Multiple myeloma in dogs: Use of the cell block technique as a new diagnostic tool

BACKGROUND

The diagnosis of multiple myeloma (MM) in dogs may be challenging and complex. The cell blocks are a diagnostic technique that allows the characterization of neoplastic cells and, therefore, might help in the diagnosis of atypical MM.

OBJECTIVE

The objective of the present work is to describe three clinical cases in which the cell blocks and immunohistochemistry contributed to the definitive diagnosis of canine MM.

METHODS

Three dogs, one female and two males, with different clinical signs, were presented for consultation with anemia, hyperproteinemia with monoclonal gammopathy, and the presence of plasmacytosis in the bone marrow. Cytologic analysis of the spleen was performed in two dogs and was suggestive of the presence of lymphocytes or plasma cells of a neoplastic nature in one of the cases and plasma cell hyperplasia associated with extramedullary hematopoiesis in the other. Given the hypotheses of lymphoid neoplasms with a plasma cell phenotype, cell blocks from aspiration punctures were performed for immunohistochemical analysis with anti-CD3, CD20, CD79αcy, PAX5, and MUM1 antibodies.

RESULTS

The results revealed positive staining for MUM1 in 80% of the cells in the spleen cell block and for CD20 and MUM1 in 70% of the cells in the bone marrow cell blocks, with negative staining for the other antibodies. The immunophenotyping results allowed the diagnosis of MM in the three cases and excluded other lymphoid neoplasms.

CONCLUSIONS

This work reinforces the importance of using cell blocks in the diagnosis of neoplasms by demonstrating their potential to aid the diagnosis of MM.

Co-Expression of T- and B-Cell Markers in a Canine Intestinal Lymphoma: A Case Report

An 8-year-old female neutered Labrador retriever was presented for a second opinion consultation due to vomiting and lethargy, having failed to respond to symptomatic therapy. Blood analysis revealed hyperbilirubinemia and hypoalbuminemia, associated with hypocobalaminemia. An abdominal ultrasound identified diffused bowel thickening and hypoechoic hepatomegaly. An ultrasound-guided liver fine-needle aspiration was performed for cytology and also for cell block immunocytochemistry. Gastric and duodenal biopsies were collected by gastroduodenoscopy. Liver cytology showed numerous lymphocytes, suggesting lymphoma at the hepatic infiltration stage, and immunocytochemistry in the cell block of the hepatic aspirate indicated co-expression of CD3 and CD20 in the lymphoid cells present. The histopathology of gastric and duodenal biopsies supported the hypothesis of gastrointestinal lymphoma due to heavy lymphoid infiltration of the gastric epithelium and intestinal mucosa, including the villi. Concurrent immunohistochemistry was performed using CD3, CD20, PAX5, and CD79αcy antibodies. Immunomarking was positive for CD3 and CD20, which overlapped populations of lymphoid cells, and was negative for all other antibodies. In the clonality test, lymphocyte co-expression of CD3 and CD20 was confirmed by monoclonal rearrangement of T-cell gamma receptors. The final diagnosis was type 2 enteropathy-associated T-cell lymphoma with hepatic infiltration. Co-expression was examined in conjunction with the PARR result in the presence of T-cell monoclonal rearrangement.

Negative impact on the reproductive potential of blue jack mackerel Trachurus picturatus by Kudoa infection of the ovary

Reproduction of Trachurus picturatus off the western Portuguese coast was studied over 1 yr. During histological analyses, the presence of Kudoa sp. was detected in advanced vitellogenic oocytes. Kudoa infections are known to cause economic loss through the induction of post-mortem liquefaction of fish muscles, but ovarian infection as reported in this study will seriously affect the reproductive potential of the species and thus impact fisheries productivity. Only females showed gonad infection which led to total degradation of advanced vitellogenic oocytes. No macroscopic, somatic or condition indices revealed differences between infected and uninfected females, rendering this infection event a concealed suppression of reproduction.

