Gallbladder carcinoid in a cat.

Carcinoids are rare tumors that originate from neuroendocrine system cells. There has apparently only been 1 report in the veterinary medical literature of a cat with a gallbladder carcinoid, with no long-term follow-up information available from that case. Furthermore, apparently only 9 dogs with gallbladder carcinoids have been reported, again with no long-term follow-up. This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant chemotherapy treatment, and long-term outcome of a domestic longhair cat with a gallbladder carcinoid. The diagnosis of a gallbladder carcinoid in the present case was based on histologic and immunohistochemical findings. Clinical signs of a gallbladder carcinoid are nonspecific and ultrasonographic findings may not be definitive; however, it should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder. The prognosis is poor, with a potentially high metastatic rate. In the present case, metastasis occurred 7 mo postoperatively despite adjuvant therapy, and the survival time was only 10 mo from the time of diagnosis. Key clinical message: This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant treatment, and long-term outcome of a cat with a gallbladder carcinoid, which should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder.

Carcinoïde de la vésicule biliaire chez un chat. Les carcinoïdes sont des tumeurs rares qui prennent leur origine des cellules du système neuroendocrinien. Dans la littérature médicale vétérinaire il n'y aurait qu'un seul cas rapporté d'un chat avec un carcinoïde de la vésicule biliaire, sans aucune information de suivi à long terme disponible pour ce chat. Également, il y aurait 9 cas rapportés de chiens avec des carcinoïdes de la vésicule biliaire, mais encore là aucun suivi à long terme. Le cas présenté ici décrit la présentation clinique, l'apparence chirurgicale, les trouvailles histopathologiques et immunohistochimiques, le traitement post-opératoire par chimiothérapie adjuvante, et le devenir à long terme d'un chat domestique à poil court avec un carcinoïde de la vésicule biliaire. Dans le cas présent, le diagnostic de carcinoïde de la vésicule biliaire était basé sur les trouvailles histologiques et immunohistochimiques. Les signes cliniques d'un carcinoïde de la vésicule biliaire sont non-spécifiques et les trouvailles échographiques pourraient ne pas être concluantes; toutefois, il devrait être considéré comme un diagnostic différentiel possible chez des chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire. Le pronostic est mauvais, avec un risque élevé de métastases. Dans le cas présent, des métastases sont apparues 7 mo post-chirurgie malgré une chimiothérapie adjuvante, et le temps de survie a été de 10 mo à compter du moment du diagnostic.Message clinique clé:Ce rapport de cas décrit la présentation clinique, l'apparence chirurgicale, les trouvaille histologiques et immunohistochimiques, la thérapie adjuvante postopératoire, et le résultat à long-terme pour un chat avec un carcinoïde de la vésicule biliaire, qui devrait être considéré comme un diagnostic différentiel potentiel chez les chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire.(Traduit par Dr Serge Messier).

Gastric neuroendocrine carcinoma (carcinoid) in a ferret (Mustela putorius furo).

A well-differentiated neuroendocrine carcinoma of the stomach (gastric carcinoid) with transcoelomic and lymph node metastasis was confirmed on post-mortem examination of a 3-year-old, spayed female, domestic ferret (Mustela putorius furo). The animal was initially presented with a history of persistent vomiting which progressed to weight loss, a palpable abdominal mass, and melena. The ferret received palliative treatment and was euthanized 9 mo after initial presentation. The clinical, ultrasonographical, cytological, gross pathological, histopathological, and immunohistochemical findings are described. Gastric neuroendocrine carcinomas are rarely reported in animals; this is the first description in a ferret. Key clinical message: Veterinary practitioners and diagnosticians should include neuroendocrine carcinoma as a differential diagnosis when encountering gastric neoplasms in ferrets and be aware of the potential for aggressive behavior and widely spread metastasis.

Carcinome neuroendocrine gastrique (carcinoïde) chez un furet ( Mustela putorius furo ). Un carcinome neuroendocrinien bien différencié de l'estomac (carcinoïde gastrique) avec des métastases transcoelomiques et ganglionnaires a été confirmé lors de l'autopsie d'une femelle furet domestique (Mustela putorius furo) stérilisée de 3 ans. L'animal a été initialement présenté avec des antécédents de vomissements persistants qui ont évolué vers une perte de poids, une masse abdominale palpable et un méléna. Le furet a reçu un traitement palliatif et a été euthanasié 9 mois après la présentation initiale. Les résultats cliniques, échographiques, cytologiques, de pathologie macroscopique, histopathologiques et immunohistochimiques sont décrits. Les carcinomes neuroendocriniens gastriques sont rarement rapportés chez les animaux; c'est la première description chez un furet.Message clinique clé:Les praticiens vétérinaires et les diagnosticiens doivent inclure le carcinome neuroendocrinien comme diagnostic différentiel lorsqu'ils rencontrent des néoplasmes gastriques chez les furets et être conscients du potentiel de comportement agressif et de métastases largement disséminées.(Traduit par Dr Serge Messier).

