True Infection by Capillaria hepatica in a Dog

Background: Capillaria hepatica is a nematode, zoonotic, with worldwide distribution. The main hosts are rodents, nevertheless other mammals can be affected. Although the parasite has high affinity for the liver, it rarely causes a hepatic disease in domestic animals and humans. The diagnosis is difficult and usually a biopsy is required. The treatment is difficult and is based in anti-helminthic and corticoid, but prevention is the best strategy against the disease. The aim of the present report is to describe a case of hepatic capillariosis in a dog approaching the clinical signs, diagnosis and therapeutic. Case: A 12-year-old Brazilian Terrier bitch, with a history of visit to the farm and regular hunting of rats, frogs, birds and other wild animals, was attended with hyporexia and apathy. At the physical exam the dog presented elevation of rectal temperature, intense jaundice and abdominal pain. In the biochemical exams was noticed a slight increase in globulins and a sharp increase in alkaline phosphatase (AP), total, direct and indirect bilirubin, suggesting a liver injury. In the ultrasonographic exam, hepatomegaly with dispersed hyperechoic areas were observed, suggesting hepatic steatosis. The patient was treated with ursodesoxicolic acid and S-adenosil metionin for 30 consecutive days, showing a clinic improvement. Two months after the end of the treatment the animal worsened, showing jaundice, ascites, motor incoordination, weakness, difficulty in food and water ingestion and changes in the mental state. In the complete blood count was observed a macrocytic hypochromic regenerative anemia, leukocytosis with neutrophilia and monocytosis and thrombocytopenia. In biochemical exams was detected decrease in creatinine and albumin and increase in alanine aminotransferase and AP, suggesting hepatopathy by biliary obstruction. There were performed exams for leishmania and ehrlichiosis that tested negative. In the ultrasonographic exam it was noticed that the liver had the same alterations and the presence of free fluid in the abdominal cavity. Due to the deterioration of the clinical picture a blood transfusion was necessary, however the patient worsened and presented respiratory difficulty for a bilateral pleural effusion. Then, the fluid was drained and a treatment with S-adenosil metionin, silymarin, ursodesoxicolic acid, doxycycline and prednisolone was started. After 17 days, a hepatic biopsy was performed, but the patient died at the surgery desk. Samples from the liver were collected for histopathologic exam. The diagnosis was confirmed in hepatic capillariosis and periportal chronic hepatitis, with the visualization of numerous parasites structures with bioperculated barrel shape. Discussion: Due to the nonspecific clinical alterations observed in the patient and the low prevalence of C. hepatica in domestic animals, there was a difficulty in the diagnosis which lead to a symptomatic, nonspecific and inefficient treatment that culminate with the death of the patient. The histopathologic exam of the liver is the best manner to find the correct diagnosis of C. hepatica infection, once the parasites eggs remains in the liver parenchyma wrapped by fibrosis and aren´t eliminate in the feces. The eggs elimination in the environment just occur after the death of the animal. Although there didn't exist a consensus about hepatic capillariosis treatment yet, if the diagnosis were done earlier, a specific treatment with better chances of a good result could be performed. We concluded that hepatic capillariosis should be included in differential diagnosis for patients with hepatic syndrome, mainly if the animal had a hunting habit and if it had access to surroundings with high rats’ infestation.

Intraabdominal lesser sac metastasis from Ewing’s sarcoma: An exceptional localization

Ewing’s sarcoma/primitive neuroectodermal tumor is rare and aggressive with a poor prognosis. Intraabdominal metastases are an uncommon condition. Metastasis in the lesser sac is an exceptional occurrence. To the best of our knowledge, this location has not been described previously. We report a case of a 15-year-old patient treated for Ewing’s sarcoma of the left arm 6 years back. She had developed a suspicious mass in the lesser sac 6 years following her primary tumor. The histopathologic exam revealed a tumor with “small round cells” that were positive for CD99, confirming the relapse of Ewing’s sarcoma. The relapse was successfully managed with chemotherapy and surgery. Intraabdominal, extraintestinal masses in patients treated previously for Ewing’s sarcoma should be considered as Ewing’s sarcoma relapse in the differential diagnosis. We fully describe the management of this atypical relapse, with different components of clinical, radiological, and histological findings.

