Intrathoracic myxosarcoma in a dog

A 3-year-old Labrador retriever dog was presented with pyrexia, dyspnoea and tachycardia. A pleural effusion was detected radiographically and ultrasonography showed pleural fluid with floating material. The fluid was drained, revealing a soft tissue mass adjacent to the left ventricle. The aspirated fluid had a proteinaceous and gelatinous appearance. Cytological examination revealed atypical mesenchymal cells in a dense eosinophilic background, interpreted as consistent with the presence of a matrix-secreting tumour, probably a myxosarcoma. Thoracoscopy confirmed the presence of the mass adjacent to the left ventricle, but showed additional smaller pleural masses. Microscopical and immunohistochemical evaluation of a biopsy sample from the mass supported the diagnosis of a myxosarcoma, which was further confirmed by transmission electron microscopy.     

Cutaneous lymphosarcoma with abnormal chromosomes in a dog

A poorly differentiated cutaneous lymphosarcoma with delayed multicentric anatomical distribution was diagnosed in a dog. The neoplasm had cells with chromosome numbers of 58 or 67 and the former cells lacked the subtelocentric marker chromosome seen in cells of canine transmissible venereal tumour with 58 chromosomes.     

Cutaneous metastases

Cutaneous metastases are not particularly common compared to metastases to other system organs, but they are an important entity to diagnose correctly given their prognostic implications. Clinically cutaneous metastases can mimic more common dermatologic disorders (e.g. cysts, adnexal tumors, lipomas, cellulitis, vascular tumors, etc.) that may result in diagnosis delay if not considered. An understanding of the clinical spectrum as well as advances in histopathologic assessment of skin metastases is vital to establish the correct diagnosis. Herein we review the clinical, histopathologic, and prognostic salient findings of three different types of cutaneous metastases: carcinomas, melanomas, and sarcomas. We also highlight important immunohistochemical studies and molecular platforms that assist in determining the primary site of origin and/or the line of differentiation.     

Cutaneous sarcoidal reaction in a patient with pulmonary tuberculosis

Sarcoidosis is a systemic disorder characterized by non-caseating epithelioid granulomas that may affect any organ system. The etiology of sarcoidosis is unknown, but several immune aberrations are thought to play a role in its pathogenesis. The possible role of mycobacterial infection in the pathogenesis of sarcoidosis has been suggested. In recent studies mycobacterial DNA was detected in lung tissues and bronchial lavage fluid of 30% to 50% of patients with sarcoidosis. We report a patient with pulmonary tuberculosis treated successfully three years earlier who developed cutaneous sarcoidosis with negative polymerase chain reaction (PCR) assay for mycobacterial DNA of the skin lesion.     

Cutaneous lesions due to babesiosis in a dog

A 5-year-old dog was identified suffering with recurrent skin lesions, fever, and progressive weight loss. Peripheral blood smear revealed presence of Babesia organisms. Dog had anemia, leucopenia, thrombocytopenia and it was treated with diminazene aceturate along with supportive therapy.     

Cutaneous mast cell tumours with pulmonary metastasis in a hen.

Multiple, firm, white, 0.5- to 2-cm dermal nodules and three discrete 0.5- to 1-cm pulmonary masses were discovered in a hen carcass at slaughter. Microscopic examination of both dermal and pulmonary tumours revealed solid sheets of individual cells with central round nuclei and granular to vacuolated cytoplasm. Both toluidine blue and Giemsa stains revealed numerous cells with metachromatic cytoplasmic granules. Dermal tumours contained both collagen degeneration and infiltrates of eosinophils. Ultrastructural examination of tumour cells confirmed the presence of typical avian mast cell granules.     