Tumor carcinoide na vesícula biliar em cão / Carcinoid gallbladder tumor in a dog

Carcinoid is a neoplasia that arises from dispersed cells of the neuroendocrine system. This tumor is uncommon in animals, and its occurrence in the gallbladder is rare. A male Basset Hound dog's corpse was taken to the Univerdade Federal de Minas Gerais to be analyzed by the Veterinary Pathology sector, without a description of its previous history. Necropsy revealed the presence of pale oral, ocular and penile mucous membranes. The gallbladder had a thickened wall and a dilated lumen, which was filled with dark and lumpy bile. Its mucosa had a whitish-red nodule, with solid and friable areas. Microscopically, there was a focal neoplastic proliferation, which wasn't encapsulated and had imprecise limits, which cells were distributed in a solid pattern and separated by a delicate fibrovascular stroma. The neoplastic cells presented oval or round shaped nucleus, which had a chromatin predominantly loose, and one or two nucleoli. Their cytoplasm was moderately abundant, and in most of the cells it was eosinophilic, granular, and had well-defined limits. Using the Grimelius coloration, neoplastic cells' cytoplasmic granules stained brownish or black, confirming the neuroendocrine origin of the neoplasia. Based on the macroscopic and microscopic findings, the diagnosis of a gallbladder carcinoid was established.(AU)

A case of feline primary duodenal carcinoid with intestinal hemorrhage.

A 15-year-old neutered male Persian cat was presented with recurrent hematemesis and melena. Abdominal ultrasonography and computed tomography revealed a mass in the proximal descending duodenal wall. Endoscopic examination revealed hemorrhage on the luminal side of the mass. Fine-needle aspiration of the mass was performed. Microscopic analysis revealed a cluster of cells with oval nuclei and indistinct cell borders, suggesting a neoplastic disease of neuroendocrine origin. The mass located near the major duodenal papilla was partially resected, and the bleeding was stopped by cauterization. However, the surgical procedures could not control the hemorrhage from the tumor mass, and the cat died of severe anemia. Immunohistopathological analysis revealed that the tumor was a duodenal carcinoid.

Dual-phase computed tomography angiography of intestinal carcinoid tumor as a lead point for cecocolic intussusception in a dog.

In an 8-year-old Labrador Retriever with progressive anorexia, constipation, and depression, CT revealed intussusception of the cecum into the ascending colon and a small cecal mass showing strong enhancement on arterial phase. The ileocecocolic junction was surgically resected and histologically diagnosed as cecocolic intussusception with carcinoid tumor. The carcinoid tumor worked as a lead point of intussusception in this case. Dual phasic CT is useful to assess the presence of gastrointestinal tumors as lead points in old dogs with intussusception.

Triple-phase helical computed tomography of an arterio-hepatic venous shunt in a hepatic tumor in a dog.

A 10-year-old French bulldog presented with an abdominal tumor. Triple-phase helical computed tomography was performed, revealing a hepatic tumor, an enlarged hepatic lymph node, and no masses in other organs. The hepatic tumor demonstrated marked enhancement, similar to that of the aorta in the arterial phase. The tumor had rich vascularization and a hepatic arterio-venous shunt formed between the hepatic artery and middle hepatic vein. The hepatic tumor was surgically removed and histological diagnosis revealed a hepatic carcinoid tumor. During surgery, rapid massive arterial hemorrhage occurred from the site of the incision. The animal died without improvement post-surgery. In the case of an arterio-venous shunt in a hepatic tumor, it is important to be careful to avoid perioperative bleeding.

Malignant Neuroendocrine Tumour (Carcinoid) of the Spleen in an African Pygmy Hedgehog (Atelerix albiventris).

A malignant neuroendocrine tumour (carcinoid) of the spleen was diagnosed on post-mortem examination of a 3-year-old, male African pygmy hedgehog (Atelerix albiventris). The animal presented with a history of inappetence, weight loss, lethargy, a wide-based gait and a palpable abdominal mass. The gross pathological, histopathological, histochemical and immunohistochemical findings are described. Primary splenic carcinoids are reported rarely in the human medical literature and this is believed to be the first report in a non-human animal.

