Dorsal rhinotomy in a dog with a chondro-osseous respiratory epithelial adenomatoid hamartoma: a case report.

OBJECTIVE: To describe the clinical presentation, novel surgical approach, and outcome of a dog diagnosed with chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH). ANIMAL: 5-year-old castrated male Yorkshire Terrier. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The dog was presented with chronic upper respiratory noise, congestion, facial swelling, ocular discharge, and an abscess on the nasal bridge. Two CT scans were performed 4 months apart. The CT scans yielded similar results: cyst-like nasal masses with severely destructive bilateral rhinitis with extensive polyostotic bony lysis. A dorsal rhinotomy with a turbinectomy and debridement of the nasal cavity were performed. A poorly defined but extensive lesion was found occupying the entirety of the left frontal sinus as well as the nasal cavity. TREATMENT AND OUTCOME: Histopathology revealed a mass consistent with COREAH. The dog recovered well from surgery, except for self-limiting subcutaneous emphysema, and 3 weeks postoperatively was reportedly doing well, with mild nasal discharge. Stridor, nasal discharge, and sneezing episodes were reported postoperatively; however, these were improved. At 18 months postoperatively, the dog died from uncontrolled seizures while hospitalized for suspected acute hemorrhagic diarrhea syndrome at a different hospital. CLINICAL RELEVANCE: COREAH should be considered a potential cause of destructive bilateral rhinitis and bony lysis in dogs. Dorsal rhinotomy can be a surgical treatment for dogs with possible COREAH with acceptable outcome, though complete remission of clinical signs may not be achieved. This is the first clinical description of COREAH in a dog.

Hamartoma affecting ampullary electroreceptors and epitheliotropic lymphoma in a captive electric eel Electrophorus varii.

Few reports are available describing lesions in captive electric eels Electrophorus spp. This report describes 2 types of cutaneous proliferative lesions (i.e. hamartoma and neoplasm) in a captive electric eel. Ampullary electroreceptor hamartomas appeared grossly as 2 discrete, smooth, pink, spherical, cutaneous masses measuring 6 and 18 mm in diameter. Histologically, hamartomas were composed of predominately spindle cells that were separated into lobules by a peripheral rim of polygonal cells. Spindle cells were arranged in vague streams and occasionally whorls within a myxomatous matrix. Polygonal cells arranged in variably sized trabeculae and cords within a pre-existing fibrovascular stroma surrounded the streams of spindle cells. Admixed with the polygonal cell population were multiple mucous glands and alarm cells, similar to those seen in normal regions of epidermis. Histochemical stains confirmed similar components in the normal ampullary electroreceptor as in the hamartomas. Lymphoma was also present, appearing grossly as patchy pitting, erythematous, and thickened areas of the skin affecting the entire animal. Lymphoma was diffusely infiltrating and expanding the epidermis, oral mucosa, and branchial mucosa up to 1.5 mm in thickness. It was composed of an unencapsulated, well-demarcated, moderately cellular neoplasm composed of lymphocytes arranged in small dense sheets and clusters that separated and effaced epidermal cells. This is the first report of lymphoma in an electric eel, and the first report of ampullary electroreceptor hamartoma in any animal species.

Bile duct hamartoma in a dog.

An 11-year-old female Collie presented with a significantly increased abdominal circumference. Computed tomography of the abdomen revealed that the left lateral lobe of the liver contained a large mass, which was excised via laparotomy. Histologically, many small, dilated, cystic luminal structures were anastomosed and connected to a net-like structure. Immunohistochemistry revealed cytokeratin 19-immunopositive areas, representing bile duct structures in the cystic lumen. Based on these results, the tumour was diagnosed as a bile duct hamartoma. To our knowledge, this is the first report of a bile duct hamartoma in a dog.

Unilateral vascular hamartomas of the vaginal tunic in a dog.

A 12-y-old, male Dachshund was presented for elective orchiectomy. The testes were of normal size. The left testis had numerous dark-red, blood clot-like foci within the vaginal tunic over the pampiniform plexus, epididymis, and testis. Histologically, the red foci were limited to the vaginal tunic and consisted of disorderly growing, variably sized, thin-walled blood vessels lined by a single layer of endothelial cells without mitoses and supported by a thin layer of pericytes. The blood vessels were distended by erythrocytes without thrombus formation. Endothelial cells had cytoplasmic immunolabeling for CD31; pericytes had strong cytoplasmic immunolabeling for α-smooth muscle actin. Our case of subclinical unilateral vascular hamartomas of the vaginal tunic in a dog has not been reported previously in domestic animals or humans, to our knowledge.

