Hyperechogenicity of the pyloroduodenal junction in small dogs: Population prevalence in 175 dogs and histological correlation in 14 specimens.

At the pyloroduodenal junction (PDJ), an increase in wall echogenicity is frequently observed. A prospective study was performed to assess the PDJ sonographically in 175 adults and small dogs (>1 year old, <11.4 kg (25 lb)) over 12 months to evaluate the prevalence of this finding. Additionally, changes in echogenicity were correlated with histology in 14 postmortem specimens. A scoring system of echogenicity change centered on the mucosa and submucosa of the PDJ was implemented; 0: no change, 1: mild, 2: moderate to marked. Other included parameters were age, sex, breed, gastric distention, gastric contents, and reported vomiting at the time of presentation. Hyperechogenicity of the PDJ was highly prevalent (scores 1 and 2: 85.7%). No statistical association between hyperechogenicity of the PDJ and age, sex, gastric distention, gastric contents, or vomiting was identified. Hyperechogenicity of the PDJ is thought to represent an anatomical transition zone, and based on histology, hyperechogenicity of the PDJ may represent a variation in distribution and amount of fibrous connective tissue, glandular number, and glandular dilation within the submucosa and mucosa.

Spindle-cell thymoma colliding with a bronchogenic cyst in a Yorkshire terrier.

An 8-year-old male Yorkshire terrier was presented to the Tufts Veterinary Hospital for evaluation of increased respiratory effort. A mediastinal mass composed of a spindle-cell thymoma within a bronchogenic cyst was diagnosed with computed tomography thoracic imaging, ultrasound-guided fine-needle aspirate biopsy, and histopathologic evaluation after surgical removal. Histologic evaluation showed a multilocular cyst structure as well as a mass characterized by spindle to polygonal thymic epithelial cells. The cyst was characterized by a lining of ciliated pseudostratified respiratory epithelium. To the authors' knowledge, this is the first report of a spindle-cell thymoma being associated with a mediastinal bronchogenic cyst in a dog.

Metastatic thyroid carcinoma in the appendicular skeleton and tibial plateau leveling osteotomy site of a dog.

A 13-year-old spayed female Labrador retriever cross dog was referred to the Foster Hospital for Small Animals at Tufts University for evaluation of a metastatic carcinoma discovered at the site of a previous tibial plateau leveling osteotomy (TPLO). The dog was previously evaluated at the primary care veterinarian for a complaint of lameness, and radiographs of the previous TPLO site revealed bony lysis associated with the TPLO plate. Surgical exploration of the site by the primary veterinarian provided evidence of osteolysis. The lytic area of the proximal tibia was biopsied, and a metastatic carcinoma was confirmed. The patient was referred for further evaluation. Following consultation and examination, a full body computed tomography (CT) scan was performed to determine the source of the carcinoma. A well-defined soft tissue attenuating mass effacing the right thyroid gland was located, along with 3, well-defined soft tissue attenuating nodules within the pulmonary parenchyma, consistent with metastatic disease. The previously diagnosed osteolytic, aggressive bone lesion of the proximal left tibia was visualized. Following the CT scan, palliative left hind-limb amputation via coxofemoral disarticulation was performed. Histological examination of the hind limb revealed neoplastic epithelial cells admixed with reactive bone. Neoplastic cells were arranged in packets with rare colloid-filled microfollicles consistent with a diagnosis of metastatic thyroid carcinoma. To the authors' knowledge, this is the first clinical report of metastatic thyroid carcinoma in the appendicular skeleton and TPLO site of a dog. Key clinical message: Our findings emphasized that thyroid carcinoma may metastasize to the appendicular skeleton, and causes other than osteomyelitis or implant-associated osteosarcoma should be considered when evaluating osteolytic lesions at a TPLO site.

