Endoscopic removal of a bronchial carcinoma in a dog using one-lung ventilation.

OBJECTIVE: To describe anesthetic management of endoscopic electrosurgical removal of a bronchial carcinoma, partially blocking the right main stem bronchus in a Cocker Spaniel. STUDY DESIGN: Clinical case report. ANIMALS: Dog with a bronchial carcinoma. METHODS: To allow sufficient space for the endoscope and to avoid an oxygen-rich gas mixture in the trachea, which carries the risk of an airway fire when electrocautery is used, a 1 lumen endobronchial tube (EBT) was inserted into the left main stem bronchus. One-lung ventilation (OLV) started with a volume-controlled ventilator was switched to pressure-controlled ventilation in combination with positive end-expiratory pressure (PEEP). RESULTS: Resection of the bronchial carcinoma was successful. The dog was hypercapnic throughout the procedure and a high alveolar-arterial oxygen gradient was measured. CONCLUSION: An EBT may be a feasible and safe option to provide OLV for bronchoscopic electrocautery with a closed thoracic cavity in dogs. CLINICAL RELEVANCE: EBT intubation for OLV should be considered as part of the anesthetic management of airway diseases treated with bronchoscopic electrocautery.

Bronchogenic adenocarcinoma in a cat: an unusual case of metastasis to the skin.

A 6-year-old, spayed, female, domestic shorthair cat was presented for decreased activity. A nodular lesion was found in the skin extending into the subcutaneous tissue of the right abdominal flank. On lateral and ventrodorsal radiographs of the thorax, an opacity involving the entire right caudal lung lobe and pleural effusion were noted. Cytologic evaluation of cells in the thoracic fluid and in the mass revealed a population of atypical epipthelial cells with marked anisocytosis and high N:C ratios, organized in acinar-like clusters. Multinucleated cells and several mitotic figures were found. The cytologic interpretation was carcinoma. Because of the progressive severity of clinical signs, the cat was euthanized. Histologic evaluation of tissues obtained at necropsy indicated a bronchogenic adenocarcinoma in the lung, with metastasis to the skin of the right flank, but no involvement of the digits. Based on immunohistochemical stains, the neoplastic cells strongly co-expressed cytokeratin and vimentin, and were negative for S-100 and actin-specific antigen. Bronchogenic adenocarcinoma is an uncommon neoplasm in cats, and the digits are the most common sites of metastasis. This case was unusual in that the skin of the abdominal wall was the primary site of metastasis, with no involvement of the digits.

Metastatic digital carcinoma in the cat: a retrospective study of 36 cats (1992-1998).

Thirty-six cats with bronchogenic carcinoma metastatic to the digit were identified. The mean age was 12.7 years, with no breed or sex predilection. Records from 19 cases were available for review. These cats presented with a primary complaint of lameness that involved primarily weight-bearing digits and the third phalanx. None had respiratory signs, despite the presence of pulmonary carcinoma. Course of disease was consistent in the 19 cases, with a mean survival time of 58 days from initial presentation. Amputation of affected digits was rarely palliative due to development of lesions in other digits and progressive nonrespiratory disease.

Probable hypercalcemia of malignancy in a cat with bronchogenic adenocarcinoma.

An eight-year-old, neutered male, domestic shorthair cat was referred with a four-day history of acute vomiting. Hypercalcemia was identified on serum biochemical testing. Thoracic radiographs showed multiple pulmonary nodular densities. Postmortem and histopathological examination identified the nodules as bronchogenic adenocarcinoma with metastases to the tracheobronchial lymph nodes, diaphragm, and parietal pleura. To the authors' knowledge, this is the first reported case of hypercalcemia of malignancy associated with bronchogenic adenocarcinoma in a cat.

Prognosis factors for survival in cats after removal of a primary lung tumor: 21 cases (1979-1994).

