than for 1.5 mg/kg epidural deracoxib. Overall pain score for all deracoxib-treated dogs was significantly lower than for placebo dogs. CONCLUSIONS: Epidural administration of deracoxib is effective at providing analgesia in an acute joint pain model; however, it does not appear to be more effective than systemic administration. CLINICAL RELEVANCE: Injectable deracoxib is effective in providing analgesia in acute inflammatory conditions of synovial joints.

Evaluation of the internal vertebral venous plexus, vertebral canal, dural sac, and vertebral body via nonselective computed tomographic venography in the cervical vertebral column in healthy dogs.

OBJECTIVE: To evaluate nonselective computed tomographic (CT) venography for evaluating the cervical internal vertebral venous plexus (IVVP), define the diameter and area dimensions of the IVVP, and determine the relationship between dimensions of the cervical IVVP and other vertebral components in medium-sized dogs. Animals-6 healthy dogs that weighed 18 to 27 kg. Procedure-Helical CT scans were performed from C1 to C7 before and after IV injection of contrast medium (480 mg of iodine/kg) and a continuous infusion (240 mg of iodine/kg). Image data were transferred to a CT workstation, and measurements were performed on displayed transverse images. Diameter and area measurements of the vertebral canal, dural sac, IVVP, and vertebral body were obtained at C3 to C7. RESULTS: Opacification of vertebral venous structures was achieved in all dogs with no adverse reactions. Sagittal diameters of the IVVP for C3 to C7 ranged from 0.6 to 3.2 mm. Transverse diameters ranged from 2.32 to 5.74 mm. The IVVP area represented 12.4% of the mean vertebral canal transverse area and 30.61% of the mean vertebral epidural space area. Area measurements of the IVVP were significantly correlated with vertebral canal area and dural sac area. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that nonselective CT venography is a safe, sensitive method for performing morphometric assessments of the cervical IVVP in dogs. Findings support the theory that there may be a physiologic or developmental relationship between cervical vertebral canal components.

A modified lateral approach to the canine cervical spine: procedural description and clinical application in 16 dogs with lateralized compressive myelopathy or radiculopathy.

OBJECTIVE: To describe a modified lateral surgical approach to the cervical spine in dogs and evaluate clinical outcomes of dogs with neurologic disorders treated with this technique. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Sixteen dogs with lesions involving the cervical spine. METHODS: Medical records (1998-2002) of dogs that had a modified lateral approach to the cervical spine were reviewed. To reduce procedural morbidity, the surgical approach was modified from original descriptions of the technique by minimizing disruption of epaxial and extrinsic thoracic limb musculature and limiting the size of the operative field to the affected vertebral segment. Signalment, neurologic status on admission; onset, progression, and duration of clinical signs; diagnostic testing, etiologic diagnosis, surgical site(s), intra- and postoperative complications, hospitalization, time to optimum recovery, neurologic status at discharge, final neurologic status, and outcome were recorded. Neurologic status (0-5) was scored preoperatively, 1 day postoperatively, at discharge, and at recheck examination (8 dogs). Telephone interviews were used to obtain additional follow-up information. RESULTS: None of the dogs had postoperative deterioration in neurologic status. Outcomes were good or excellent in dogs with intervertebral disc disease, 3/4 dogs with caudal cervical spondylomyelopathy, 1/2 dogs with spinal neoplasia, and in 1 dog with the vascular anomaly; long-term outcomes were unknown in 2 dogs. Intraoperative complications occurred in 3 dogs and included controllable venous plexus hemorrhage (2) and incorrect lesion localization (1). One dog was euthanatized because of postoperative complications. Hospitalization, time to optimal recovery, and overall outcome were not different from previously reported results using other surgical approaches to treat analogous neurologic conditions. CONCLUSIONS: A modified lateral approach to the cervical spine is viable for surgical treatment of cervical myelopathic or radiculopathic lesions when exposure to foraminal and lateralized lesions of the vertebral canal involving the C2-C7 vertebral articulations is desirable. CLINICAL RELEVANCE: A modified lateral approach to the cervical spine can be successfully used in dogs of all sizes to treat caudal cervical spondylomyelopathy, other anomalous conditions of the cervical spine, intervertebral disc disease, and spinal neoplasms. Although long-term follow-up was not available for all patients, outcomes were generally favorable.

CT myelography of the thoraco-lumbar spine in 8 dogs with degenerative myelopathy.