Carcinome métastatique de la thyro ï de dans le squelette appendiculaire et site d'ostéotomie de n ivellement du plateau tibial d'un chien. Une chienne croisée Labrador retriever stérilisée âgée de 13 ans a été référée au Foster Hospital for Small Animals de l'Université Tufts pour l'évaluation d'un carcinome métastatique découvert sur le site d'une ostéotomie de nivellement du plateau tibial (TPLO) antérieure. Le chien a été précédemment évalué chez le vétérinaire de soins primaires pour une plainte de boiterie, et les radiographies du site TPLO précédent ont révélé une lyse osseuse associée à la plaque TPLO. L'exploration chirurgicale du site par le vétérinaire initial a mis en évidence une ostéolyse. La zone lytique du tibia proximal a été biopsiée et un carcinome métastatique a été confirmé. Le patient a été référé pour une évaluation plus approfondie. Après consultation et examen, une tomodensitométrie (CT) du corps entier a été réalisée pour déterminer la source du carcinome. Une masse d'atténuation des tissus mous bien définie effaçant la glande thyroïde droite a été localisée, ainsi que trois nodules d'atténuation des tissus mous bien définis dans le parenchyme pulmonaire, compatibles avec une maladie métastatique. La lésion osseuse ostéolytique et agressive du tibia gauche proximal précédemment diagnostiquée a été visualisée. Après la CT, une amputation palliative du membre postérieur gauche par désarticulation coxofémorale a été réalisée. L'examen histologique du membre postérieur a révélé des cellules épithéliales néoplasiques mélangées à de l'os réactif. Les cellules néoplasiques étaient disposées en paquets avec de rares microfollicules remplis de colloïdes compatibles avec un diagnostic de carcinome thyroïdien métastatique. À la connaissance des auteurs, il s'agit du premier rapport clinique de carcinome thyroïdien métastatique dans le squelette appendiculaire et le site TPLO d'un chien.Message clinique clé :Nos résultats ont montré que le carcinome thyroïdien peut métastaser au squelette appendiculaire et que des causes autres que l'ostéomyélite ou l'ostéosarcome associé à l'implant doivent être prises en compte lors de l'évaluation des lésions ostéolytiques sur un site TPLO.(Traduit par Dr Serge Messier).

Odontogenic-like neoplasms of the rabbit cheek: pathological features and comparison to cutaneous trichoblastoma and jaw-associated ameloblastoma.

Odontogenic neoplasms demonstrate unique histopathological features and are thought to arise from the germinal tissues of the developing tooth germ, effectively restricting their anatomic origin to the tooth-bearing regions of the jaw and directly associated soft tissues of the oral cavity. Ectopic odontogenic-like neoplasms located in the skin of cats, rabbits, and human beings challenge these assumptions. Here we describe the clinical, pathological, and immunohistochemical features of 6 spontaneously occurring odontogenic-like neoplasms arising in the cutaneous tissue of the cheek in client-owned pet rabbits, including ameloblastoma-like (n = 3), ameloblastic fibroma-like (n = 2), and ameloblastic carcinoma-like neoplasms (n = 1). Microscopically, all the cheek tumors featured neoplastic epithelium exhibiting odontogenic architectural structures (plexiform ribbons, anastomosing trabeculae, follicles, cysts, and irregular structures with rounded botryoid protuberances) and 1 or more cardinal odontogenic epithelial features (basal palisading, antibasilar nuclei, and central stellate reticulum-like cells). The pancytokeratin, cytokeratin 5/6, cytokeratin 14, and vimentin immunohistochemical patterns of these odontogenic-like lesions were most similar to those of jaw-associated ameloblastoma and differed from those of cutaneous trichoblastoma. All neoplasms were narrowly excised, and for lesions with clinical follow-up information, none had evidence of recurrence 1-7 months after surgical removal. Although evidence suggests that these odontogenic-like tumors of the rabbit cheek may be derived from ectopic rests of transformed tooth germ, the histogenesis of these lesions remains unresolved.

Neuroimaging in infants with prenatal opioid exposure: Current evidence, recent developments and targets for future research.

