Cutaneous mast cell tumours (mcts) are the most common skin tumours in dogs. Due to the prevalence of canine mcts and the variable histiocytoma dog pictures biologic behavior of this disease, accurate prognostication and a thorough understanding of MCT biology are histiocytoma dog pictures critical for the treatment of this disease. A cytologic diagnosis of mast cell tumor with evidence of histiocytoma dog pictures prior hemorrhage was made, and the masses were surgically removed. Cytological evaluation of fine-needle aspirates from the cutaneous mass from the axillary comprised histiocytoma dog pictures many well-differentiated, highly granulated mast cells with moderate numbers of eosinophils. Nuclei were varied in size and shape with high nuclear’to’cytoplasmic ratio, prominent nucleoli, marked atypical and mitotic figures. Microscopically, mass consisted of sheets of neoplastic round cells that formed histiocytoma dog pictures nonencapsulated nodules in the dermis and infiltrated into the adjacent histiocytoma dog pictures dermal collagen, and also there was diffuse subcutis invasion of round to histiocytoma dog pictures pleomorphic tumor cells. Tumor cells had moderate to abundant cytoplasm, round to ovoid nuclei with scattered chromatin, and mitotic figures. In this tumor, cytoplasmic granules showed atypical metachromasia. In addition, eosinophils were scattered among the mast cells at the periphery histiocytoma dog pictures of the nodules. The presence of eosinophils and the observation, at high magnification, of cells with cytoplasmic metachromatic granules. Invasion of the deep subcutaneous fat or cutaneous muscles were histiocytoma dog pictures a common feature of grade III tumour. Finally, a diagnosis of grade III cutaneous mast cell tumor was histiocytoma dog pictures made.
Mast cell tumors (mcts) are highly invasive and metastatic and are the most frequent histiocytoma dog pictures round cell tumors in dogs, comprising 16–21% of all cutaneous tumors diagnosed [ 1, 2], and are the most common skin tumors in dogs [ 3], representing about 7% to 21% of all dog skin tumors and 11% to 27% of malignant skin tumors in this species [ 4]. Canine mcts have variable biologic behaviors, ranging from solitary benign masses that can be cured with histiocytoma dog pictures surgery alone to systemic and potentially fatal metastatic disease [ 5], and are always considered potentially malignant, but their true metastatic potential is not entirely known [ 6].
Round cell tumors consist of discrete cells that are round histiocytoma dog pictures to oval rather than fusiform. Included in this group are mast cell tumor, histiocytoma, lymphosarcoma (including reticulum cell sarcoma) and transmissible venereal tumor. The differential diagnosis of round cell tumors by histologic examination histiocytoma dog pictures without concomitant cytologic characterization may, in some instances, depend more on age of animal, growth rate, location of tumor, number of tumors and lymph node involvement rather than histologic histiocytoma dog pictures criteria. Mastocytosis is a rare group of diseases characterized by abnormal histiocytoma dog pictures proliferation and infiltration of mast cells within the tissues. The skin is most frequently involved but mast cells also histiocytoma dog pictures accumulate in the bone marrow, gastrointestinal tract, lymph nodes, spleen, and liver. Mast cell tumors in association with oncocytes thus should be histiocytoma dog pictures considered supportive evidence of an FNA diagnosis of adenolymphoma. Mastocytosis should be considered in the differential diagnosis of urticaria histiocytoma dog pictures and solitary mastocytomas may remain active into adolescence, raising concern for systemic progression [ 7– 13].