Multiple biliary duct hamartomas in a cat resulting in a hepatic mass: A case report.

A 13-year-old, male neutered domestic short-haired cat was diagnosed with multiple biliary duct hamartomas after liver lobectomy for a suspected malignant hepatic mass. Distinguishing ultrasonographic findings included a lobular, mostly well-defined, heterogeneous, predominantly hyperechoic, left hepatic mass. Computed tomography (CT) confirmed the presence of a lobular, well-defined, fluid to soft tissue attenuating, heterogeneously hypoenhancing left divisional hepatic mass. Grossly, a large left sided multilobular pale pink gelatinous hepatic mass was surgically excised. Histopathologically, the mass was composed of irregular cystic spaces lined by cuboidal epithelium and separated by mature regular fibrous tissue. Three months following surgery there was no evidence of recurrence or progression of disease on repeat abdominal ultrasound (AUS).

Meningothelial hamartoma on the forehead of a young cat.

A 1 year and 2-months-old neutered male cat underwent surgical resection of a cutaneous nodule on the midline of the forehead that had been present since approximately 6 months of age. Histopathologically, the nodule was composed of interlacing collagenous fibres interspersed with varying numbers of spindloid cells with round to oval nuclei and moderate to abundant amounts of pale eosinophilic cytoplasm. Similar to meningothelial cells, the spindloid cells were immunopositive for vimentin, neuron-specific enolase, E-cadherin and somatostatin receptor 2. Based on these findings and the absence of nuclear atypia and mitotic figures, the nodule was diagnosed as meningothelial hamartoma. Although cases of cutaneous meningioma have been reported, this is the first report of meningothelial hamartoma in a domestic animal.

Pulmonary hamartoma in an elk calf.

Hamartomas are benign tumor-like lesions composed of disorganized growth of mature mesenchymal or epithelial tissues indigenous to the organ involved. Sporadically observed in ruminants, vascular, fibrous, nasal, and pulmonary hamartomas have been reported in calves; pulmonary and cutaneous forms have been reported in sheep. A full-term elk calf found dead had a large intrathoracic mass replacing the left caudal lung lobe and compressing other thoracic organs. Histologically, cross- and tangential sections of bronchi were separated by collagenous mesenchyme and irregularly shaped canaliculi and saccules resembling terminal bronchioles. Rarely present were regions in which saccules, lined by simple cuboidal epithelium, transitioned into attenuated epithelium lining fully developed alveoli. These findings are consistent with a pulmonary hamartoma. To our knowledge, pulmonary hamartoma has not been reported previously in a non-domestic ruminant.

CSF from a puppy with a cerebral vascular hamartoma.

A 9-week-old puppy with refractory seizures and a dome-shaped head presented to the Mississippi State College of Veterinary Medicine Specialty Center for suspected hydrocephalus. Computerized tomography (CT) findings included transtentorial herniation and an intra-axial mass with dystrophic mineralization. Cerebrospinal fluid analysis revealed an increased nucleated cell count of 1100/µl (RI < 5/µl), erythrocyte count of 2.2 × 106 /µl, and markedly increased microprotein of 1939 mg/dl (RI < 30 mg/dl). On cytologic examination of the CSF, numerous erythrophagocytic, and hemosiderin-laden macrophages were observed, which indicated chronic active hemorrhage. Many neutrophils, macrophages, and lymphocytes that contained numerous intracytoplasmic, pleomorphic, bright yellow crystals were observed. Considering the ongoing hemorrhage, the crystals were presumed to be hematoidin. A biopsy with histopathology was performed on the intra-axial mass, and the results were consistent with a vascular hamartoma. We speculate that the formation of these crystals was related to the ongoing hemorrhage associated with the vascular hamartoma. Identification of these crystals may be useful to aid in the identification of chronic hemorrhage associated with vascular malformations or lesions within the central nervous system.

Locally extensive follicular hamartomas with concurrent follicular cysts and dermoid cysts on the head of a dog.