Opinions of Portuguese Veterinarians on Telemedicine-A Policy Delphi Study

Telemedicine has only received limited attention by veterinary professional regulatory bodies, particularly in Europe. In Portugal, telemedicine is currently outside what is considered acceptable practice by the regulator, the Portuguese Veterinary Order (Ordem dos Médicos Veterinários). As part of a wider research aimed at gathering evidence for developing a new veterinary Code of Professional Conduct, this study describes the use of the Policy Delphi technique to gather the views and perceptions of a purposeful sample of 41 Portuguese veterinarians regarding telemedicine. Four main issues were addressed using mixed research methods: teleconsultation, teleconsulting, teleadvice, and the regulator's role. Responses highlight participants' perception of both the relevance of medical digital technologies in improving healthcare and their limitations. Overall opinion was that, although restrictions to remote veterinary practice should be reduced, improved guidance and regulation are warranted. Eighty percent of participants considered that limits to the use of veterinary telemedicine should be imposed and two thirds considered that a remote consultation must always be preceded by a face-to-face consultation. While most respondents thought that vet-to-vet teleconsulting using social media (namely Facebook) should not be banned, 83% recognized that it should be regulated by ethical standards. Participants' concerns with telemedicine had mostly to do with reputational risk for the veterinary profession, while overlooking privacy or confidentiality issues. A consultative group should be established to ensure that telemedicine providers comply with professional requirements. It is expected that these results will support policy-making by the Portuguese Veterinary Order and by veterinary regulators at other jurisdictions.

First description of a herpesvirus infection in genus Lepus

During the necropsies of Iberian hares obtained in 2018/2019, along with signs of the nodular form of myxomatosis, other unexpected external lesions were also observed. Histopathology revealed nuclear inclusion bodies in stromal cells suggesting the additional presence of a nuclear replicating virus. Transmission electron microscopy further demonstrated the presence of herpesvirus particles in the tissues of affected hares. We confirmed the presence of herpesvirus in 13 MYXV-positive hares by PCR and sequencing analysis. Herpesvirus-DNA was also detected in seven healthy hares, suggesting its asymptomatic circulation. Phylogenetic analysis based on concatenated partial sequences of DNA polymerase gene and glycoprotein B gene enabled greater resolution than analysing the sequences individually. The hare’ virus was classified close to herpesviruses from rodents within the Rhadinovirus genus of the gammaherpesvirus subfamily. We propose to name this new virus Leporid gammaherpesvirus 5 (LeHV-5), according to the International Committee on Taxonomy of Viruses standards. The impact of herpesvirus infection on the reproduction and mortality of the Iberian hare is yet unknown but may aggravate the decline of wild populations caused by the recently emerged natural recombinant myxoma virus.

First description of a fatal equine infection with Halicephalobus gingivalis in Portugal. Relevance for public health

Halicephalobus gingivalis is a small saprophytic rhabditid nematode, represented only by females with a typical rhabditoid oesophagus and one egg in the uterus, capable of infecting vertebrates. This opportunistic parasite present in the soil, manure and decaying humus, is thought to penetrate through previous injuries to the mouth, eyes and skin of horses and migrate to various organs. The brain is one such organ, where the females lay their eggs, leading to malacia and causing a sudden onset of neurological signs, such as anorexia, ataxia, urinary incontinence, blindness, decreased menace and tonal reflexes, tremors and aggressiveness. The disease is invariably fatal whenever brain lesions are present, and the diagnosis usually achieved only post‐mortem. The present work aims to describe the first case of infection by H. gingivalis ever reported in Portugal. An 8‐year old warmblood horse presented with an 8‐day history of progressive blindness involving the left eye, initially with normal pupillary reflexes, advancing to bilateral blindness and increasing deterioration in clinical condition. After euthanasia, the animal was submitted for necropsy. Organ samples were collected and fixed in 10% neutral buffered formalin for routine histopathology. A large mass was found in the left kidney corresponding to fibrous tissue heavily infiltrated with inflammatory cells and numerous nematodes. In the brain, multiple, bilateral and asymmetrical foci of malacia containing several rhabditoid nematodes, larvae and zygotes, and high numbers of inflammatory cells were found. The nematodes were identified as H. gingivalis. The clinical history, necropsy and histological findings presented constitute a typical case of H. gingivalis infection in a horse, never previously described in Portugal to the authors’ best knowledge. Humans can be infected by contact with contaminated manure, which makes this nematode a public health concern, especially for people living and/or working in close proximity to horses.