MCTs are most often graded histologically by the scheme described histiocytoma dog pictures by patnaik et al. [ 14]. Tumours of grade I are circumscribed, mainly dermal in location, and consist of well-differentiated mast cells with prominent metachromatic cytoplasmic granules. Poor cellular differentiation, aggressive growth pattern, moderate to high mitotic activity, mitotic atypia and sparse to absent cytoplasmic granulation are the histiocytoma dog pictures major features of grade III tumours. Grade II mcts constitute an intermediary form between the two histiocytoma dog pictures other grades, but they tend to infiltrate more deeply than grade I histiocytoma dog pictures neoplasms [ 14, 15]. MCTs are routinely diagnosed by cytology and histopathology. Case presentation
Cytohistophatology of dermal mass from the axillary of the dog. Representative photomicrographs of mass cell tumuor of patnaik grade. (A and B) grade III. High-grade mast cell tumour was characterized by highly pleomorphic tumour histiocytoma dog pictures cells with a high mitotic index, anisokaryosis and infiltration of the surrounding dermis and subcutis. Haematoxylin and eosin stain. Bar, 50 μm. The smears show n were prepared at the initial presentation histiocytoma dog pictures and stained with wrigth-giemsa solution. Histopathologically, the presence of eosinophils and the observation, at high magnification, of cells with cytoplasmic metachromatic granules and also, neoplastic cells often exhibited an aggressive behavior, high cellularity, cellular pleomorphism, and various morphologic patterns. Eosinophils are present at the periphery of the mass (figure 1 C and D, HE, 400x).
One formalin-fixed, paraffin wax-embedded section of each neoplasm was stained with haematoxylin and histiocytoma dog pictures eosin (HE). Tumour was classified independently by two pathologists in order to histiocytoma dog pictures confirm the diagnosis according to the WHO criteria [ 16]. Also tumour was graded according to the criteria proposed by histiocytoma dog pictures patnaik et al. [ 14] and kiupel et al. [ 17], as well, moderately or poorly differentiated (grades I, II or III, respectively) [ 14, 17]. These criteria included the following histomorphological features: extent of tumour (invasiveness), cellular morphology, size of cytoplasmic granules, mitotic activity and stromal reaction. Invasiveness was assessed as follows: non-invasive (tumours confined to the superficial dermis and interfollicular spaces); moderately invasive (tumours with lower dermal and limited subcutaneous tissue invasion); highly invasive (tumours with massive infiltration of subcutaneous and deep tissue). Mitotic activity was assessed on toluidine blue-stained sections, five high power fields (hpfs) being evaluated in each case with a × 40 objective. The data were expressed as mean number of mitoses per histiocytoma dog pictures hpf (mitotic index) and tumours were classified according to the following grading system: 0 (mitotic figures absent); 1 (mitotic index ranging from 0 to 2 mitoses/hpf); 2 (mitotic index 2/hpf). Invasiveness and mitotic activity assessment were used to define the histiocytoma dog pictures histological grade, and also as individually evaluated parameters. Hematological findings
However, in some regions of the tumor tissue shows neoplastic cells histiocytoma dog pictures extending into the subcutis. Neoplastic cells had distinct cell borders and widely variable amounts histiocytoma dog pictures of pale to brightly eosinophilic cytoplasm. Furthermore, tumour had neoplastic cells containing numerous fine eosinophilic to basophilic histiocytoma dog pictures cytoplasmic granules consistent with mast cell granules and also highly histiocytoma dog pictures pleomorphic tumour cells with a high mitotic index, anisokaryosis and infiltration of the surrounding dermis and subcutis were histiocytoma dog pictures observed (figure 2C and 2D). Pathology grading of cutaneous mast cell tumor
In this case is characterized by one or more of histiocytoma dog pictures the following criteria: at least 3 mitotic figures in 5 hpf, at least 2 multinucleated (2 or more nuclei) cells in 5 hpf, at least 2 bizarre nuclei (highly atypical with marked indentations, segmentation, and irregular shape) in 5 hpf; karyomegaly (ie, nuclear diameters of at least 10% of neoplastic mast cells vary by at least 2-fold). The selected field was it that was most highly mitotically histiocytoma dog pictures active or had the highest degree of anisokaryosis.