CT myelography of the T11-L2 region was performed in 8 large-breed dogs with a clinical diagnosis of degenerative myelopathy (DM) and 3 large-breed dogs that were clinically normal. CT myelographic characteristics were recorded for each dog, at each disc level. Area measurements of the spinal cord, dural sac, vertebral canal, and vertebral body were recorded at 4 slice locations for each disc level. Mean area ratios were calculated and graphically compared, by slice location and group. In all dogs, CT myelography identified morphologic abnormalities that were not suspected from conventional myelograms. Characteristics observed with higher frequency in DM versus normal dogs were: spinal stenosis, disc protrusion, focal attenuation of the subarachnoid space, spinal cord deformity, small spinal cord, and paraspinal muscle atrophy. Mean spinal cord:dural sac, spinal cord:vertebral canal, dural sac: vertebral canal, and vertebral canal:vertebral body ratios were smaller in DM versus normal dogs at more than one disc level. Some CT myelographic characteristics in DM dogs were similar to those previously reported in humans, dogs and horses with stenotic myelopathy.

Bilateral cavernous sinus syndrome in dogs: 6 cases (1999-2004).

OBJECTIVE: To determine clinical features, diagnostic imaging abnormalities, underlying disease, disease progression, and outcome in dogs with bilateral cavernous sinus syndrome. DESIGN: Retrospective study. ANIMALS: 6 dogs. PROCEDURE: Dogs were included if clinical signs consistent with bilateral cavernous sinus syndrome (i.e., deficits of the third, fourth, and sixth cranial nerves and at least 1 of the first 2 branches of the fifth cranial nerve) were present and a lesion of the cavernous sinus was identified by means of diagnostic imaging or postmortem examination. RESULTS: 5 dogs were evaluated because of problems referable to abnormal ocular motility or pupillomotor dysfunction, and 1 dog was evaluated because of partial motor seizures involving the face and bilateral mydriasis. Four dogs had neurologic signs referable to an extrasinusoidal lesion at the time of initial examination, and the remaining 2 dogs eventually developed extrasinusoidal signs. Besides neuroanatomic location, the only consistent neuroimaging feature was variably intense, heterogeneous enhancement of cavernous sinus lesions. Neoplasia was histologically confirmed as the underlying cause in 5 of the dogs and was suspected in the remaining dog. Median survival time for the 4 dogs that were treated was 199 days (range, 16 to 392 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that bilateral cavernous sinus syndrome is rare in dogs but should be suspected in dogs with compatible clinical signs. Affected dogs have a poor prognosis, and dogs with clinical signs of bilateral cavernous sinus syndrome should be systematically evaluated for neoplastic disease.

Neuronal ceroid-lipofuscinosis in a Labrador Retriever.

An 8-year-old Labrador Retriever with an 11-month history of progressive partial seizures and necropsy examination findings characteristic of the lamellar form of canine neuronal ceroid-lipofuscinosis (NCL) is presented. The clinical, light microscopic, and ultrastructural features of this case most closely resemble human adult-onset NCL (Kufs disease). This is the first report of NCL occurring in the Labrador Retriever breed.

Characterization of matrix metalloproteinase-2 and -9 in cerebrospinal fluid of clinically normal dogs.

OBJECTIVE: To characterize matrix metalloproteinase (MMP)-2 and -9 in CSF of clinically normal dogs. SAMPLE POPULATION: Samples of CSF collected from 23 dogs. PROCEDURE: Dogs were anesthetized, CSF samples were collected, and dogs were then euthanatized. Each CSF sample was evaluated immediately for RBC count, WBC count, and protein and glucose concentrations, and cytologic examination also was performed. Samples were considered normal when protein concentration was < 25 mg/dL and CSF contained < 6WBCs/microL and < 25 RBCs/microL. Samples were stored at -70 degrees C. Sections of brain tissue were collected and processed for histologic examination. The MMPs were evaluated by use of gelatin zymography and a polyclonal antibody-based sandwich ELISA. RESULTS: Mean WBC count for CSF samples was < 1 WBC/microL (range, 0 to 3 WBCs/mL). Mean protein concentration was 12 mg/dL (range, 8 to 17 mg/dL). Mean RBC count was 3.65 RBCs/microL (range, 0 to 21 RBCs/microL). All CSF samples generated a clear band on zymography gels that corresponded to the human commercial standard of proenzyme MMP-2. Other major clear bands were not detected on zymography gels. Bands correlating to MMP-9 were not detected in any samples. The ELISA results revealed a mean +/- SD proenzyme MMP-2 concentration of 5.61 +/- 1.92 ng/mL (range, 3.36 to 10.83 ng/mL). CONCLUSIONS AND CLINICAL RELEVANCE: The proenzyme form of MMP-2 is detectable in CSF of clinically normal dogs, whereas MMP-9 is not detectable. Additional investigation of MMPs in CSF from dogs with various diseases of the nervous system is indicated.

