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Benito MB, Fuentes MP, Manso‐Diaz G, Madonado BS, Diaz CP. Clinical signs, diagnostic imaging and histopathology in a dog with granulomatous meningoencephalitis manifested as a polyneuropathy. Vet Record Case Reports 2022. [DOI: 10.1002/vrc2.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Miguel Benito Benito
- Small Animal Medicine and Surgery Department Complutense University of Madrid Madrid Spain
- Neurology and Neurosurgery Service Hamilton Specialists Referrals High Wycombe UK
| | - Miriam Portero Fuentes
- Small Animal Medicine and Surgery Department Complutense University of Madrid Madrid Spain
| | - Gabriel Manso‐Diaz
- Small Animal Medicine and Surgery Department Complutense University of Madrid Madrid Spain
| | - Belén Sánchez Madonado
- Small Animal Medicine and Surgery Department Complutense University of Madrid Madrid Spain
| | - Carmen Pérez Diaz
- Small Animal Medicine and Surgery Department Complutense University of Madrid Madrid Spain
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Bongartz U, Nessler J, Maiolini A, Stein VM, Tipold A, Bathen-Nöthen A. Vestibular disease in dogs: association between neurological examination, MRI lesion localisation and outcome. J Small Anim Pract 2019; 61:57-63. [PMID: 31515806 DOI: 10.1111/jsap.13070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/26/2019] [Accepted: 08/19/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To determine whether the neurological examination correctly distinguishes between central and peripheral vestibular lesions in dogs. MATERIALS AND METHODS Retrospective study on dogs with vestibular disease presenting to two referral clinics in Germany. RESULTS Ninety-three dogs were included; neurological examination suggested central vestibular disease in 62 and a peripheral lesion in 31. MRI diagnosis was central vestibular disease in 68 dogs and peripheral in 25. Of the 62 dogs with a lesion localisation diagnosed as central vestibular by neurological exam, 61 were correctly identified (98.4%). Twenty-four of the 31 dogs diagnosed with a peripheral lesion by neurological exam had a consistent lesion on MRI (77.4%). CLINICAL SIGNIFICANCE The neurological examination is efficient at identifying lesions in the central vestibular system but less so for peripheral lesions. Therefore it is prudent to recommend imaging in dogs that show signs of peripheral vestibular syndrome but do not rapidly respond to treatment.
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Affiliation(s)
- U Bongartz
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.,Veterinary Practice A. Bathen-Nöthen, Hatzfeldstraße 6, 51069, Köln, Germany
| | - J Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Maiolini
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - V M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - A Bathen-Nöthen
- Veterinary Practice A. Bathen-Nöthen, Hatzfeldstraße 6, 51069, Köln, Germany
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Diangelo L, Cohen-Gadol A, Heng HG, Miller MA, Hague DW, Rossmeisl JH, Bentley RT. Glioma Mimics: Magnetic Resonance Imaging Characteristics of Granulomas in Dogs. Front Vet Sci 2019; 6:286. [PMID: 31555671 PMCID: PMC6722480 DOI: 10.3389/fvets.2019.00286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/13/2019] [Indexed: 01/03/2023] Open
Abstract
Granulomas can "mimic" gliomas on magnetic resonance imaging (MRI) in human patients. The goal of this retrospective study was to report canine brain granulomas that were consistent with glioma based upon MRI, report their histologic diagnosis, and identify MRI criteria that might be useful to distinguish granuloma from glioma. Ten granulomas, initially suspected to be glioma based on MRI, were ultimately diagnosed as granulomatous meningoencephalomyelitis (n = 5), infectious granulomas (n = 3) or other meningoencephalitis (n = 2). Age was 1.6-15.0 years and two dogs were brachycephalic breeds. MRI characteristics overlapping with glioma included intra-axial, heterogeneous, T2-weighted hyperintense, T1-weighted hypointense to isointense mass lesions with contrast-enhancement. Signals on fluid attenuation inversion recovery, gradient echo and diffusion weighted imaging also matched glioma. Peri-lesional edema and mass effect were toward the high end of findings reported for glioma. MRI characteristics that would be considered unusual for glioma included dural contact (n = 4), T2-hypointensity (n = 2), concomitant meningeal-enhancement (n = 9), and minor changes in the contralateral brain (n = 2). Cerebrospinal fluid analysis revealed albuminocytological dissociation or mild pleocytosis. These cases show that granulomas can "mimic" glioma on canine brain MRI. In individual cases, certain MRI findings may help increase the index of suspicion for granuloma. Lack of pronounced cerebrospinal fluid pleocytosis does not exclude granuloma. Signalment is very useful in the suspicion of glioma, and many of these dogs with granuloma were of ages and breeds in which glioma is less commonly seen.
