Tissue cytology of masses on my dog

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SunshineLW
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Tissue cytology of masses on my dog

#1 Post by SunshineLW » Wed Apr 04, 2018 10:31 am

I took these samples from my dog last night. They are from two different masses that have been growing over the course of several weeks. Currently, I'm consulting with veterinary oncologists for a preliminary diagnosis. I'm confidant that the first mass is a lipoma. My guess for the second mass is perianal adenoma/ adenocarcinoma. In the second mass, I can identify several cytologic characteristics of malignancy (ex., cellular and nuclear pleomorphism, basophilia, anisokaryosis, and variable nucleolar size, shape, and number); however, no evidence of multinucleation, increased or abnormal mitosis, abnormal chromatin patterns, or phagocytic activity). I'm currently planning to having both masses removed, so I'll try to provide updates as to the definitive diagnoses and images of tissue histopathology (if I can get my hands on the slides).

[Note: Tissue cytology occasionally leads to a preliminary diagnosis upon which diagnostic/ therapeutic decisions can be made. Biopsy/ surgical resection and tissue histopathology is usually required to make a definitive diagnosis and to determine if adequate surgical margins were obtained.]

Fine Needle Aspirate of Mass 1 (possible lipoma): https://flic.kr/s/aHskyN9bQS

Fine Needle Aspirate of Mass 2 (guess of perianal adenoma/ adenocarcinoma): https://flic.kr/s/aHsmh4xBj3

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zzffnn
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Re: Tissue cytology of masses on my dog

#2 Post by zzffnn » Wed Apr 04, 2018 12:06 pm

Very nice! Thank you for sharing.

My 12yo Boston Terrier has two bean sized (possible) lipoma too, on his belly and back. At his age (even though he is otherwise healthy), do you think we should do surgery on him?

I had a lipoma on my thigh removed too. Aren't those usually benign (though I know cytology is needed to confirm)? Mine is/was, at least.
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SunshineLW
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Re: Tissue cytology of masses on my dog

#3 Post by SunshineLW » Wed Apr 04, 2018 1:03 pm

Lipomas are very common in older dogs and are estimated to occur in ~9% of dogs and ~3% of cats. They are almost always benign and it is very unusual for them to cause detrimental effects to the animal. I have piece of mind knowing that the mass on my dog's belly is most likely a lipoma. I say "most likely" because fine needle aspirate (FNA) and cytology can falsely diagnose lipoma if the sample is taken from the subcutaneous fat, rather than from the mass. Therefore, before giving the preliminary diagnosis of lipoma, one must be extremely certain that the sample was taken from the mass; NOT from the surrounding subcutaneous tissue. Even when you know that your sample was taken from the mass, there is still the possibility of a false-positive diagnosis of lipoma because the needle has to pass through the subcutaneous tissue in order to get into the mass, which may be composed of cells that do not readily exfoliate and, therefore, only fat cells (lipocytes) are seen on cytology.

In general, presumed lipomas are only removed when they begin to interfere with normal function. The majority of lipomas are asymptomatic and do not require surgical intervention.

Lipomas should feel soft and lobulated; like a ball of fat covered in skin. They should be relatively well-marginated from the normal surrounding tissue. They are often found in the subcutaneous tissue of the thorax and abdomen, as well as other areas.

I am not concerned about the presumed lipoma in my dog because I am confident that I sampled from the center of the mass and I did not see anything other than lipocytes. This is what I would do if I thought my otherwise healthy animal had a presumed lipoma (especially if it had the mass for months-to-years in the absence of unusual growth or other signs):

1) Measure and record length, width, and depth every 2-4 weeks (depending on rate of growth). I would take the animal to see the veterinarian if the mass began growing at an unusually rapid rate. (This is what I would use to measure the mass: https://www.ebay.com/itm/150mm-6inch-Di ... SwMVdYGqxZ)

2) I would take the animal to the vet if the mass was interfering with normal function (ex., growing into the armpit and causing the dog to limp).

3) I would take the animal to the vet if the mass was originally soft and moveable, but is now firm, immobile, and extending deeper into the soft tissue.

4) I would take the animal to the vet if the mass was originally covered by hair, but it is now balding and the surface of the skin feels thin.

5) I would take the animal to the vet if the mass began to ulcerate through the surface of the skin.

6) I would take the animal to the vet if he/she was showing any unusual signs, which may or may not be directly related to the mass.

In my dog's case, I am worried about the perianal mass. If the veterinarian is to anesthetize him to remove the perianal mass, I see no harm in asking the veterinarian to also remove the presumed lipoma.

Sources: Stephen J. Withrow, David M. Vail. Withrow & MacEwen's Small Animal Clinical Oncology, 5th ed. St. Louis, Mo. :Saunders Elsevier, 2013. Print.

Disclamer: If you have questions specific to your animal, they should be answered by your veterinarian who has the necessary veterinarian-client-patient relationship to make any recommendations. NEVER trust veterinary medical information provided by non-peer-reviewed sources over the internet. Especially in forums, I have seen people give veterinary advice that can cause more harm than good.

