Cutaneous Angiomatosis in a Young Dog

Infantile hemangioma in a subadult Chinese pangolin: a case report

BACKGROUND

Hemangiomas are a relatively common type of tumor in humans and animals. Various subtypes of hemangiomas have been described in the literature. The classification methods for hemangiomas differ between human and veterinary medicine, and the basis for tumor classification can be found in the literature.

CASE PRESENTATION

This study describes a tumor in the subcutaneous tissue of the right dorsum of an artificially rescued juvenile Chinese pangolin. Computed tomography (CT) examination yielded the preliminary diagnosis of a vascular malformation, and surgery was performed to resect the tumor. Histopathological examination showed that the tumor mainly was consisted of adipose tissue, capillaries, and spindle cells in the fibrous stroma. Immunohistochemistry showed the positive expression of CD31, CD34, α-SMA, GLUT1 and WT-1 in the tumor tissue, and the tumor was eventually diagnosed as an infantile haemangioma.

CONCLUSION

The final diagnosis of infantile hemangioma was depended on the histopathological immunohistochemical and CT examination of the neoplastic tissue. This is the first report of infantile hemangioma in a critically endangered species Chinese pangolin.

2-Methoxyestradiol and Hydrogen Peroxide as Promising Biomarkers in Parkinson's Disease

Estrogens function in numerous physiological processes including controlling brain cell growth and differentiation. 2-Methoxestradiol (2-ME2), a 17β-estradiol (E2) metabolite, is known for its anticancer effects as observed both in vivo and in vitro. 2-ME2 affects all actively dividing cells, including neurons. The study aimed to determine whether 2-ME2 is a potentially cancer-protective or rather neurodegenerative agent in a specific tissue culture model as well as a clinical setup. In this study, 2-ME2 activity was determined in a Parkinson's disease (PD) in vitro model based on the neuroblastoma SH-SY5Y cell line. The obtained results suggest that 2-ME2 generates nitro-oxidative stress and controls heat shock proteins (HSP), resulting in DNA strand breakage and apoptosis. On the one hand, it may affect intensely dividing cells preventing cancer development; however, on the other hand, this kind of activity within the central nervous system may promote neurodegenerative diseases like PD. Thus, the translational value of 2-ME2's neurotoxic activity in a PD in vitro model was also investigated. LC-MS/MS technique was used to evaluate estrogens and their derivatives, namely, hydroxy and methoxyestrogens, in PD patients' blood, whereas the stopped-flow method was used to assess hydrogen peroxide (H2O2) levels. Methoxyestrogens and H2O2 levels were increased in patients' blood as compared to control subjects, but hydoxyestrogens were simultaneously decreased. From the above, we suggest that the determination of plasma levels of methoxyestrogens and H2O2 may be a novel PD biomarker. The presented research is the subject of the pending patent application "The use of hydrogen peroxide and 17β-estradiol and its metabolites as biomarkers in the diagnosis of neurodegenerative diseases," no. P.441360.

Vertebral Angiomatosis in a Dog

A 3 yr old spayed female Cavalier King Charles spaniel was referred for insidious ataxia and paraparesis. A thoracolumbar lesion was suspected. Computed tomography showed focal osteolysis of the vertebral body and pedicles of T5. In addition, a hyperdense, extradural material within the vertebral canal, causing spinal cord compression on the right side, was present. The lesion was confirmed with magnetic resonance imaging. A T4-T5 hemi-dorsal laminectomy was performed to decompress the spinal cord. Histopathological examination was consistent with vertebral angiomatosis. After the surgery, the dog rapidly improved; however, 5 mo later the clinical signs relapsed. Vertebral angiomatosis is a vasoproliferative disorder, rarely reported as a cause of myelopathy in cats. This condition has not previously been reported in dogs. This case report describes the clinical features, the diagnostic findings, and the follow-up of a young dog with vertebral angiomatosis.