Prenatal opioid exposure (POE) has shown to be a risk factor for adverse long-term cognitive and behavioral outcomes in offspring. However, the neural mechanisms of these outcomes remain poorly understood. While preclinical and human studies suggest that these outcomes may be due to opioid-mediated changes in the fetal and early postnatal brain, other maternal, social, and environmental factors are also shown to play a role. Recent neuroimaging studies reveal brain alterations in children with POE. Early neuroimaging and novel methodology could provide an in vivo mechanistic understanding of opioid mediated alterations in developing brain. However, this is an area of ongoing research. In this review we explore recent imaging developments in POE, with emphasis on the neonatal and infant brain, and highlight some of the challenges of imaging the developing brain in this population. We also highlight evidence from animal models and imaging in older children and youth to understand areas where future research may be targeted in infants with POE.

Atypical and malignant canine intracranial meningiomas may have lower apparent diffusion coefficient values than benign tumors.

Canine intracranial meningiomas can be graded based on histological classification as benign (grade I), atypical (grade II), and anaplastic or malignant (grade III). In people, grade II/III meningiomas behave more aggressively, have a higher potential for recurrence after surgical resection, and have lower apparent diffusion coefficient (ADC) values with diffusion weighted imaging (DWI). In this retrospective analytical cross-sectional study, 42 dogs had ADC values quantified in an attempt to differentiate tumor histologic grade. Our hypothesis was that ADC values would be significantly lower in grade II and III versus grade I meningiomas in dogs. On each ADC image, a polygonal region of interest (ROI) was hand-drawn along the lesion's periphery, excluding fluid-filled and hemorrhagic regions. Mean ADC value (ADCmean ) and minimum ADC value (ADCmin ) were calculated. Additionally, two smaller, ovoid ROI were drawn within the lesion with mean ADC calculated (ADCmean sR and ADCmin sR ). Normalized ADC values using white matter were also calculated (ADCn and ADCn sR ). Grades of each tumor were assigned based on histopathology review. Association between ADC parameters and histological grade was tested by means of two-sample t-tests. There were 14 grade I (33.3%), 25 grade II (59.5%), and three grade III (7.2%) meningiomas. ADCmean sR and ADCmin sR were significantly lower when comparing grade II/III to grade I (P < .05). Grade II tumors had significantly lower ADCmean , ADCmean sR , ADCmin sR , ADCn , and ADCn sR than grade I meningiomas. This preliminary study supports the potential of ADC values to help predict the histological grade of intracranial meningiomas in dogs.

Suspected Acute Respiratory Distress Syndrome Associated With the Use of Intravenous Lipid Emulsion Therapy in a Dog: A Case Report.

A 12-year-old male neutered Bichon Frise presented to the Emergency Department for stupor and bradycardia after ingestion of chocolate covered 450 mg (90 mg/kg) tetrahydrocannabinol. The patient was hospitalized for supportive care, IV fluid therapy and monitoring in the intensive care unit. During hospitalization the patient became comatose and bradypneic. Treatment with intravenous lipid emulsion (ILE) therapy was instituted to accelerate toxin elimination, reduce the risk of complications related to progressive obtundation and shorten hospitalization time. Five hours after infusion, the patient developed severe respiratory distress and was ultimately euthanized. Post-mortem histologic evaluation of lung revealed severe pulmonary edema consistent with acute respiratory distress syndrome. There are infrequent reports of adverse effects associated with ILE therapy for toxicosis in veterinary medicine despite reports of complications such as acute respiratory distress syndrome in human literature. The purpose of this report is to describe the potential for a severe adverse event after treatment of a toxicosis with ILE therapy.

Radiographic Differentiation of Cranial Mediastinal Lymphomas from Thymic Epithelial Tumors in Dogs and Cats.