Detection of rabbit Haemorrhagic disease virus 2 during the wild rabbit (Oryctolagus cuniculus) eradication from the Berlengas archipelago, Portugal

BACKGROUND

In the regular wildlife monitoring action carried out in the summer of the past few years at the Berlenga Island, wild rabbits (Oryctolagus cuniculus) have been repeatedly found dead. However, the origin of those deaths was never investigated. Our aim was to investigate the cause of death of 11 rabbits collected between April and May 2016.

RESULTS

While screening samples from rabbit carcasses for the major viral rabbit pathogens, five tested positive to RHDV2 but all were negative for RHDV and myxoma virus (MYXV). For six RHDV2-negative specimens, emaciation and parasitism were considered the most probable cause of death. Lesions identified in the RHDV2-positive rabbits included non-suppurative diffuse hepatic necrosis and pulmonary lesions varying from congestion and oedema of the lungs to interstitial pneumonia. Sequencing analysis of the vp60 gene obtained from two specimens showed identical vp60 sequences. Comparison with other known RHDV2 strains from public databases through BLAST analysis revealed a closer similarity with strains from Alentejo collected during 2013. Maximum Likelihood and Bayesian phylogenetic analysis showed that the 2016 strains from the archipelago have a higher resemblance with a group of strains mostly collected in the South of Portugal between 2013 and 2014.

CONCLUSION

The results suggest that RHDV2 may have been introduced on the Berlenga Island a few years ago, having evolved separately from mainland strains due to insularity.

An Update on Canine, Feline and Bovine Papillomaviruses

Over recent years, a growing number of papillomaviruses have been identified, which cause a wide range of lesions in domestic and wild animals. Papillomavirus-induced lesions may have a great impact on animal health, and some diseases observed in farm animals are associated with significant economic losses. This concise review brings together recent advancements on animal papillomavirus research, providing the scientific community and veterinary practitioners with an update on this rapidly evolving field. Among others, bovine, canine and feline papillomaviruses (BPV, CPV and FcaPV) are most extensively discussed, in view of the recent discovery of new viral types and their worldwide importance for animal health. Feline papillomaviruses 2 is an emerging, highly prevalent pathogen in domestic cats, associated with a subset of malignant skin lesions. Aspects related to cross-species infection by BPV and its environmental co-factors are also addressed. Animal papillomaviruses are also fascinating models for studying molecular and cell biology and have recently inspired some major breakthroughs. Overall, it is clear that additional, international and systematic efforts are needed to clarify which lesions are caused by which viral types and to develop experimental models for studying animal papillomavirus.

St Gallen molecular subtypes in feline mammary carcinoma and paired metastases-disease progression and clinical implications from a 3-year follow-up study

Considering that scarce data are available on disease progression of feline mammary carcinoma (FMC), this study aimed to analyze the clinical, pathological, and immunophenotypic features collected from 61 queens with FMC and to compare the concordance ratios of the expression levels of five molecular markers (ER, PR, fHER2, CK5/6, and Ki-67) between primary tumors (PT) and metastatic lesions. The results showed that cats with luminal A mammary carcinomas (MC) had higher overall survival (924.6 days, p = 0.001) and longer disease-free period (385.4 days, p = 0.005) compared to the ones with other MC subtypes. In fact, queens with triple negative/basal-like MC showed the lowest survival (mean 156.2 days) and the shortest disease-free survival (mean 28 days) among the molecular subtypes of MC. The lung was the organ most frequently affected by metastases, and animals with lung and/or pleural metastases were more likely to display metastases at three or more locations (p = 0.039). A large heterogeneity in protein expression levels was found between PT and paired metastases, with both estrogen and progesterone receptors more likely to be downregulated in metastases. Paired metastases frequently had higher Ki-67 index than PT, whereas fHER2 overexpression was seen in 46 samples (30 %) and CK5/6 expression was found in 50.7 % of metastases (36/71). Results also revealed that disease progression leads to a high percentage of triple negative/basal-like metastases (9/23; 39.1 %) associated with the absence of luminal A subtype in distant metastases (0/23). This study highlights the prognostic importance of immunophenotyping of MC in cats, although the modified protein expression identified in metastases contributes to justify why possible targeted therapies may fail in some animals with metastatic disease. Altogether, the results obtained also demonstrate that FMC can be used as a model to study human breast cancer.