Canine cutaneous mcts were graded according to the patnaik and histiocytoma dog pictures the kiupel systems [ 14, 17]. Grade III MCT was poorly demarcated accumulations of poorly differentiated histiocytoma dog pictures mast cells with severe nuclear pleomorphism. Invasion of the deep subcutaneous fat or cutaneous muscles were histiocytoma dog pictures a common feature of grade III tumour. Finally, a diagnosis of grade III cutaneous mast cell tumor was histiocytoma dog pictures made. Discussion
Dogs are at risk for cutaneous MCT, which accounts for up to 21% of all skin tumours [ 3]. The diagnosis of MCT by cytology or histopathology is straight histiocytoma dog pictures forward in the majority of cases, but forming an accurate prognosis is more challenging [ 5]. Prognostic factors of significance included grading (cytology and histopathology), staging (regional and distant metastases), breed, tumour localisation and treatment (surgery, radiation and chemotherapy). Cytological examination after fine needle aspiration is useful in establishing histiocytoma dog pictures the diagnosis but histopathology is needed for grading [ 18]. Cytology often is helpful in the diagnosis of mcts because histiocytoma dog pictures of the characteristic appearance of mast cells with routine staining. As is the case with findings from other species, wright–giemsa stain resulted in more intensely stained granules in the histiocytoma dog pictures neoplastic mast cells. The mechanism of the differences in staining is unclear. Several subtypes of mast cells have been identified in humans histiocytoma dog pictures and dog based primarily on granule contents and biological function.
This study clearly showed a cellular infiltrate of mast cells, mononuclear cells and eosinophils in the thickened, hyperplastic, and hyperkeratinized epidermis. Mast cells and eosinophils, as opposed to the mononuclear cells of delayed hypersensitivity, predominated, suggesting an immediate hypersensitivity reaction. Once activated, mast cells at the edge of a wound are known histiocytoma dog pictures to release inflammatory mediators within injured tissue by degranulation [ 19]. Thus, it would seem that immediate hypersensitivity reactions may be responsible histiocytoma dog pictures for the development of skin lesions due to tumor in histiocytoma dog pictures dogs. However, the present results suggest that the intense proliferation of mast histiocytoma dog pictures cells following tumor occurs predominantly in the skin.
The results of this study suggest that cellular proliferation plays histiocytoma dog pictures a significant role in the progression of canine mcts. Although the results of this study confirm the results of histiocytoma dog pictures previous studies that have shown the prognostic significance of cellular histiocytoma dog pictures proliferation in canine mcts [ 14, 15, 18, 19] cellular proliferation should not be evaluated as a single prognostic histiocytoma dog pictures factor for canine mcts but should be evaluated in tandem histiocytoma dog pictures with additional prognostic indicators. Furthermore, the histologic characteristics of the MCT cells in this affected histiocytoma dog pictures dog was moderate to abundant cytoplasm, round nuclei with scattered chromatin, fibrous stroma, and eosinophil infiltration. Little necrosis was seen.
Several grading systems have been proposed to classify canine mast histiocytoma dog pictures cell tumors. The system most commonly used classifies the tumor from grades histiocytoma dog pictures I to III, depending on how well the mast cells are differentiated, mitotic activity, location within the skin, invasiveness, and the presence of inflammation or necrosis, with grade III being the most aggressive (characterized by the presence of undifferentiated, immature mast cells with a high potential for metastasis) [ 20, 21]. In the current case, the presence of multiple large nodules, the extension into the dermis, and the poorly differentiated mast cells could be comparable to histiocytoma dog pictures grade III described for dogs. Recently, a new 2-tier histologic classification for canine cutaneous tumors has been proposed histiocytoma dog pictures [ 22]. This grading system is based on the presence of mitotic histiocytoma dog pictures figures, multinucleated cells, bizarre nuclei, and karyomegaly to predict biological behavior, likely time to metastasis, new tumor development, and survival time. In the present case, although the neoplasia did not show any of these histological histiocytoma dog pictures parameters, the presence of multiple cutaneous tumors suggests a malignant behavior. Grade III tumours have a very poor prognosis even with histiocytoma dog pictures treatment, which might discourage owners from extensive surgery. This may explain the discrepancy in surgery performed in MCT histiocytoma dog pictures cases of different grades. This result agrees with the findings by murphy et al. [ 23] that showed dogs with poorly differentiated tumours had a significantly histiocytoma dog pictures shorter survival time. These results suggest that all multiple cutaneous mcts should be histiocytoma dog pictures treated as individual neoplasms and prognosis should be dependent on histiocytoma dog pictures individual variables such as grade and not related to the histiocytoma dog pictures number of tumours present, which was shown not to affect survival. Mitotic index and size were not found to be independent histiocytoma dog pictures predictors of survival. Conclusions
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