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Affiliation(s)
- Lauren Diangelo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Aaron Cohen-Gadol
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States.,Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Margaret A Miller
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Devon W Hague
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, United States
| | - R Timothy Bentley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
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Park ES, Uchida K, Nakayama H. Comprehensive Immunohistochemical Studies on Canine Necrotizing Meningoencephalitis (NME), Necrotizing Leukoencephalitis (NLE), and Granulomatous Meningoencephalomyelitis (GME). Vet Pathol 2012; 49:682-92. [DOI: 10.1177/0300985811429311] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In dogs, there are several idiopathic meningoencephalitides, such as necrotizing meningoencephalitis (NME), necrotizing leukoencephalitis (NLE), and granulomatous meningoencephalomyelitis (GME). Although they are often assumed to be immune mediated, the etiology of these diseases remains elusive. In this study, the histopathology of the lesions caused by these conditions and the inflammatory cell populations produced in response to them were examined among dogs affected with GME, NME, or NLE to understand their pathogeneses. The brain tissues of dogs with NME (n = 25), NLE (n = 5), or GME (n = 9) were used. The inflammatory cells were identified by immunohistochemistry using antibodies against CD3, IgG, CD20, CD79acy, and CD163. In NME and NLE, malacic changes were located in the cerebral cortex, as well as the cerebral white matter and thalamus, respectively. The distribution of the brain lesions in NME and NLE was breed specific. In GME, granulomatous lesions that were mostly composed of epithelioid macrophages were observed in the cerebral white matter, cerebellum, and brainstem. Although the proportions of IgG-, CD20-, and CD79acy-positive cells (B cells) were not significantly different among the GME, NME, and NLE lesions, that of CD3-positive cells (T cells) was increased in GME. In NME and NLE, CD163-positive cells (macrophages) had diffusely infiltrated the cerebral cortex and white matter, respectively. However, in GME, CD163-positive cells accumulated around the blood vessels in the cerebral and cerebellar white matter. The distributions of these lesions were quite different among GME, NME, and NLE, whereas there were no marked differences in the proportions of inflammatory cells.
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Affiliation(s)
- E. S. Park
- Department of Veterinary Pathology, Faculty of Agriculture, University of Tokyo, Tokyo, Japan
| | - K. Uchida
- Department of Veterinary Pathology, Faculty of Agriculture, University of Tokyo, Tokyo, Japan
| | - H. Nakayama
- Department of Veterinary Pathology, Faculty of Agriculture, University of Tokyo, Tokyo, Japan
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Granger N, Smith PM, Jeffery ND. Clinical findings and treatment of non-infectious meningoencephalomyelitis in dogs: a systematic review of 457 published cases from 1962 to 2008. Vet J 2010; 184:290-7. [PMID: 19410487 DOI: 10.1016/j.tvjl.2009.03.031] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 03/25/2009] [Accepted: 03/27/2009] [Indexed: 11/22/2022]
Abstract
Non-infectious meningoencephalomyelitis (NIME) presents clinicians with diagnostic problems because specific diagnosis requires histopathological examination of central nervous system (CNS) tissue. In the absence of a precise diagnosis, clinicians refer instead to 'meningoencephalomyelitis of unknown origin' (MUO). This article compares published data on histopathologically diagnosed disease (granulomatous meningoencephalomyelitis and necrotising encephalitis) with information available on the clinically-defined category of MUO. Small, middle-aged female dogs are most commonly affected by all types of NIME, but there is considerable overlap in diagnostic parameters of these diseases. Future clinical trials must aim to compare prospectively two or more randomly allocated treatments and to include pre-trial power calculations. This article provides the necessary background information to permit rational patient selection on clinical presentation alone, rather than requiring CNS biopsy, thus maximising patient recruitment whilst minimising heterogeneity.