PCNA and grade in 13 canine oral squamous cell carcinomas: association with prognosis

This study evaluated the prognosis factors of age, tumour size, anatomic location, histological grade and proliferating cell nuclear antigen (PCNA) expression in 13 dogs with oral squamous cell carcinoma (OSCC) with bone invasion and without signs of lymph node or distant metastasis. All animals were treated with radical excision performed with at least 1 cm margin, based on computed tomography images. In the 2-year follow-up, median disease-free survival was 138 days for dogs with grade 3 tumours and was not reached for those with grade 2 tumours. Grade 3 tumours and PCNA labelling index ≥65% were related with a shorter disease-free survival time and consequently poor prognosis (p = 0.003 and p = 0.034, respectively). Mean PCNA labelling index was significantly higher in recurrent cases (p = 0.011). Histological grade and PCNA expression may be important prognosis factors in canine OSCC.

p63 and E-cadherin Expression in Canine Oral Squamous Cell Carcinoma

The expression of p63 and E-cadherin was studied in 22 oral squamous cell carcinomas in the dog according to immunohistochemical techniques. The association between these markers and clinicopathologic parameters was assessed. All tumor cells studied showed enhanced p63 expression. Regarding E-cadherin expression, 17 of 22 cases (77.3%) showed decreased immunoreactivity, and in 13 of 22 cases (59.1%), its expression was cytoplasmic. Neither p63 nor E-cadherin expression patterns were associated with tumor size, bone invasion, or lymph node metastasis. p63 score was related to proliferating cell nuclear antigen proliferative index (P = .020). A statistically significant correlation between the expression patterns of these 2 markers was noted (P = .026). Furthermore, they were related with tumor grade. An atypical p63 labeling and a cytoplasmic E-cadherin staining were statistically related with a higher tumor grade (P = .022 and P = .017, respectively). These findings suggest that changes in p63 and E-cadherin expression are frequent events in oral squamous cell carcinoma in dogs.

Pacheco's parrot disease in macaws of the Lisbon's Zoological Garden. Description of an outbreak, diagnosis and management, including vaccination

The Lisbon's Zoological Garden, Portugal, has maintained for many years a large collection of psittacine birds without any serious health problems. Unexpectedly, in April 1999, a total of nine macaws died after a short period of illness. Clinical signs consisted mainly of anorexia, ruffled feathers and yellowish droppings. A herpesvirus was isolated from brain, trachea, lung, liver, spleen, kidney and intestine of each of the examined dead birds, confirming that all animals succumbed during viraemia. Serotyping of the isolate in cross neutralization tests with reference sera prove that the outbreak was caused by serotype 3 of Pacheco's parrot disease herpesviruses. An autogenous, formalin-inactivated vaccine with adjuvant (aluminium hydroxid gel) was prepared from one of the isolates and injected intramuscularly 14 days and six weeks after the onset of mortality in an attempt to protect the remaining psittacine birds in the zoo from the disease. The autogenous vaccine was well tolerated and was able to rapidly stop virus spread and morbidity and mortality among the psittacine birds. Follow-up studies demonstrate that all nine blood samples from vaccinated birds obtained nine month' after the second vaccination contain neutralizing antibodies. Twenty five month' after vaccination two out of four serum samples were still antibody positive. No herpesvirus was isolated from faecal samples nine and twenty five months after the onset of the outbreak. These data prove that the autogenous vaccine played a major role in containing a severe outbreak of Pacheco's parrot disease in a large collection of psittacine birds.

Chemo-angiogenic profile of bovine urinary bladder tumors distinguishes urothelial carcinomas from hemangiosarcomas

Angiogenesis and inflammation are two processes regulated by numerous common molecular mechanisms. Inflammation can stimulate angiogenesis, and angiogenesis can facilitate inflammation; both mechanisms have been shown to be involved in carcinogenesis. With this study we sought to gain an understanding of the molecular mechanisms involved in tumor angiogenesis and inflammation in urinary bladder tumors. Tumor specimens were collected at slaughter from Friesian cows chronically exposed to bracken fern. Bracken chronic toxicity is characterized by the presence of multiple mixed tumors in the bladder, being reported throughout the world under the designation of bovine enzootic hematuria. We conducted molecular analyses of angiogenic factors and chemokine production by real-time RT-PCR, and also assessed microvessel density (MVD), microvessel pericyte coverage index (MPI) to reveal mature vessels, the extent of tumor-infiltrating leukocytes (TILk) and tumor cell apoptosis and proliferation in both epithelial and endothelial-derived bovine urinary bladder tumors. We defined a profile of chemokines/chemokine receptors (Mip1beta, CCR1) and angiogenesis-related factors (VEGF, VEGFR2) that allow distinguishing between urothelial carcinomas (epithelial origin) and hemangiosarcomas (endothelial origin). Taken together, our data reveals previously unrecognized paracrine and autocrine chemo-angiogenic loops in the context of bovine urinary bladder tumorigenesis.