A case of hepatic carcinoid in a red deer hind (Cervus elaphus).

A carcinoid tumour in the liver of a red deer hind (Cervus elaphus) is described. Macroscopically, the liver was considerably enlarged with multifocal, firm, yellow and red nodular neoplastic masses, which were histopathologically diagnosed as hepatic carcinoids. The diagnosis was confirmed by modified Grimelius staining, which demonstrated numerous small argyrophilic granules in the cytoplasm of neoplastic cells, and by immunohistochemistry. The neoplastic cells gave a strong positive reaction for neuron-specific enolase (NSE) and synaptophysin and a weak positive reaction for chromogranin A. To our knowledge, this is the first report of a hepatic carcinoid in red deer.

Cytologic and immunohistochemical characterization of a lung carcinoid in a dog.

An 11-year-old neutered male Yorkshire Terrier was presented to the Haemaru Referral Animal Hospital with a history of unresponsive tracheal collapse and an incidental finding of a lung nodule in the left caudal lung lobe on radiography. Thorough physical examination and imaging studies revealed no other masses. Cytologic examination of C-arm mobile fluoroscopy-guided fine-needle aspirates revealed numerous free nuclei and a low number of small round cells with moderate to abundant pale basophilic cytoplasm. Some cells contained indistinct basophilic granules in their cytoplasm, and extracellular pink material was noted. A caudal lung lobectomy was performed, and histologic evaluation of the mass revealed round to polygonal cells with abundant eosinophilic granular cytoplasm and round nuclei with mild anisokaryosis and 0-3 mitotic figures per high-power field. Cells were arranged in packets separated by fine fibrovascular stroma, suggestive of a pulmonary neuroendocrine neoplasm, specifically a carcinoma/carcinoid. The cells were immunoreactive for chromogranin A and neuron-specific enolase, and negative for cytokeratin, synaptophysin, calcitonin, thyroglobulin, parathyroid hormone, CD79a, light lambda, and vimentin. With these findings the tumor was diagnosed as a primary lung carcinoid. Eleven months after resection, there was no evidence of tumor regrowth or metastasis. The absence of necrosis, few mitotic figures, minimal pleomorphism, and benign behavior of this tumor resembled those of a typical carcinoid in humans.

Adjuvant carboplatin for the treatment of intestinal carcinoid in a dog.

A ten-year-old castrated male dog was presented due to a two-day history of constipation and tenesmus. At physical examination, the dog was depressed and unresponsive. Aggressive behavior was elicited by deep abdominal palpation and a mass was detected during the examination. Imaging studies evidenced a large jejunal mass. The lesion (6 cm in diameter) was surgically removed. The histopathology report gave a diagnosis of completely excised intestinal carcinoid. The patient recovered well from the procedure and was scheduled for adjuvant chemotherapy. The dog received four doses of carboplatin (300 mg/m2) every three weeks without showing signs of toxicity. The dog is still in remission after 18 months and is reassessed on a three-month schedule. This report represents the first description of long-term control of intestinal carcinoid in the dog and the first of adjuvant chemotherapy for this rare and aggressive neoplasm.

Poorly differentiated rectal carcinoid in a cow.

A carcinoid tumor was found as a solitary soft mass in the wall of the rectum adjacent to the anorectal junction in an adult Holstein cow. Microscopically, the tumor involved the submucosa and partly invaded the muscular layer. It consisted of a compact arrangement of a great number of large polygonal cells and a small number of small dark cells, some of which showed argyrophilia (Grimelius positive). Immunohistochemically, both types of tumor cells were positive for vimentin, keratin, and S-100 protein and weakly positive for neuron-specific enolase (NSE), whereas they were negative for some endocrine markers such as chromogranin A, insulin, glucagon, somatostatin, serotonin, adrenocorticotropic hormone, and calcitonin. Electron microscopy revealed membrane-bound secretory granules in the cytoplasm of some small dark cells. In such a poorly differentiated carcinoid, the morphologic characteristics of the small dark cells were strong evidence for the diagnosis. This is the first description of a poorly differentiated carcinoid developing in the rectum of a cow.

A thymic carcinoid in a Bengal tiger (Panthera tigris).

An 18-yr-old Bengal tiger (Panthera tigris) presented with acute onset hind limb paresis. Radiographic and ultrasonographic imaging revealed a caudal abdominal aortic thrombus and a cranial mediastinal mass. Necropsy confirmed aortic thrombosis. Necrotizing enteritis and multifocal renal thrombosis were also noted. The cranial mediastinum contained a bilobed mass that histologically and ultrastructurally was consistent with a carcinoid.