Left atrial myxosarcoma with systemic metastasis: a case report

The term myxosarcoma is currently not used in standard classification for soft tissue tumors, but restricted to cardiac tumors. Primary cardiac myxosarcoma is a very rare disease and is difficult to differentiate from myxoma clinically and pathologically. We report a case of left atrial myxosarcoma with widespread systemic metastasis in a 21-yr-old male. The patient presented with sudden onset of intermittent dyspnea and orthopnea. Echocardiography showed a mobile, pedunculated tumor, 7.5x5x2 cm in size, at left atrium. Histologically, the excised tumor showed an amorphous finely fibrillar and mucinous stroma, in which irregular cords and clusters of lepidic cells and large stellate cells with plump vesicular nuclei resembled the usual type of cardiac myxoma were noted. And it showed focally cellular area with great nuclear pleomorphism and frequent mitoses. The patient received combination chemotherapy, peripheral blood stem cell collection transplantation and operations for systemic metastases in the brain, skeletal muscle and lung. He is alive at present 37 months after initial diagnosis and has no more new metastatic lesion.     

Leiomyosarcoma of the pericardium, with epicardial metastases and peripheral eosinophilia in a dog

A dog with a history of dyspnoea, anorexia and ascites showed on examination signs of right-sided heart failure, pleural effusion and peripheral eosinophilia. Diagnostic imaging suggested the presence of a mediastinal mass, and histopathological and immunohistochemical examination of a biopsy sample led to a diagnosis of leiomyosarcoma. On post-mortem examination, an extensive mass was found, which encircled the heart and obliterated the pericardial sac, with probable metastatic spread to the epicardium. Eosinophilic infiltration of the neoplastic mass, lamina propria of the stomach and duodenum, interstitium of the kidney, and submucosa of the bladder was consistent with a possible paraneoplastic eosinophilia.     

Clear-cell odontogenic carcinoma with pulmonary metastases resembling pulmonary meningothelial-like nodules

Clear-cell odontogenic carcinoma (CCOC) is a rare neoplasm with malignant potential and unknown cytogenetic alterations. We describe the case of a 43-year-old woman who presented with an unusual odontogenic epithelial tumor. Histologically, the tumor was composed of clear-cell areas and exhibited a squamous pattern with little nuclear pleomorphism similar to benign squamous odontogenic tumor. Multiple small pulmonary nodules occurring 3 years after primary surgical treatment histologically closely resembled benign minute pulmonary meningothelial-like nodules (MPMN) with clear-cell features. Comparative genomic hybridization (CGH) and immunohistochemistry, performed as diagnostic adjuncts, revealed in the odontogenic tumor and the pulmonary lesions a very similar pattern of chromosomal aberrations (loss of 9, gains of 14q, 19 and 20 in both, and additional loss of 6 in the odontogenic tumor) and the same pattern of expression (positive for cytokeratin 5, 6, 8, 19 and negative for cytokeratin 18, epithelial membrane antigen, and vimentin), differing from that of MPMN. These findings confirmed the final diagnosis of metastasizing CCOC with partial squamous differentiation, substantiated the unfavorable prognosis of the clear-cell component, and highlighted the diagnostic impact of CGH and immunohistochemistry for classification of these morphologically peculiar pulmonary CCOC metastases.     

Carcinoid tumorlets simulate pulmonary metastases in women with breast cancer

A pulmonary carcinoid tumorlet (PCT) is a nodular proliferation of neuroendocrine cells smaller than 0.5 cm. On computed tomographic (CT) imaging, these nodules are nonspecific in appearance and can mimic metastatic disease. Cases of multiple PCTs diagnosed between 1992 and 2003 in patients with history of breast cancer were identified through a search of the pathology files. The clinical information was abstracted from the medical records. We identified 12 women with a history of breast cancer and biopsy-proven PCTs, who were treated at our institution in a period of 12 years. Only 3 women were smokers. The mean age at diagnosis of the breast cancer was 62.8 years. The breast cancer was invasive carcinoma in 10 cases (9 ductal and 1 lobular) and ductal carcinoma in situ and malignant phyllodes tumor in 1 case each. Six women received radiotherapy; 5, chemotherapy; and 4, hormonal treatment, alone or in combination. Pulmonary carcinoid tumorlets were identified within 5 months from diagnosis of the breast malignancy in 7 patients and at follow-up (range, 57-162 months) in the remaining 5. In all cases, the PCTs consisted of multiple pulmonary nodules that were radiologically interpreted as suspicious for pulmonary metastases. Misdiagnosis of metastatic carcinoma was rendered intraoperatively by frozen section analysis in 3 cases. None of the patients had known metastatic disease at the time of diagnosis of PCTs. Three patients subsequently developed recurrent disease, including 2 with extramammary spread. Pulmonary carcinoid tumorlets are radiologic and histologic mimickers of pulmonary metastases in patients with a history of breast cancer. Consideration should be given to the possibility of PCTs in patients with breast cancer with pulmonary nodules, even if multiple.     