Progressive angiomatosis, resembling human skeletal-extraskeletal angiomatosis, arising in multiple digits in two dogs

Two dogs presented with progressive, expansile and invasive lesions on a hind paw. Case 1, a 10-year-old female Shetland sheepdog had diffusive and aggressive-looking lesions on the middle digits of the left hind paw. Radiographic examination showed invasion into and destruction of the underlying bone. A malignant tumour was suspected initially; however, histological features of atypical vascular proliferations without mitotic activity were consistent with progressive angiomatosis. Case 2, an 11-year-old female English springer spaniel presented with similar lesions in the same toes, also involving bone. Progressive angiomatosis was suspected clinically, as tumour cells were not detected by cytology and screening did not detect metastatic disease. Histopathology confirmed the diagnosis. Progressive angiomatosis is an uncommon non-malignant condition which should be considered as a differential diagnosis for radiographically lytic digital lesions.

Identification of Histopathological Criteria for the Diagnosis of Canine Cutaneous Progressive Angiomatosis

Simple Summary

In animals, cutaneous progressive angiomatosis (CPA) is a disorder with variable prognosis related to the extension and depth of infiltration of the surrounding tissues by vessels. CPA may share some microscopical features with other vascular proliferations such as low-grade well-differentiated capillaritic hemangiosarcoma (HS), making the diagnosis not always straightforward. The aim of this study is to assess the most common diagnostic microscopical features of CPA in dogs. Eleven histopathological criteria were analyzed on 31 CPA and 11 primary cutaneous HS in dogs. Features significantly associated with CPA included: lobular growth, interposition of connective tissue and adnexa between the vascular proliferation, presence of nerve fibers, and a mixed vascular proliferative component. Absence of plump/prominent endothelial cells, lack of atypia, and lack of mitoses were also significant factors for differentiating CPA from HS. In conclusion, the presence and/or absence of multiple microscopical clues allowed for the distinction of CPA from HS.

Abstract

The term angiomatosis is used to denote a group of well-known to poorly characterized proliferative vascular entities. In animals, cutaneous progressive angiomatosis (CPA) is a disorder with variable prognosis related to the extension and depth of infiltration of the surrounding tissues by vessels. CPA may share some microscopical features with other vascular proliferations such as low-grade well-differentiated capillaritic hemangiosarcoma (HS), making the diagnosis not always straightforward, especially in small biopsies. The aim of this study is to retrospectively assess the most common diagnostic microscopical features of CPA in dogs. In this work, 11 histopathological criteria were analyzed on 31 CPA and 11 primary cutaneous HS in dogs. Features significantly associated with CPA included: lobular growth, interposition of connective tissue and adnexa between the vascular proliferation, presence of nerve fibers, and a mixed vascular proliferative component. Absence of plump/prominent endothelial cells, lack of atypia, and lack of mitoses were also significant factors differentiating CPA from HS. Additional distinctive findings in CPA, although with no statistical association to CPA diagnosis, were vascular shunting, absence of necrosis, and endothelial cell piling up. In conclusion, the combined use of different microscopical clues allowed for the distinction of CPA from HS and was considered useful for the diagnosis of CPA.

Progressive cutaneous angiomatosis in the metatarsal region of a cat

CASE DESCRIPTION

A 1.5-year-old 4.0-kg (8.8-lb) castrated male mixed-breed cat was evaluated because of an 8-month history of repeated bleeding from a hole in the skin next to the left metatarsal pad.

CLINICAL FINDINGS

The cat had swelling in the distal region of the left pelvic limb, and blood dripped from a 2-mm-diameter hole in the skin adjacent and proximal to the metatarsal pad. Radiographic findings for the distal aspect of the left pelvic limb were compatible with a soft tissue inflammatory process. Results of histologic examination of a wedge biopsy sample, including the affected skin and subcutaneous tissue, indicated cutaneous angiomatosis. Angiography revealed anomalous vessels in the metatarsal region.

TREATMENT AND OUTCOME

Surgical resection of the skin, subcutaneous tissue, and anomalous vessels in the affected metatarsal region of the left pelvic limb was performed. However, similar abnormal clinical signs recurred and did not respond to treatment, including prednisolone (2.0 mg/kg [0.9 mg/lb], PO, q 12 h for 4 days) and doxycycline (10 mg/kg [4.5 mg/lb], PO, q 24 h). The left pelvic limb was amputated, and no recurrence of similar abnormalities in the cat's other limbs was evident within a 15-month follow-up period.