OBJECTIVE: To identify possible prognostic factors for survival time in cats with a primary lung tumor after surgical excision. STUDY DESIGN: Retrospective clinical study. ANIMAL POPULATION: 21 cats with histologically confirmed primary lung tumors removed surgically. METHODS: Medical records for cats treated between 1979 and 1994 at 14 participating veterinary referral hospitals were reviewed. RESULTS: After surgical resection and recovery, 18 cats died from metastatic disease with a median survival time of 115 days (range, 13 to 1,526 days). Three cats were lost to follow-up at 119 days, 251 days, and 410 days after the surgical procedure. Contingency table analysis to determine if an association existed between clinical findings (breed, age, gender, body weight, clinical signs, duration of clinical signs, and radiographic findings) or histological features and survival time was performed. Only histological morphology of the primary lung tumor showed a significant association with survival time. Twelve cats with moderately differentiated tumors had a significantly longer survival time (median, 698 days; range, 19 to 1,526 days) than the nine cats with poorly differentiated tumors (median, 75 days; range, 13 to 634 days). CONCLUSIONS: Surgical resection of a solitary primary lung tumor in cats is indicated. CLINICAL RELEVANCE: A poor prognosis for long-term survival is warranted for those cats having a poorly differentiated primary lung tumor.

Endogenous lipid (cholesterol) pneumonia associated with bronchogenic carcinoma in a cat.

An 11-year-old, female domestic longhair was presented for dyspnea, vomiting, and left forelimb lameness. A mass in the left caudal lung lobe was seen on thoracic radiographs. The mass was resected during thoracotomy, and histopathology confirmed a diagnosis of endogenous lipid pneumonia. The cat recovered slowly from surgery and was euthanized 11 days following discharge because of persistent respiratory difficulties. Necropsy findings included lipid pneumonia and bronchogenic carcinoma, with probable tumor metastasis to the small intestine, spleen, kidney, and left triceps muscle.

Primary lung neoplasia in a beagle colony.

As part of long-term pulmonary carcinogenesis studies in dogs, it is important to analyze the incidence of spontaneous lung neoplasia. Primary lung carcinoma incidence was determined in two control populations of Beagle dogs observed for their life spans. One population comprised 216 dogs (112 males and 104 females) that were controls for life span studies, and another comprised 182 dogs (50 males and 132 females) that were retirees from a breeding colony. Forty lung neoplasms were noted in the 398 dogs; 35 neoplasms were carcinomas classified as papillary adenocarcinoma (20), bronchioloalveolar carcinoma (9), adenosquamous carcinoma (5), or bronchial gland carcinoma (1). The other five neoplasms were a malignant fibrous histiocytoma, three adenomas, and a fibroma. The crude incidence of lung carcinomas averaged for both populations was 8.8% (35/398) and was dominated by a relatively high incidence of lung neoplasia in aged dogs, those dying after the median life span of 13.6 years.

Stapling techniques in pulmonary surgery.

There are only a few reports in the veterinary literature describing the use of stapling equipment and techniques for pulmonary surgery. These reports indicate that complications associated with these procedures are minimal. Although pulmonary lobectomy procedures originally described independent isolation and ligation of the hilar vessels, it became apparent that, with the use of the smaller staples, especially the ones designed for vascular use, this was unnecessary. Therefore, en bloc hilar stapling is the procedure of choice. This makes the surgical procedure extremely quick to perform. Similarly, there is no indication to routinely oversew staple lines when performing a partial lobectomy. This is a tedious procedure and may actually increase the chance of air leakage. If point areas of leakage do occur, these can be independently occluded either with sutures or individual vascular clips. Selecting the correct size of TA stapler and staples to create the correct length of staple line is critical. It is important that all the tissue to be ligated lie comfortably within the staple line. It is better to use a stapler that is too long and collect the extra staples on a sponge than to use one that is too short that results in leakage from nonstapled tissue. In general, the 4.8-mm staples should not be used for pulmonary surgery in the dog and cat. They do not compress the tissue enough to prevent leakage. For most complete lobectomies, where the hilus of the lung can be adequately isolated, the TA 30 V3 is the stapler of choice. When performing a partial lobectomy, a longer stapler is often required. If a TA 55 or TA 90 is necessary, it should be used with 3.5-mm staples. Even though stapling techniques have made pulmonary surgical procedures safe, easy, and quick to perform, they are not totally free of problems and complications. Experience in the use of the equipment is essential, as is good surgical judgment as to when to use or not to use these techniques. The absence of reported clinical complications, either short- or long-term, attests to the success of these techniques.