In both dogs and cats, the most common cranial mediastinal masses (CMMs) are lymphoma and thymic epithelial tumors (TETs). Pretreatment differentiation of these tumors using fine needle aspiration or biopsy is essential because lymphomas are treated medically, whereas TETs are treated surgically. The purpose of this retrospective study was to determine whether thoracic radiographic findings can be used to aid clinicians in preliminarily differentiating the two tumor types before cytology or histopathology results become available. Medical records, available cytologic or histologic samples, and thoracic radiographs were evaluated for 62 dogs and 28 cats. Seventeen radiographic criteria were assessed by two examiners, and regression modeling was performed to test for significant predictors of tumor type. In dogs, CMMs with at least two well-defined radiographic margins on a lateral view and CMMs causing a rightward shift of the cardiac silhouette on a ventrodorsal or dorsoventral view were significantly more likely to be TETs than lymphomas (P < .001 and P < .01, respectively). No significant predictive variables were identified in cats. Radiographic findings do not eliminate the need for invasive sampling, but in dogs, they may guide the clinician in providing preliminary information to owners regarding the staging and therapeutic measures that may eventually be recommended.

Distribution and correlation of pancreatic gland size and duct diameters on MRCP in patients without evidence of pancreatic disease.

PURPOSE: To use MRCP to investigate age-related changes and gender differences of the pancreas and to correlate pancreatic gland size and duct diameter. METHODS: In this institutional review, board-approved, HIPAA-compliant study, 280 patients (age 20-88 years) without a history of pancreatic or liver disease who had undergone MRI/MRCP from 2004 to 2015 were identified. The anteroposterior size and main duct diameter of the pancreatic head, body, and tail were measured. The pancreatic gland and duct sizes were compared between genders, and among seven age subgroups (20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89). RESULTS: The pancreatic head and body were significantly larger in males than females (head, p < 0.01; body, p = 0.03), while the tail and the duct diameters of the pancreatic head, body, and tail showed no gender difference. As the age of male participants increased, there was an associated increase in size of the pancreatic gland initially (largest at age 50-59 (body) and 60-69 (head)), followed by subsequent decline in size thereafter. Additionally, the pancreatic duct diameter was found to increase gradually. In females, the size of the pancreatic gland decreased, while the diameter of the pancreatic duct increased with age. Moderate positive correlation for gland size and strong positive correlation for duct diameter among different pancreatic regions were found. Weak negative correlation was found between gland size and duct diameter. CONCLUSIONS: There are gender differences in the gland size of the pancreatic head and body. The pancreatic gland size increases until the sixth decade in males, with a more continuous decrease in gland size with age in females. Both males and females demonstrate a marked decrease in gland size after the eighth decade. The duct diameter increases with age in both males and females.

Clinical features of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis.

BACKGROUND: Histologic features of pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) have been described in dogs but without a thorough clinical description. OBJECTIVES: To report the clinical features, diagnostics, treatment, and outcome of dogs with histologic evidence of PVOD and PCH. ANIMALS: Fifteen pet dogs meeting histopathologic criteria of PVOD (occlusive remodeling of small-sized to medium-sized pulmonary veins) or PCH (alveolar capillary proliferation and congestion), or both. METHODS: Medical records of dogs with PVOD and PCH identified based on histopathologic features between 2003 and 2017 were retrospectively reviewed. RESULTS: Fifteen dogs met inclusion criteria of a histologic diagnosis of PVOD or PCH or both. Dogs were older (median 11 years) with no apparent breed or sex predisposition. Dogs presented with acute clinical signs (median 3 days), usually respiratory distress. Thoracic radiography (available in 10 dogs) revealed right cardiomegaly and patchy or diffuse interstitial to alveolar patterns, with 9 dogs having a normal left cardiac silhouette. In 5 dogs tested, pulmonary arterial hypertension (PAH) was documented. In all 3 dogs, thoracic computed tomography scans showed pulmonary arterial enlargement and perivascular diffuse nodular ground-glass opacities. Ten of 15 dogs died within 1 day; median survival was 3 days. CONCLUSIONS AND CLINICAL IMPORTANCE: In dogs with PAH, the inability to document left-sided congestive heart failure and failure to identify another cause of signs of respiratory disease should increase suspicion for PVOD and PCH. With increased awareness of PVOD and PCH by clinicians and pathologists, dogs with compatible clinicopathologic features should be evaluated for these pulmonary vascular disorders.