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Re: Tissue cytology of masses on my dog

#4 Post by zzffnn » Wed Apr 04, 2018 5:14 pm

Thank you! Yes, I did let a vet see it and it was the vet who said that it is most likely lipoma. She only recommended monitoring. We did not do cytology. I understand this is a casual forum and not a formal place for medical advice.
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Re: Tissue cytology of masses on my dog

#5 Post by Pat Thielen » Wed Apr 04, 2018 5:28 pm

Thanks for this post -- It is very interesting and I found your photos to be very good and informative. This is an area I know very little about; I couldn't spot abnormal cells if you pushed my nose into them! So, seeing this post and your images really helps me get an understanding of what is going on. And I am very happy that your dog is more than likely not in any danger from this. Australian Shepherds are such a wonderful breed (I had a border collie years ago).
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Re: Tissue cytology of masses on my dog

#6 Post by SunshineLW » Wed Apr 04, 2018 8:59 pm

zzffnn wrote:Thank you! Yes, I did let a vet see it and it was the vet who said that it is most likely lipoma. She only recommended monitoring. We did not do cytology. I understand this is a casual forum and not a formal place for medical advice.
A lot of veterinarians are comfortable making this diagnosis without cytology. I enjoy using the microscope too much to pass up an opportunity to look at the cells. It’s not perfect, but it's another tool to help bring the owner peace of mind. If you ever decide to do cytology on your Boston, ask the vet for the slide and to not use oil. You can make a permanent mount and add it to your collection. I think the lipocyte is one of the most beautiful cells on cytology. The fixative washes away the lipid and all that remains is the cell membrane and nucleus.

Please, do not take my disclaimer as an insult your intelegance. I made it mostly to protect myself, but also to remind the casual reader that humans make mistakes, especially when they are unable to evaluate an animal in person. I enjoy answering all types of veterinary-related questions if you couldn’t tell from my long-winded reply. If I don't know the answer off the top of my head, I'm bound to have it somewhere in my library.

Thank you for telling me about your Boston and empathizing with me about the situation. The Boston Terrier is one of my favorite breeds. They are chock full of personality.
Last edited by SunshineLW on Wed Apr 04, 2018 9:28 pm, edited 2 times in total.

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Re: Tissue cytology of masses on my dog

#7 Post by zzffnn » Wed Apr 04, 2018 9:18 pm

Thank you, LW. No insult taken at all. I have near zero intelligence in Veterinary parasitology or cytology anyway :mrgreen:

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Re: Tissue cytology of masses on my dog

#8 Post by SunshineLW » Wed Apr 04, 2018 9:49 pm

Pat Thielen wrote:Thanks for this post -- It is very interesting and I found your photos to be very good and informative. This is an area I know very little about; I couldn't spot abnormal cells if you pushed my nose into them! So, seeing this post and your images really helps me get an understanding of what is going on. And I am very happy that your dog is more than likely not in any danger from this. Australian Shepherds are such a wonderful breed (I had a border collie years ago).
Pat, thank you for the kind words and sentiment. I am very new to tissue cytology, so I doubt I know much more than yourself. I'll continue sharing pictures and you'll soon begin to see the patterns. You never know what skills you'll need in the event of a zombie-virus outbreak. I love my Aussies, but Collies are also incredible dogs.

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Re: Tissue cytology of masses on my dog

#9 Post by SunshineLW » Wed Apr 04, 2018 10:00 pm

zzffnn wrote:Thank you, LW. No insult taken at all. I have near zero intelligence in Veterinary parasitology or cytology anyway :mrgreen:
The microscopist in veterinary medicine will inevitably find himself/ herself studying pathology, cytology, oncology, dermatology, and/or parasitology. I have no doubt that there is another dimension in which Dr. ZZFFNN, DVM is a master of those sciences.

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Re: Tissue cytology of masses on my dog

#10 Post by SunshineLW » Wed Apr 18, 2018 11:34 am

On April 5th, I had both masses excised (see images below).

On April 16th, I consulted with a renowned veterinary oncologist/ cytologist at Texas A&M College of Veterinary Medicine. She agreed with my preliminary diagnoses of Lipoma and Perianal Adenoma.

Yesterday, I submitted both masses to TVMDL for tissue processing and histopathologic interpretation.

This Friday, I will receive the histopath slides and definitive diagnoses (hopefully). I'm looking forward to imaging the slides and sharing the results.
Attachments
Fatty mass floating in a glass of water.
Fatty mass floating in a glass of water.
Excised Lipoma 3 2.jpg (112.03 KiB) Viewed 874 times
Excised Lipoma 2 2.jpg
Excised Lipoma 2 2.jpg (196.5 KiB) Viewed 874 times
Excised Lipoma 1 2.jpg
Excised Lipoma 1 2.jpg (215.97 KiB) Viewed 874 times
Excised Dermal Nodule 2.jpg
Excised Dermal Nodule 2.jpg (328.9 KiB) Viewed 876 times

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