A 5-month-old, male intact Australian shepherd dog was presented with nodular lesions affecting the dorsal head. A locally diffuse form of follicular hamartomas, with concurrent dermoid cysts and follicular cysts, was diagnosed by histopathological examination. Complete surgical excision of the affected skin and closure with a subdermal plexus advancement flap led to long-term resolution.

Un berger australien mâle intact âgé de 5 mois a été présenté avec des lésions nodulaires affectant la face dorsale de la tête. Une forme localement diffuse d'hamartomes folliculaires, avec des kystes dermoïdes et des kystes folliculaires concomitants, a été diagnostiquée par examen histopathologique. L'éxérèse chirurgicale complète de la peau atteinte et la fermeture avec un lambeau d'avancement du plexus sous-cutané ont conduit à une résolution à long terme.

Un perro pastor australiano macho entero de 5 meses de edad se presentó con lesiones nodulares que afectaban el dorso de la cabeza. Mediante examen histopatológico se diagnosticó una forma localmente difusa de hamartomas foliculares, con quistes dermoides y quistes foliculares concurrentes. La escisión quirúrgica completa de la piel afectada y el cierre con una zona avanzada en colgajo del plexo subdérmico condujo a una resolución a largo plazo.

Multiple follicular abnormalities in a 1-year old cat consistent with basaloid follicular hamartomas.

BACKGROUND: In humans, basaloid follicular hamartomas are benign follicular tumours, that can be solitary or multiple, in which case they show autosomal dominant inheritance. HYPOTHESIS/OBJECTIVES: This study describes clinical and histopathological findings observed in a young cat, which could be consistent with basaloid follicular hamartomas. CASE DESCRIPTION: Multiple follicular abnormalities, consistent with cutaneous diffuse basaloid follicular hamartomas, were observed in skin samples from a one-year old neutered domestic short hair cat. Clinical signs were diffuse symmetrical alopecia with exaggerated skin markings (ventral abdomen, thorax and medial aspects of the limbs) and intense follicular-centred thickening (face and feet). Microscopic lesions were characterised by multiple proliferative follicular abnormalities in all samples. The epidermis showed a very irregular surface with the follicles filled with variably pigmented keratin. The epithelial walls of the follicles had multiple small hyperplastic basaloid cells foci. In the superficial dermis under the epidermis and around the follicles, fibroblastic spindle-shaped mesenchymal cells with a homogeneous moderate density were present in the collagenous connective tissue. The interfollicular epidermis was also abnormal with multiple small proliferating trichoblastic foci originating from the basal layer. RNAscope testing for feline papillomavirus was negative. CONCLUSIONS AND CLINICAL RELEVANCE: This case report provides the first evidence of clinical and histopathological findings of multiple follicular abnormalities, consistent with cutaneous diffuse basaloid follicular hamartomas in a cat.

De multiples anomalies folliculaires, compatibles avec des hamartomes folliculaires basaloïdes diffus cutanés, ont été observées dans des échantillons de peau d'un chat domestique à poils courts castré âgé d'un an. Les signes cliniques étaient une alopécie diffuse symétrique avec des marques cutanées exagérées (abdomen ventral, thorax et face médiale des membres) et un épaississement folliculaire intense (face et pieds).

Múltiplas anormalidades foliculares, consistentes com hamartomas cutâneos foliculares basaloides difusos, foram observadas em amostras de pele de um gato doméstico de pelo curto castrado de um ano de idade. Os sinais clínicos foram alopecia simétrica difusa com marcações cutâneas exuberantes (abdômen, tórax e aspecto medial dos membros) e espessamento folicular central intenso (face e patas).

Se observaron múltiples anomalías foliculares, consistentes con hamartomas foliculares basaloides difusos cutáneos, en muestras de piel de un gato doméstico de pelo corto castrado de 1 año. Los signos clínicos fueron alopecia simétrica difusa con marcas cutáneas exageradas (abdomen ventral, tórax y cara medial de las extremidades) e intenso engrosamiento de la piel centrado en los folículos (cara y pies).

Dysplastic gangliocytoma of the cerebellum in a cat.