Ultrasonographic and clinicopathologic features of segmental dilatations of the common bile duct in four cats.

CASE SERIES SUMMARY: This case series documents ultrasonographic and clinicopathologic features of four cats with marked segmental dilatations of the common bile duct (CBD). All cats had additional ultrasonographic changes to the hepatobiliary system, including hepatomegaly, tubular to saccular intra/extrahepatic biliary duct dilatation and biliary debris accumulation. Based on all available data the presence of extrahepatic biliary duct obstruction (EHBDO) was ruled out in 3/4 cases and was equivocal in one case. One cat underwent re-routing surgery to address the CBD dilatation after multiple recurrent infections, one cat was euthanized and had a post-mortem examination and two cats were medically managed with antibiotics, liver protectants, gastroprotectants and cholerectics. RELEVANCE AND NOVEL INFORMATION: The ultrasonographic features of the CBD in this population of cats were supportive of choledochal cysts (CCs). The maximal diameter of the CBD dilatations exceeded 5 mm in all cases, a sign that has been previously reported to be consistent with EHBDO. In our study, dilatations were segmental rather than diffuse. Given the high morbidity and mortality associated with hepatobiliary surgery in cats, segmental dilatation of the CBD should not prompt emergency surgery. Some cats may respond to medical management. Careful planning for cyst resection was beneficial in one cat. Evaluation of CC morphology (eg, size, location, concurrent intrahepatic anomalies) may assist in selecting cats that could benefit from surgical intervention.

Metallosis in a Dog as a Long-Term Complication Following Total Hip Arthroplasty.

Metallosis is the accumulation of metallic debris in soft tissues resulting from wear following total joint replacement. A dog was evaluated for lameness 4 years after total hip arthroplasty using a titanium alloy and cobalt chromium total hip system. Radiographs revealed severe acetabular component wear, implant-bone interface deterioration, and peri-acetabular osteolysis. During surgical revision, black periarticular tissue surrounded the implants. Histologically, there was fibrosis and granulomatous inflammation with abundant, intra- and extracellular, black, granular material and smaller amounts of clear punctate to acicular material. Laser capture microdissection followed by x-ray fluorescence microscopy indicated the material contained large amounts of titanium with smaller amounts of vanadium, cobalt, and chromium, confirming the diagnosis of metallosis. The clear material was birefringent under cross-polarized light, stained positive with Oil-Red-O, and thus was consistent with polyethylene. Metallosis exhibits characteristic gross and histologic lesions and is a differential diagnosis for aseptic loosening of hip implants.

Aquatic Bird Bornavirus-Associated Disease in Free-Living Canada Geese ( Branta canadensis ) in the Northeastern USA.

During the winter of 2013-14, 22 Canada geese ( Branta canadensis ) were admitted to the Wildlife Clinic at the Cummings School of Veterinary Medicine at Tufts University with nonspecific neurologic abnormalities and emaciation. Five of these geese, along with three geese that were submitted dead, were evaluated via histopathology, immunohistochemistry, and reverse transcription PCR (RT-PCR) for bornaviruses. Histopathologically, six of the eight birds had lymphoplasmacytic encephalitis. One bird, which also had encephalitis, had a dilated esophagus. Lead poisoning, West Nile virus, avian influenza, and avian paramyxovirus infection were excluded from the diagnosis. Brain tissue from all eight geese was positive for bornaviral N-antigen on immunohistochemistry. Frozen brain tissue from five birds was available for bornavirus RT-PCR. Three of the five birds were positive for the bornavirus M gene. Formalin-fixed paraffin-embedded brain tissue was evaluated on the remaining three geese via RT-PCR, with one of these geese testing positive. A bornavirus was subsequently cultured in duck embryo fibroblasts from the brain of one Canada Goose. This virus genome was sequenced, and the virus was identified as aquatic bird bornavirus 1. We were unable to identify any unusual features of this genome that would account for its apparent pathogenicity, given that subclinical infection with bornavirus in waterfowl is common in North America.