A new device for stereotactic CT-guided biopsy of the canine brain: design, construction, and needle placement accuracy.

An inexpensive device was created for computed tomographic (CT)-guided stereotactic biopsy of the canine brain. The accuracy of the device was tested using 16, formalin-perfused, canine head specimens. For each dog, a 6-inch biopsy needle was guided into pituitary gland and caudate nucleus targets. Needle tracks were measured using the CT computer and infused with tissue staining solution. Hit success and actual needle track lengths were determined from sliced brain specimens. The device enabled accurate orientation and placement of the canine head in the slice plane, such that progressive penetration of the biopsy needle could be monitored. The caudate nucleus was hit 12/16 times (75% accuracy) and the pituitary gland 15.5/16 times (98.6% accuracy). Hit proportions for the two targets did not differ (P < 0.05). A significant difference was found between CT and actual track length for both targets (P < 0.01). This was attributed to incomplete staining of the bevel portion of the needle track.

Dystrophin-deficient muscular dystrophy in a Labrador retriever.

Sex-linked muscular dystrophy associated with dystrophin deficiency has been reported in several breeds of dogs and is best characterized in the golden retriever. In this case report, a young, male Labrador retriever with dystrophin-deficient muscular dystrophy is presented. Clinical signs included generalized weakness, lingual hypertrophy, and dysphagia. Electromyographic abnormalities including complex repetitive discharges were present. Serum creatine kinase concentration was dramatically elevated. Histopathological changes within a muscle biopsy specimen confirmed a dystrophic myopathy, and dystrophin deficiency was demonstrated by immunohistochemical staining. While X-linked muscular dystrophy has not previously been reported in the Labrador retriever, a hereditary myopathy with an autosomal recessive mode of inheritance has been characterized. A correct diagnosis and classification of these two disorders are critical for breeders and owners since both the mode of inheritance and the prognosis differ.

Use of computed tomographic densitometry to quantify contrast enhancement of compressive soft tissues in the canine lumbosacral vertebral canal.

OBJECTIVES: To evaluate computed tomography (CT) densitometry as a technique for quantifying contrast enhancement of compressive soft tissues in the canine lumbosacral vertebral canal and to determine whether the degree of contrast enhancement can be used to help predict tissue type or histopathologic characteristics. ANIMALS: 29 large breed dogs with lumbosacral stenosis. PROCEDURE: Contrast-enhanced CT of L5-S3 was performed by use of a previously described protocol. At each disk level, CT densities of a water-filled syringe, epaxial muscles, and 4 vertebral canal locations were measured. Mean tissue enhancement was calculated by vertebral canal location, using water-filled syringe enhancement as a correction factor. Corrected CT enhancement was compared with tissue type, degree of tissue inflammation, and degree of tissue activity. RESULTS: Intravenous contrast administration of contrast medium significantly increased CT densities of water-filled syringes and epaxial muscles. Corrected CT enhancement of vertebral canal soft tissues at stenotic sites was greater than at nonstenotic sites. There was no association between enhancement and tissue type for any vertebral canal location. There was no correlation between enhancement and degree of tissue inflammation. There was a correlation between enhancement and tissue activity in the dorsal vertebral canal only. CONCLUSIONS AND CLINICAL RELEVANCE: A water-filled syringe is a useful calibration tool for CT density measurements. The degree of tissue contrast enhancement, measured by CT densitometry, can be helpful for predicting the location of compressive soft tissues in dogs with lumbosacral stenosis. However, it is of limited value for predicting compressive soft-tissue types or histopathologic characteristics.

A comparison of the cytologic and histologic features of meningiomas in four dogs.

The cytologic and histologic features of 2 intracranial and 2 spinal (extramedullary cervical) canine meningiomas were compared. Cerebrospinal fluid analysis in 2 cases revealed mild, mixed cell pleocytosis, primarily composed of small lymphocytes and monocytoid cells, with a moderate increase in total protein concentration. Cytologic features suggestive of meningioma included cells with both epithelial and mesenchymal characteristics and a tendency towards cell clustering. Tumor location also was useful in making a diagnosis. The 4 meningiomas differed histologically from one another, and included angioblastic, psammomatous, meningotheliomatous, and microcystic anaplastic types, which conformed to a classification scheme for human meningiomas. The classification scheme could not be applied to cytologic specimens.