Urinary Bladder Lesions in Bovine Enzootic Haematuria

In cattle, bracken fern chronic toxicity is characterized by the presence of multiple tumours in the bladder (bovine enzootic haematuria). From October 1999 to March 2003, 433 urinary bladders with macroscopical lesions were collected in the slaughterhouse of São Miguel Island (Azores, Portugal), an endemic area where Pteridium aquilinum infestation in pastures is high. Bladder lesions were divided into three main categories (inflammatory lesions, non-neoplastic epithelial abnormalities and tumours) and described in detail. In some cases, neoplastic growth was confined to a single site, but in most cases multiple tumours developed within the same bladder. Epithelial tumours alone were present in 51.2% of the affected bladders, mesenchymal tumours alone in 17.4%, and both epithelial and mesenchymal tumours in the remaining 31.4%. The large number of tumours examined (870) revealed new categories not yet included in other veterinary classification systems, namely, inverted papilloma, papillary neoplasm of apparent low malignant potential, and haemangioendothelioma.

Pithomycotoxicosis (facial eczema) in ruminants in the Azores, Portugal

Outbreaks of pithomycotoxicosis (facial eczema), a hepatogenous photosensitisation caused by the mycotoxin sporidesmin, have affected ruminants in the Azores Islands of Portugal after warm, humid periods during late summer and autumn. Twenty-two outbreaks were recorded in cattle between 1999 and 2001, affecting 11.4 per cent of the animals in the affected herds, and in 2000 there was an outbreak in one sheep flock in which more than 20 per cent of the sheep died. The clinical signs included decreases in milk production, weight loss, photosensitisation and its sequelae, including death. The animals had high activities of gamma glutamyltransferase in their serum, and icterus and severe liver disease, including biliary hyperplasia and fibrosis, were found postmortem. The characteristic spores of the toxigenic saprophytic fungus Pithomyces chartarum were found on grass; all 381 isolates of the fungus were toxigenic for sporidesmin by elisa, and the results were confirmed by high-performance liquid chromatography analysis. Cattle from farms at greatest risk of pithomycotoxicosis were protected by supplementing their concentrate feed with zinc oxide, or using a slow-release intraruminal zinc bolus.

Small-cell carcinoma of the lung resembling a brachial plexus tumour

A small-cell carcinoma of the lung was identified in a six-year-old female German shepherd dog with a history of chronic lameness of the left forelimb, Horner's syndrome and sensory deficits on the caudal portion of the left forelimb below the elbow. A mass, the exact location of which was difficult to ascertain, was identified during radiographic examination of the thorax. It was easily identified, using magnetic resonance imaging, as an apical tumour of the left lung with dorsal extension and involvement of paraspinal structures, such as spinal nerve roots C8 to T1 and the sympathetic trunk. Postmortem examination confirmed a mass in the left apical lobe of the lung, compatible with a diagnosis of small-cell carcinoma by histopathology and immunohistochemistry. This clinical presentation is similar to Pancoast syndrome described in humans.