Diagnosis of pediatric colonic volvulus with abdominal radiography: how good are we?

BACKGROUND: Colonic volvulus is rare in children and associated with colonic dysmotility. Diagnosis of colonic volvulus on radiographs in these patients can be challenging. The purpose of the study was to identify the accuracy of abdominal radiographs and findings suggestive of colonic volvulus. MATERIALS AND METHODS: A retrospective (2003- 2014) study of all children with colonic volvulus proven surgically or endoscopically reviewed their medical charts for underlying disease and clinical presentation as well as their original radiograph reports. Two pediatric radiologists (reader 1 and reader 2) independently reviewed the radiographs. The kappa test was used to evaluate interobserver variability. RESULTS: There were 19 cases of colonic volvulus in 18 patients (11 males) a mean age 14 years. Cecal volvulus was the most common finding at 14/19 cases (74%). Sixteen of 18 (89%) patients had neurological impairment and 10 of 18 (56%) had intestinal dysmotility. The most common presentation was abdominal distension (14/19 [74%]) and pain (11/19 [58%]). Colonic volvulus was diagnosed in only 7/16 (44%) of the abdominal radiographs. The specific finding of a coffee-bean sign was retrospectively observed only by reader 2 in two cases. Absence of rectal gas and focal colonic loop dilation were the most common findings by the readers (average 73.5% and 87%, respectively) with Kappa values of 0.3 and 0.38, respectively. CONCLUSION: Diagnosis of colonic volvulus in children can be challenging. Radiologists should be alerted to the possibility of colonic volvulus when there is focal colonic loop distention or absent rectal gas.

Ultrasonographic and clinicopathological features of pyloroduodenal adenomatous polyps in cats.

Objectives The aim of the study was to report the ultrasonographic and clinicopathological findings in cats with confirmed pyloroduodenal adenomatous polyps. Methods Clinicopathological data, ultrasonographic and histopathological findings were collected retrospectively from medical records. Results Pyloroduodenal polyps appeared as small moderately echogenic and homogeneous nodules filling most of the proximal duodenal or pyloroduodenal lumen. The most common presenting signs in this study included acute vomiting and anorexia in 4/6 cats and lethargy in 3/6 cats. Two cats presented with severe anemia, suggestive of active bleeding. One cat presented with increased bilirubin without anemia, suggestive of impaired bile flow. Five cats survived surgical removal of the polyp and were free of clinical signs 817 days after the procedure. Conclusions and relevance Pyloroduodenal polyps have subtle ultrasonographic changes that can easily be mistaken for ingesta. They are characterized by a discrete small (up to 1.5 cm in diameter) homogeneous echogenic nodule filling the pyloroduodenal lumen. Pyloroduodenal polyps are benign lesions but can cause severe clinical signs including gastrointestinal bleeding or biliary obstruction. The prognosis is excellent with surgical removal.

Mammary development, hyperestrogenemia, and hypocortisolemia in a male cat with an adrenal cortical carcinoma.

A 14-year-old neutered male domestic shorthaired cat was diagnosed with an adrenal cortical carcinoma causing hyperestrogenemia that resulted in mammary hyperplasia and sexual behavior. A right adrenalectomy and mammary gland biopsy were performed. Adrenal cortical neoplasia should be ruled out in any neutered male cat with mammary development and/or exhibiting sexual behavior.

Développement mammaire, hyperœstrogénémie et hypocortisolémie chez un chat mâle atteint d'un corticosurrénalome malin. Un corticosurrénalome malin, causant l'hyperœstrogénémie et produisant une hyperplasie mammaire et un comportement sexuel, a été diagnostiqué chez un chat domestique à poil court mâle stérilisé âgé de 14 ans. Une surranélectomie droite et une biopsie de la glande mammaire ont été réalisées. Un diagnostic de corticosurrénalome devrait être éliminée chez tout chat stérilisé ayant un développement mammaire et/ou manifestant un comportement sexuel.(Traduit par Isabelle Vallières).