Hypertrophic osteopathy in three horses and a pony.

Hypertrophic osteopathy was diagnosed in 3 horses and in a pony, ranging in age from 8 to 21 years. There were 2 females, 1 sexually intact male, and 1 gelding. In 3 animals, hypertrophic osteopathy was associated with pulmonary abscesses, bronchogenic squamous cell carcinoma, and ovarian granulosa-cell tumor, respectively, and resulted in death or euthanasia. Duration of the condition ranged from 1 to 4 months. In 1 horse, hypertrophic osteopathy was believed to be secondary to pregnancy, and resolved following uncomplicated delivery of a live foal.

Chest roentgenographic techniques for demonstrating human lung tumour xenografts in nude rats.

Roentgenographic techniques were investigated for imaging orthotopic lung tumours in anaesthetized nude rats endobronchially implanted with human lung cancer cells. A conventional radiographic unit with a dual-screen, double-emulsion film mammographic receptor produced images preferable to those from a mammographic unit because of superior resolution. Typical exposure factors were 300 mA, 29 kVp, and 17 ms at a focus-film distance of 76 cm with a 2.11 by 2.41 mm effective focal spot and inherent filtration of 1.2 mm aluminium. Sensitivity for tumour detection was 0.93 for 59 animals with pathologically proved tumours and 0.96 for 54 animals with tumours larger than 4 mm or 50 mg. For 24 pathologically tumour-free animals, specificity was 1.00. For 55 animals radiographically judged to have tumours, positive predictive value was 1.00. For all 83 animals, accuracy was 0.95. This technique effectively demonstrates orthotopic human lung tumours in nude rats and should be useful for noninvasive monitoring of tumour presence, location, size, and changes in size.

Primary malignant pulmonary neoplasia in two horses.

Although primary malignant pulmonary neoplasia of horses is rarely encountered, this diagnosis was confirmed in 2 horses on the basis of necropsy and histopathologic findings. One horse, with cystic mucinous adenocarcinoma, had respiratory tract and neurologic signs directly attributable to the neoplasm, and a tentative antemortem diagnosis of pulmonary neoplasia was made. The other horse, with anaplastic bronchogenic carcinoma, did not have clinical signs of pulmonary neoplasia.

A spontaneous bronchogenic carcinoma in a Sykes monkey (Cercopithecus mitis stuhlmani).

A male blue monkey (Cercopithecus mitis stuhlmani), a subspecies of the Sykes group, was purchased from a commercial trapper as an adult in July 1978 and kept at the Institute of Primate Research, Kenya, for 2 years. The animal developed acute respiratory distress and died. Small nodular foci were found in the lung at necropsy and diagnosed as bronchogenic carcinoma on histopathology.

Classification of lung carcinomas in the dog and cat.

A total of 218 lung carcinomas from dogs and cats were examined histologically. The tumors were classified into adenocarcinoma, squamous-cell carcinoma, bronchial gland carcinoma, and alveolar-cell carcinoma. We believe that adenocarcinoma should be subdivided into differentiated and undifferentiated types because the two are distinct histologically and vary in frequency in the cat and dog. It is also important to recognize bronchial gland carcinoma, a distinct histological type, and to subdivide alveolar-cell carcinoma into three separate types: anaplastic small-cell and large-cell types, and adenomatosis type.