Immunohistochemical studies of epithelial cell proliferation and p53 mutation in bovine ocular squamous cell carcinoma

Bovine ocular squamous cell carcinoma (OSCC) is the second most common cause of rejection due to neoplasia in slaughterhouses on Sao Miguel Island, Azores, and accounts for significant economic losses. To obtain a better insight into the genesis and neoplastic transformation process of bovine OSCC, abnormal protein expression and proliferation index were assessed by the immunohistochemical evaluation of p53 and Ki67, respectively. OSCC samples were collected from 15 bovines and were classified histologically according to the degree of differentiation into three categories: poorly, moderately, and well differentiated. Immunohistochemistry using polyclonal anti-human p53 antibody and polyclonal anti-human Ki67 antibody was performed. Ten of 15 tumors tested were immunoreactive for p53. Twelve tumors demonstrated Ki67 expression. As in human squamous cell carcinoma, p53 overexpression is frequent in bovine OSCC, providing support for a possible role of the protein in the pathogenesis of this neoplasia. No correlation between the percentage of p53 stained nuclei and the degree of differentiation was observed, although different patterns of staining were seen according to the degree of keratinization of the tumor cells. With the exception of the moderately differentiated OSCC group, Ki67 index showed significant correlation with the histologic pattern, increased proliferation being found in poorly differentiated OSCC (P = 0.013).

Bacteriological study of the liver in dogs

This study aimed to confirm the possible presence of bacteria in the liver of healthy dogs. Laparotomy was performed in 20 animals admitted for routine abdominal surgery. To be selected for the study, dogs had to be healthy adults without clinical liver disease, signs of infection or macroscopic liver abnormalities. Biopsy samples were histologically and bacteriologically examined. Bacteriological analysis was negative for the livers of eight of the dogs. The remaining animals harboured a diverse bacterial flora in their liver. Twelve bacterial species were identified. Histology showed that the livers of 19 dogs had minor or no abnormalities, and only one animal had interstitial fibrosis and trabecular disarrangement. Histological changes were not related to the presence of bacteria. Thus the results showed that the liver of healthy dogs may harbour different bacterial species. These microorganisms did not cause any detectable manifestation of disease, despite being potential pathogens.

Mixed germ cell tumour of the spinal cord in a young dog

A spinal cord mixed germ cell tumour was identified in a two-year-old, female Airedale terrier with a history of progressive paraplegia. At necropsy, a discrete pale pink spinal cord mass was identified at the L5 vertebra, which extensively invaded the associated spinal cord segments L6 and L7. Histologically, the tumour was located within the subarachnoid space and invaded the spinal cord. It was composed of three different types of cells: small round cells, forming clusters or islands, similar to germ cells identified in testicular germinomas; large cells with eosinophilic or amphophilic cytoplasm, forming trabeculae; and a third, rarer type of well differentiated epithelial cells, forming acinar or tubular structures. Immunohistochemical examination revealed reactivity to antibodies against alpha-fetoprotein and broad spectrum cytokeratins. The composition, cytological features and immunohistochemical staining of this neoplasm are similar to germ cell tumours previously reported in the suprasellar region and in the eye of dogs.

Immunological and histopathological studies in a rodent model infected with Leishmania infantum promastigotes or amastigotes

Infection with Leishmania infantum promastigotes (group I) and amastigotes (group II) was evaluated over 32 weeks, using Syrian golden hamsters as an experimental model. Spleen cells strongly responded to the specific antigen at 12 (group I) and 16 weeks (group II) post-inoculation (p.i.) and lower stimulation index values coincided with the parasite burden peak. Western-blot analysis detected antibodies during the 1st week p.i. and the number of recognized proteins increased with the time of infection, reaching a maximum at the peak parasite burden. Histopathology revealed hypoplasia in spleen white pulp and the liver showed a periportal infiltration of inflammatory cells and small granulomas, becoming increasingly more severe as the infection developed. Both organs exhibited a secondary amyloid deposition at the end of the experiment, especially the spleen. In this study, progressive visceral disease was observed as in natural human and canine infections; however, the incubation period was longer in the promastigote than in the amastigote infection.

Dhori virus induced lesions in mice

Dhori and Thogoto viruses are till now the only recognized tick-borne orthomyxoviruses. Like Thogoto virus, also Dhori is highly hepatotropic for laboratory mice; the lesions in several organs resemble those described for influenza virus.

Pathological lesions in mice infected with Thogoto virus, a tick-borne orthomyxovirus

The RNA structure of tick-borne Thogoto virus was found very closely related to that of the Orthomyxovividae family. Pathological lesions in the lungs, liver and intestine of white mice inoculated with Thogoto virus resemble to those described for influenza virus, however, an important differential characteristic is the high hepatotropism of Thogoto virus. Thogoto virus infection in the liver of mice seems suitable for the study of virus-induced necrotic lesions.