CLINICAL RELEVANCE

Findings in the cat of the present report highlighted that cutaneous angiomatosis could recur in a short period of time and that amputation of the affected limb was a viable treatment option when surgical resection was not successful.

Feline vertebral angiomatosis: two cases

CASE SERIES SUMMARY

Two cats aged between 1 and 2 years were presented for paraparesis, general discomfort, back pain and urinary retention. Extradural spinal cord compression at the level of T4 and T8 was evident on CT examination and on MRI. Hemilaminectomy and partial corpectomy were performed to achieve spinal cord decompression. Histopathology of the abnormal bone tissue was suggestive of vertebral angiomatosis. After initially worsening, both cats recovered their normal gait and functional urination. Both cats have been followed-up for >1 year, without any recurrence.

RELEVANCE AND NOVEL INFORMATION

This is the first report of vertebral angiomatosis with complete data (CT, MRI, surgical procedures, histopathology and >1 year follow-up) and provides important information about the prognosis of this rare vascular malformation.

Multi-system progressive angiomatosis in a dog resembling blue rubber bleb nevus syndrome in humans

A six-year-old, neutered, female golden retriever was presented with generalised, dark purple to black cutaneous nodules and gastrointestinal haemorrhage. Histopathologically, all cutaneous nodules were diagnosed as benign cavernous haemangiomas. Endoscopic analysis revealed similar nodules in the oesophagus, stomach and duodenum. At laparotomy, similar nodules were seen on the visceral peritoneal lining of abdominal organs. Metastatic haemangiosarcoma was ruled out based on histological features and lack of primary tumour in spleen, liver or heart ultrasonographically. Blood loss associated with gastrointestinal haemorrhage was managed with blood transfusion. To the authors' knowledge, this is the first canine case of multi-system progressive angiomatosis resembling blue rubber bleb nevus syndrome in humans.

Gastric Smooth Muscle Hamartomas Mimicking Polyps in a Dog: A Case Description and a Review of the Literature

This report presents a case of two smooth muscle hamartomas of the stomach in a 10-year-old male Boxer. The clinical history of the animal was of chronic vomiting, weight loss, and intermittent gastric distension, and it died because of chronic and congestive heart failure. Gross, histology, and immunohistochemistry (IHC) exams were performed. On necropsy, in the pyloric region of the stomach, two closely related polypoid growths between 10 and 15 mm in diameter were identified. On the cut sections, both polyps presented white to gray color, with homogenous architecture and well-defined limits. The thickness of the submucosal layer was seen to be increased to 1 cm. No other gastric alterations were identified by the necropsy exam. Histologically, both masses growth consisted of hyperplastic glands lined by foveolar epithelium, arranged in a papillary or branching pattern, and supported by a core of well-vascularised and marked smooth muscle tissue interspersed between glands. No dysplastic cells and mitotic figures were observed in these lesions. Immunohistochemistry revealed a strong cytoplasm labelling for smooth muscle actin of the bundles around the mucosal glands. To our knowledge, this is the first report of smooth muscle hamartomas mimicking multiple gastric polyps in dogs.

Caudal vascular hamartoma accompanied by aberrant arteriovenous structures in a dog

A 9-year-old, female German Shepherd Dog presented with a firm bulging lesion at the tip of the tail. Histologically, the lesion was characterized by numerous poorly circumscribed clusters of vascular structures resembling capillaries that were separated by normal or mucinous connective tissues. The capillary-like vascular structures were composed of several layers: a single von Willebrand factor-positive endothelial cell layer with round, oval, or flattened hyperchromatic nuclei; and 1 or 2 surrounding spindle-shaped smooth muscle actin-positive pericyte layers. In the deep portion of the lesion, there were large vessels that showed morphological aberrations. These thin-to-thick-walled blood vessels corresponded to arteries and veins of varying diameters and were surrounded by fibrosis. The present case report describes a rare cutaneous vascular hamartoma, accompanied by aberrant arteriovenous structures.