A 2.5-year-old cat presented with progressive ataxia and lethargy. Magnetic resonance imaging (MRI) showed enlargement of the cerebellum and herniation of cerebellar vermis. Postmortem examination confirmed the MRI findings, and histopathology showed numerous large dysplastic neurons populating and displacing the Purkinje cell layer and extending into the molecular and granular layers of the cerebellum. The lesion was diagnosed as dysplastic gangliocytoma of the cerebellum. In humans, this tumor is often associated with Cowden syndrome, a genetic disorder characterized by multiple hamartomas and an increased risk of developing certain neoplasms, known to be linked to a germline mutation of the phosphatase and tensin homolog (PTEN) gene. Reduction in PTEN nuclear and cytoplasmic immunohistochemical labeling of dysplastic neurons in this case suggested a possible PTEN mutation involved in the tumorigenesis. This report provides a detailed pathology description of the tumor and the use of neuronal and PTEN markers which will help guide pathologists presented with this rare condition in the future.

Nasal Smooth Muscle Hamartoma in a Dog: a Novel Subtype.

A 3-year-old, female spayed, Pug-cross dog presented with a 2-year history of nasal congestion and focal facial deformity. Complete surgical excision was elected following nasopharyngoscopy, endoscopic biopsy and subsequent computed tomography (CT) scan. Nasopharyngoscopy revealed a friable, polypoid mass of the right nasal conchae occluding the right nasal passage. Biopsies of the mass showed expansion of the submucosa by dense bundles of well-differentiated smooth muscle cells that were strongly immunoreactive for ⍺-smooth muscle actin and desmin. Post-procedure CT revealed a large space-occupying mass in the nasal cavity with minimal lysis of the adjacent calvarium. Histology following complete excision confirmed the results obtained on the initial endoscopic biopsy. The final diagnosis was smooth muscle hamartoma.

Linear arrector pili muscle hamartoma on the tail of a sphynx cat.

Arrector pili muscle (APM) hamartoma is reported in humans and dogs. We describe a linear APM hamartoma in a sphynx cat. The lesion was characterized by multiple nodules distributed linearly along the tail, made of randomly arranged hypertrophic smooth muscles, the size of which tended to wax-and-wane during a one year follow-up.

L'hamartome du muscle arrecteur du poil (APM) est décrit chez l'homme et chez le chien. Nous décrivons un hamartome APM linéaire chez un chat sphynx. La lésion était caractérisée par de multiples nodules répartis en ligne sur la queue, composés de fibres musculaires lisses hypertrophiques désordonnées, dont la taille a évolué par poussée au cours d'une période de suivi d'un an.

El hamartoma del músculo erector piloso(APM) ha sido descrito en humanos y en perros. Describimos un hamartoma APM lineal en un gato esfinge. La lesión se caracterizó por múltiples nódulos distribuidos linealmente a lo largo de la cola, compuestos de músculos lisos hipertróficos dispuestos al azar, cuyo tamaño tendía a fluctuar durante un año de seguimiento.

O hamartoma do músculo eretor do pelo (MEP) é relatado em humanos e cães. Nós descrevemos um hamartoma linear em um gato sphynx. A lesão foi caracterizada por múltiplos nódulos distribuídos linearmente ao longo da cauda, constituídos por músculos lisos hipertróficos dispostos aleatoriamente, cujo tamanho tendia a aumentar e diminuir ao longo do acompanhamento de um ano.

Clinical, MRI, and Histopathological Features of Hypothalamic Neuronal Hamartoma in a Young Vizsla.

Human hypothalamic neuronal hamartomas are rare, nonprogressive, congenital malformations of the hypothalamus that do not expand or metastasize to other locations. A 1 yr old female vizsla was presented for progressive intracranial multifocal neurological signs present since adoption at 3 mo of age. MRI of the brain showed an ill-defined, intra-axial, space-occupying, nonenhancing lesion located in the ventral middle cranial fossa. Histopathological examination was consistent with hypothalamic neuronal hamartoma. This is the first report describing clinical, imaging, and histopathological features of a hypothalamic neuronal hamartoma in a dog. These findings are compared with their human counterparts.

An Angiomyomatous Hamartoma With Features of Vascular Transformation of Sinuses in the Mediastinal Lymph Node of a Beagle Dog.

