In Focus - An ASVCP Case Series
Case 8
Contributed by: Christopher Shiprack, DVM, (clinical pathology resident - University of Minnesota)
Faculty mentor: Daniel Heinrich, DVM, DACVP
A 4.5-year-old, female spayed mixed-breed dog was presented to the University of Minnesota Veterinary Medical Center Small Animal Surgery Service for an exploratory laparotomy. A mid-abdominal soft-ball sized mass lesion was discovered one week prior by the referring veterinarian and blood work was normal at that time. Abdominal ultrasound was performed and identified a 9.3 x 6.8 x 7.3 cm complex mass with a central portion that contained a linear hyperechoic region and discrete acoustic shadowing suggestive of foreign material.
What are your differentials based on the attached images?
The images show primarily mixed inflammatory cells (macrophages and neutrophils), fewer mesenchymal cells, and large amounts of refractile linear foreign material. The linear foreign material is variably basophilic to slightly eosinophilic, refractile under normal bright light, and is permissive to birefringent polarized light. This material was frequently surrounded by and embedded within large aggregates of macrophages and other inflammatory cells. The cytologic interpretation was textiloma (AKA gossypiboma) with moderate macrophagic to granulomatous inflammation and reactive fibroplasia.
“Textiloma” (or gossypiboma) refers to the granulomatous inflammatory reaction to textile or sponge material left within a patient following surgery and is considered a rare, but preventable, surgical complication. Cytologic descriptions of these lesions are infrequent but do exist within the veterinary literature [1-3]. Additionally, although rare, secondary neoplasms, particularly osteosarcoma associated with previous cranial cruciate ligament tear correction surgery, have been reported to develop at the site of a textiloma in dogs [4-6].
The patient was taken to surgery and the mass was removed. A
OK. We gave you new website headers and all. But we wanted to make it extra special. Did you see this incredible surgical granuloma with a polarized suture fragment? Just wild.
#animatedgif #cytology #polarizedlight #asvcp
ASVCP Media and Communications Committee
Just keep swimming...
Swimming into the holiday...
The ASVCP is happy to provide the prettiest (microscopic) thing you will see all day.
The effect of immersion oil on the aspirate from a 1.0 cm mass on the limb of a 10-month-old German Shepherd, consistent with calcinosis circumscripta. Just gorgeous.
A 2.5-year-old, male Mastiff was presented to the University of Florida's Small Animal Hospital for evaluation of a two-week history of hematuria and dribbling urine. The dog had been treated with antibiotics for a presumptive urinary tract infection, with no improvement. Multiple radiopaque uroliths were identified on abdominal radiographs. Urinalysis revealed an alkaline urine (pH 8.5) with a specific gravity of 1.037 and significant proteinuria. On a wet-mount slide review, red blood cells and sperm were too numerous to count, leukocytes were frequently observed, and abundant large, flat, colorless, hexagonal cystine crystals were identified. The dog was taken to surgery for a cystotomy, removal of uroliths, and castration.
Many dog breeds are predisposed to forming cystine uroliths, including Dachshund, Mastiff, Chihuahua, Welsh Corgi, Bullmastiff, Scottish Deerhound, Basset Hound, Irish Terrier, English Bulldog, and Newfoundland. Cystine uroliths are extremely rare in cats. Male dogs are predominantly affected, and most cystine uroliths are found in the lower urinary tract. Newfoundlands are an exception, as cystine uroliths form in younger males and females alike, and can also be found in the kidneys. Cystinuria is always abnormal and associated with a defect in tubular reabsorption of cystine, inherited as an autosomal recessive trait in Newfoundlands, a breed in which the magnitude of the tubular defect is also more severe. Testing for this mutation is available, which allows for better breeding management. The formation of cystine stones in some canine breeds may be androgen‐dependent (type III cystinuria), and the underlying cause of this proposed androgen dependency is currently unknown. Cystine uroliths can be removed surgically or mechanically, but recurrence is common. Prevention of cystine urolithiasis may be possible with diet in some patients.