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Affiliation(s)
- Nicolas Granger
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
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Talarico LR, Schatzberg SJ. Idiopathic granulomatous and necrotising inflammatory disorders of the canine central nervous system: a review and future perspectives. J Small Anim Pract 2010; 51:138-49. [DOI: 10.1111/j.1748-5827.2009.00823.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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KITAGAWA M, OKADA M, WATARI T, SATO T, KANAYAMA K, SAKAI T. Ocular Granulomatous Meningoencephalomyelitis in a Dog: Magnetic Resonance Images and Clinical Findings. J Vet Med Sci 2009; 71:233-7. [DOI: 10.1292/jvms.71.233] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Masato KITAGAWA
- Laboratory Comprehensive Veterinary Clinical Studies, Nihon University School of Veterinary Medicine
| | - Midori OKADA
- Nihon University Research Center
- Pet Clinic ANIHOS
| | - Toshihiro WATARI
- Laboratory Comprehensive Veterinary Clinical Studies, Nihon University School of Veterinary Medicine
| | - Tsuneo SATO
- Department of Veterinary Pathology, Nihon University School of Veterinary Medicine
| | - Kiichi KANAYAMA
- Department of Veterinary Physiology, Nihon University School of Veterinary Medicine
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Kneissl S, Konar M, Fuchs-Baumgartinger A, Nell B. Magnetic resonance imaging features of orbital inflammation with intracranial extension in four dogs. Vet Radiol Ultrasound 2007; 48:403-8. [PMID: 17899971 DOI: 10.1111/j.1740-8261.2007.00267.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This retrospective study describes the clinical and magnetic resonance (MR) imaging features of chronic orbital inflammation with intracranial extension in four dogs (two Dachshunds, one Labrador, one Swiss Mountain). Intracranial extension was observed through the optic canal (n=1), the orbital fissure (n=4), and the alar canal (n=1). On T1-weighted images structures within the affected skull foramina could not be clearly differentiated, but were all collectively isointense to hypointense compared with the contralateral, unaffected side, or compared with gray matter. On T2-, short tau inversion recovery (STIR)-, or fluid-attenuated inversion recovery (FLAIR)-weighted images structures within the affected skull foramina appeared hyperintense compared with gray matter, and extended with increased signal into the rostral cranial fossa (n=1) and middle cranial fossa (n=4). Contrast enhancement at the level of the affected skul foramina as well as at the skull base in continuity with the orbital fissure was observed in all patients. Brain edema or definite meningeal enhancement could not be observed, but a close anatomic relationship of the abnormal tissue to the cavernous sinus was seen in two patients. Diagnosis was confirmed in three dogs (one cytology, two biopsy, one necropsy) and was presumptive in one based on clinical improvement after treatment. This study is limited by its small sample size, but provides evidence for a potential risk of intracranial extension of chronic orbital inflammation. This condition can be identified best by abnormal signal increase at the orbital fissure on transverse T2-weighted images, on dorsal STIR images, or on postcontrast transverse or dorsal images.
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Affiliation(s)
- Sibylle Kneissl
- Department for Diagnostic Imaging, Infectious Diseases and Clinical Pathology, University of Veterinary Medicine, Veterinärplatz 1, A-1210 Vienna, Austria.
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