Two similar benign, nonneoplastic vascular lesions have been described in the lymph nodes of humans and animals: angiomyomatous hamartoma (AMH), which is characterized by the replacement of lymphoid tissue by blood vessels, smooth muscle, and fibrous tissue, and vascular transformation of sinuses (VTS), which is considered a reactive transformation of lymph node sinuses into capillary-like vascular channels. We hereby report a lesion with features common to both lesions in the mediastinal lymph nodes of a 1-year-old beagle dog in a 1-month toxicity study. Grossly, enlargement and red discoloration were observed, while microscopically, the lesion was characterized by effacement of the lymph node parenchyma with replacement by mature blood vessels, smooth muscle, and fibrous tissue, associated with lymphoid atrophy, which is consistent with AMH. However, multifocal areas of anastomosing or plexiform capillary-like channels lined by normal to slightly plump endothelium, similar to those described for VTS, were also present. Immunohistochemistry analysis revealed abundant positive staining for smooth muscle actin and endothelial cells (von Willebrand factor/factor VIII) and the absence of proliferation (Ki67). In conclusion, these lesions most likely represent a mixture of both AMH and VTS.

Glioneuronal Hamartomas in the Central Nervous System of Two Goats.

Two goats (6 months old and 5 years old) were evaluated for neurological signs including laboured breathing, stiffness and obtundation. Solitary masses were noted in the brainstem and spinal cord, respectively. Histopathology of both cases revealed the lesions were composed of a mixture of glial and neuronal cells, consistent with glioneuronal hamartomas. The cause of death was attributed to the mass in the 6-month-old, while the cause of death in the 5-year-old was attributed to listeriosis. Hamartomas of neural origin are rarely described in veterinary species, and this report represents the first report of glioneuronal hamartomas in goats.

Lateral rhinotomy and coblation for treatment of a nasal hamartoma in a dog.

CASE DESCRIPTION: A 4-year-old spayed female French Bulldog was referred for treatment of a suspected right-sided nasal angiofibroma associated with a 4-month history of unilateral nasal discharge and stertor. CLINICAL FINDINGS: The dog appeared healthy other than right-sided mucoid debris and decreased airflow through the right naris. The dog was anesthetized, and a large intranasal mass was observed obstructing the right nasal passage and abutting the nasal septum. TREATMENT AND OUTCOME: A lateral rhinotomy was performed, and rigid endoscopes (0° and 30°) were used to examine the right nasal cavity. The mass filled the anterior aspect of the nasal cavity and involved a portion of the nasal turbinates with some erosion. A coblation unit was used to ablate tumor tissue laterally to remove the tumor in piecemeal fashion. Recovery was routine with only minor epistaxis after surgery, and the dog was discharged the next day. Eight months after surgery, follow-up CT revealed right-sided nasal turbinate and conchal atrophy consistent with prior mass ablation. No macroscopic recurrence was detected, and the owners reported only rare, clear rhinorrhea. CLINICAL RELEVANCE: Findings suggested that coblation may be an alternative to radiation therapy for vascular tumors with minimal invasion and low metastatic potential.

Repeated surgical treatment and long-term outcome of a cat with vertebral vascular hamartoma.

A 30-month-old Maine Coon presented with progressive proprioceptive ataxia, paraparesis, thoracolumbar pain, and decreased appetite. An extradural mass was detected within the left side of the 13th thoracic vertebral canal that compressed the spinal cord on magnetic resonance (MR) and was considered to be mineralized on computed tomography (CT) images. The resected mass was diagnosed as a vertebral vascular hamartoma. Clinical signs improved, but recurrence was diagnosed by MR and CT imaging at 7 months after surgery. Repeated excisional surgery yielded the same diagnosis and the clinical signs abated. Fifteen months after the second surgery, there was apparent vertebral deformation, but there was no further change on CT images by 29 months.

Odontomas in Frogs.

Odontomas are variably differentiated, hamartoma-like proliferations of odontogenic epithelium, pulp ectomesenchyme (odontoblasts), and dental matrix. Frogs are polyphyodont and homodont. Their teeth also differ from mammals in that they are restricted to the upper jaw in adults and lack a periodontal ligament and cementum, attaching directly to the underlying bone. Odontomas were identified in an African clawed frog (Xenopus laevis), a false tomato frog (Dyscophus guineti), and a tomato frog of unknown species (Dyscophus sp.). All of the examined odontomas were composed of numerous tooth-like structures comprising an arc of dentinal matrix lined on the convex surface by ameloblasts and on the concave surface by odontoblasts. Masson's trichrome and immunohistochemistry with pan-cytokeratin supported these findings. The pathogenesis of these lesions may be displacement of the dental lamina, which has been shown in research studies to lead to de novo proliferation of dental elements in frogs.