Cutaneous metastases from gastric carcinoma: an unusual presentation

We report the case of a 71-year-old gentleman who intially developed cutaneous metastases from gastric carcinoma on his chin and cheek resembling sebaceous cysts.     

Miliary pulmonary metastases from a clinically occult pleural mesothelioma

Mesothelioma is a rare neoplasm of the serosal membranes. Signs and symptoms of a pleural effusion typically herald discovery of the tumor. We report a case of miliary metastatic mesothelioma involving both lungs in a 54-year-old man who presented with right-sided chest discomfort, numerous pulmonary nodules detected by computed tomography of the chest, and absent pleural effusion. Immunohistochemical and electron microscopy studies performed on wedge biopsies of parenchymal pulmonary nodules led to the diagnosis of metastatic mesothelioma. Subsequent pleural evaluation and biopsy of pleural thickening noted at a site of prior chest wall trauma identified the primary neoplasm and confirmed the diagnosis as malignant epithelioid mesothelioma. The histologic appearance of discohesive epithelioid cells in a distinctly myxoid background was the clue in this case leading to the consideration of metastatic mesothelioma and a thorough immunohistochemical evaluation of the tumor. This case shows that mesothelioma may metastasize throughout the lungs in a miliary pattern and the metastases may be clinically detected before the primary pleural tumor. Metastatic mesothelioma is a consideration for metastatic pulmonary tumors of unknown origin.     

Well-differentiated extraosseous chondrosarcoma of the foot with pulmonary metastases

We report a case of a 38-year-old man with a well-differentiated extraosseous chondrosarcoma of the foot. This case is unusual because the tumor originated in the soft tissues of the foot and developed pulmonary metastases. It is also interesting to note that at the time of recurrence 8 years later, the lesion invaded the third metatarsophalangeal joint and adjacent bones. Well-differentiated chondrosarcoma resembling hyaline cartilage, primary in soft tissue, is a rare histological type, and only a few cases have been reported in the foot. The patient is alive and well 4.5 years after resection of the foot tumor and partial resection of the lung metastases.     

Cutaneous stimuli and their relation to spinal reflexes in the dog

Summary Observations were made on 8 adult dogs in which the spinal cord was divided between the VI and VII thoracic vertebrae. Massage, scratching, and electrical stimulation were used to prevent dystrophy in the caudal portion of the cord. Two dogs were not stimulated, in two treatment was started after 2 months, while in the remainder the special stimulation treatment was started 2 weeks after the operation.The activity and stability of various spinal cord reflexes and the ability to form atypical reactions served as the indices of the functional condition of the distal portion. The results of the experiments showed that the stimulation, especially when begun soon after the operation, was effective in arousing various spinal cord reflexes, even to the extent of elaborating new ones.When no special stimulation was given, after only a few months, there was an almost complete loss of reflexes with inevitable deterioration of the condition of the muscles and joints and of locomotion.Presented by Active Member of the AMN SSSR V. V. Parin     

肺转移瘤的外科治疗进展

肺转移瘤切除是胸外科的常规手术,作为晚期癌症患个体化治疗一部分正逐渐递增.据报道,转移瘤切除术后的5年生存率为30%~50%.由于缺乏随机对照试验(randomisedcontrolledtrial,RCT),转移瘤切除的疗效只能基于回顾性研究进行评价.本文就目前关于肺转移瘤切除的外科治疗现状进行综述.