Case Of the Month

Histiocytic sarcoma in a 10-year-old FS English Bulldog: Our Case Of the Month September 2015

A 10-year-old FS English Bulldog was presented due to diarrhea, decreased appetite, and vomiting 3-4 times in a day. An interstitial lung pattern was seen on radiographs. Upon physical examination the patient was QAR with a painful abdomen upon palpation. A CBC found WBC 18.8, neutrophils 15416, monocytes 1692, and 0 eosinophils. A blood chemistry found amylase 1678, TP 7.7, globulins 4.4, Creatinine 2.0, and anaplasma positive. A urine culture was negative and a urinalysis showed a specific gravity of 1.007, protein +2, Blood +3, WBC 11-20, and RBC 21-50.

Outcome

Cause of the effusion could be paraneoplastic or owing to systemic inflammatory response. Guarded prognosis depending on underlying cytology. Aggressive treatment for nephritis is recommended. Gastrointestinal protectants, broad spectrum antibiotics, sedation and 25-gauge FNA of the right kidney would be recommended. U/S guided FNA of the right kidney was performed without complication.

Comments

Pathology results from U/S guided FNA of the right kidney found: Neoplastic cells suggesting round cell tumor or extremely pleomorphic carcinoma. Telecytology interpretation was performed by Dr. Larry McGill, Ph.D Diplomate, ACVP Medical Director (Emeritus) and Veterinary Pathologist.

Sampling

US-guided 25 g FNA revealed histocytic sarcoma of the right kidney.

Sonographic Differential Diagnosis

Nephritis gastritis vs emerging nephric neoplasia of round cell origin. Recommend US-guided FNA to further define mixed inflammation of the renal cortices vs round cell infiltrative disease that would yield a monopopulation.

Image Interpretation

Normal echocardiogram for this breed. Abdominal sonogram: Irregular kidneys with pericapsular inflammatory pattern. Corticomedullary detail loss and pericapsular ill-defined echogenic fat noted more prominently in the right kidney with subtle architectural disruption. pericapsular fluid noted around the left kidney suggestive for acute insult. Trace amount of pleural effusion was noted through the diaphragm. Thickened gastric wall with artifact.