Angiofibroma of the nasal cavity in 13 dogs

This case series describes a rare entity, nasal angiofibroma, in 13 dogs that were presented to the University of Wisconsin, School of Veterinary Medicine from 1988 to 2000. All dogs in this case series presented with clinical signs and radiographic changes that were strongly suggestive of a locally invasive neoplasm. However, histopathology completed on transnostral core biopsy samples revealed benign appearing vascular proliferation with secondary lymphosuppurative inflammation was established despite cytologic criteria of malignancy present in five dogs. On the basis of the outcomes in this case series, nasal angiofibroma should be considered a differential for dogs presenting with clinical signs consistent with a malignant nasal tumour.

Skeletal-extraskeletal angiomatosis in a dog

An 8-year-old castrated male mixed-breed dog had an ill-defined hemorrhagic and painful lesion in the base of the claw of the second digit of the right forelimb. Radiographically, the expansile and lytic lesion affected the distal phalanx. The digit was amputated and submitted for histologic examination. Histologically, the distal phalanx was largely replaced by a mass composed of variably sized cavernous vascular spaces lined by a single layer of flattened endothelial cells. A similar mass was in the subcutis adjacent to the distal phalanx. The benign vascular proliferation involving the medulla of bone and a second tissue type in this dog is consistent with skeletal-extraskeletal angiomatosis as described in humans. To the authors' knowledge, this is the first report of skeletal-extraskeletal angiomatosis in the veterinary literature.

Cutaneous progressive angiomatosis on the muzzle of a dog, treated by laser photocoagulation therapy

A 10-year old, female, cocker spaniel was presented with a bleeding lesion on the muzzle and nasal planum observed initially as a small raised nodule at 1 year of age. This became clinically more pronounced at 5 years of age, progressively enlarged thereafter and was diagnosed initially as a vascular tumour. On clinical examination, multiple confluent nodules of variable diameter (0.5-1.5 cm) deformed the outline of the nose. Histological examination revealed a progressive angiomatosis with multifocal infiltrative growth of increased dermal vascularization with different sized and type of anastomosing vessels lined by a monolayer of reactive endothelium, often arranged as papillary projections into the lumina. Partial nosectomy, the first therapeutic approach, was unsuccessful and the lesion relapsed within 6 months. However, subsequent laser photocoagulation therapy provided a good cosmetic outcome, no relapse 1 year later, and appeared to provide an effective alternative to ablation surgery.

Cutaneous angiomatosis in a llama (Lama glama)

Cutaneous angiomatosis was diagnosed in an adult female llama (Lama glama). Lesions were raised or plaque-like, erythematous, firm to soft in consistency and were observed on the face and skin of the axillary, abdominal, perineal and inguinal regions. The lesions were not painful or pruritic. Microscopical examination revealed an irregular parakeratotic lamellar hyperkeratosis associated with diffuse proliferation of arterioles and venules in the superficial dermis. Immunohistochemical analysis determined that the cells forming these vessels and perivascular cells expressed factor VIII-related antigen, vascular endothelial growth factor (VEGF), CD31 and smooth-muscle alpha-actin. These studies confirmed the diagnosis of cutaneous angiomatosis.

Pleomorphic leiomyosarcoma in the hind leg of a Taiwanese macaque (Macaca cyclopis)

An adult, captive Taiwanese monkey (Macaca cyclopis) presented clinically with a large, rapidly growing mass located in the crus of the left hind leg. The overlying skin was severely ulcerated and necrotic. Radiographs suggested an invasive neoplasm in soft tissue with no bone involvement. The animal's clinical condition progressively worsened over the next 3 months until it died. Necropsy revealed that the mass infiltrated the surrounding skeletal muscle with no evidence of distant metastasis. Microscopically, the mass was highly cellular and composed of round to spindle cells with frequent rhabdoid cells characterized by abundant eosinophilic glassy cytoplasmic inclusions and large, bizarre nuclei. Phosphotungstic acid hematoxylin staining failed to reveal distinct cross-striations within the neoplastic cells. Neoplastic cells were strongly positive for smooth muscle actin and vimentin but were negative for sarcomeric actin, myoglobin, desmin, cytokeratin, S100, and lysozyme. The gross, microscopic, and immunohistochemical findings supported the diagnosis of pleomorphic leiomyosarcoma.