Immunohistochemical evaluation of a malignant intestinal carcinoid in a dog.

An intestinal carcinoid with multiple metastases was identified in a 5-year-old male Shih Tzu with a clinical history of anemia, fatigue, anorexia, vomiting, intermittent diarrhea, intestinal bleeding, and progressive emaciation. There was a yellowish-white mass 15 mm in diameter in the anterior jejunum and white nodules consistent with metastases in many organs. Histopathologically, the mass consisted of neoplastic cells arranged in lobules, trabeculae, or closely interdigitating islands of cells. Neoplastic cells were generally polygonal with round hyperchromatic nuclei, modest amounts of eosinophilic cytoplasm, and eosinophilic cytoplasmic granules. Mitoses were common. Rosette formations of tumor cells were apparent in metastatic tumors. Immunohistochemically, tumor cells stained positive for cytokeratin 13, synaptophysin, protein gene product 9.5, neuron-specific enolase, chromogranin A, calcitonin gene-related peptide, serotonin (5-HT), and Leu-7. Serum 5-HT concentrations for this dog were increased 10-fold compared with those of normal dogs. All findings were consistent with a diagnosis of a malignant intestinal carcinoid.

A carcinoid tumor in the gallbladder of a dog.

A cholecystectomy was performed on a 10-year-old spayed female mixed-breed dog with chronic weight loss, persistently increased liver enzyme activities, and cholecystomegaly identified by ultrasonographic examination. A subsequent diagnosis of a biliary carcinoid was made based on a neuroendocrine-type histologic pattern, cytoplasmic argyrophilia by Grimelius staining, immunopositivity for chromogranin A, and the ultrastructural finding of cytoplasmic secretory granules in neoplastic cells. Extrahepatic biliary carcinoid tumors are rare tumors of humans and have not been documented in domestic animals.

Chronic vomiting associated with a gastric carcinoid in a cat.

A geriatric domestic shorthair cat was presented for evaluation of chronic vomiting. Chronic renal failure was diagnosed on the basis of physical examination findings and results of a serum biochemical profile and urinalysis. Endoscopically obtained gastric biopsies were suggestive of a carcinoid tumor. Subsequently, an exploratory celiotomy with partial gastrectomy was performed. Histopathological and electron microscopic analysis of surgical biopsy specimens confirmed the diagnosis of a gastric carcinoid, which has not been previously reported in the cat. Following complete excision, the cat remained clinically stable and free of signs of gastrointestinal disease for 4 months before requiring treatment for progressive renal failure.

Hepatic carcinoid, hypercortisolism and hypokalaemia in a dog.

A German Shepherd dog was diagnosed with periodic myopathy secondary to persistent hypokalaemia. Hormone analysis revealed excess cortisol secretion. A neuroendocrine carcinoma, thought to be a primary hepatic carcinoid, was detected in the liver. Ectopic adrenocorticotrophin hormone secretion was suspected as the cause of hypercortisolism and hypokalaemia, although this could not be confirmed by immunohistochemical staining.

Ultrasonography of canine gastric epithelial neoplasia.

Signalment, clinical and ultrasonographic findings from 16 dogs with histologically confirmed gastric epithelial neoplasia were reviewed. The most common clinical findings were vomiting, anorexia and weight loss. Hematemesis and melena were uncommon findings. Ten (10/16) dogs were female and there were four Chows. The most common ultrasonographic findings were transmural thickening of the gastric wall associated with altered wall layering. A poorly echogenic lining often was noted on the innermost and/or the outermost portions of the gastric wall, separated by a more echogenic central zone. The distribution of these changes was variable. This ultrasonographic feature, called pseudolayering, was present in 14 dogs. It was believed to most likely correlate to the unevenly layered tumor distribution noted histopathologically. The maximum wall thickening ranged from 1 cm to 2.7 cm. Regional lymphadenopathy was identified ultrasonographically in 15 dogs. Ultrasound-guided fine-needle aspiration biopsy or automated microcore biopsy, endoscopic biopsy, surgical biopsy or necropsy resulted in the diagnosis of carcinoma in 15 dogs and of carcinoid tumor in one dog. The results of this study suggested that ultrasonography was a useful tool for the detection and diagnosis of canine gastric epithelial neoplasia. Furthermore, ultrasonography can assist in obtaining diagnostic samples and in clinical staging of the tumor.