Synovial Sarcoma of the Hand

The incidence of synovial sarcoma is 1.548 per 1,000,000. Synovial sarcoma localized to the palmar surface should, therefore, be considered extremely rare. This report documents a 34-year-old male with a right hand mass that had been present for a few years, continuing to grow in size. The mass was located at the palm and extended from the mid-third metacarpal to involve all digits except the thumb. The mass was determined to be monophasic synovial sarcoma on histopathologic exam. Fluorescence in situ hybridization for SYT gene rearrangement was positive in 72% of cells. Resection of the mass was followed by radiation and chemotherapy. The patient had a long-term follow-up of 3.5 years with no evidence of any local recurrence of the tumor. This report increases awareness of this extremely rare malignancy—an awareness that is crucial for early diagnosis and improved survival rates. It is more common at younger ages but it can occur at any age, so it should be suspected and included in the differential diagnosis, especially when evaluating slow growing, nonresolving hand lesions.

A Case of Tumor of Follicular Infundibulum Involving the Vulva

Tumor of the follicular infundibulum or infundibuloma is a relatively rare benign adnexal tumor usually solitary and located in the head, neck, and trunk. Here we present a 70-year-old woman with a tender vulvar lesion. Histopathologic exam shows a well-circumscribed lesion with a subepidermal horizontally oriented, plate-like proliferation of pale appearing squamous epithelial cells with numerous points of connections with the overlying epidermis and peripheral palisading. Overall these histopathologic features are consistent with the diagnosis of tumor of follicular infundibulum involving genital skin.

Multilobular Tumor of Bone in a Dog

Background: Multilobular tumor of bone (MTB) is a primary bone neoplasm, uncommon in dogs. This tumor was called of many names for a long time, as: chondroma rodens, multilobular osteochondrosarcoma, multilobular osteoma, multilobular chondroma, calcificating aponeurotic fibroma, although MTB was preferred chosen, because these other name could be correlated with humans’ tumors. This tumor is observed specially in skull bone, although it was reported in zygomatic arc, hard palate, axilla, spine and penis. Mostly happen in big breeds dogs, and middle to old age patients. Clinical signs depending of region and how aggressive the tumor is, usually are related to compression of any structure. The growth of MTB is frequently slow and progressive, locally invasive, occurring relapse after surgical revomal, although the tumor has low to moderate metastatic potential. The aim of this study is to report a case of MTB in a female dog and describe anatomopathological changes.Case: A female dog, mixed breed, 13 year-old, of middleweight was admitted in Pathology Department of College of Agricultural Sciences and Veterinary Medicine (FCAV-Unesp), Campus of Jaboticabal - SP, to be undergone to necropsy. The patient have never shown any epileptic crisis or neurologic signs. In macroscopic examination was found a mass in skull, which invaded the orbit and frontal sinus, but it was not invading brain cavity. The neoplasm had and irregular surface, firm consistent, color was white mixed to red areas, after cut it was granular and rough, and had some point mineralized areas. The lobs of lung had much firm masses, colored gray to white. In cytology it was observed fusiform to polyhedric isolated mesenchymal cells, moderated pleomorphic, basophilic cytoplasm, thin granulated nuclear chromatin, and visible nucleoli that was involved by eosinophilic extracellular matrix. The proposed diagnostic was bone sarcoma. Histopathological assessment showed mesenchymal neoplastic proliferation, and multilobular characteristic, the lobules had different sizes and was well organized, and they were separated by thin conjunctive septs. In the center of lobules, there was an “island” with mineralized or chondroitin bone matrix, in some of these islands there were osteoclast. The cells had moderated pleomorphism and low mitotic activity (three mitotic cells in ten high-power field). At least, it showed big necrosis areas and invasion of near tissue. In lung was observed metastatic areas, which had same histopathologic way of primary neoplasm in skull. That way, the histopathologic exam was similar to Multilobular tumor of bone grade II.Discussion: The MTB is an uncommon neoplasm, which assaults mostly skull bone in large breeds dogs and middle age of eight years old. This case accord to literature about breed size, age and local of tumor. The clinical signs in this dog was related to region what it was growing and near structure compression. Besides that, the patient had lung metastasis, that is the principal metastatic sites according to literature. The Histopathologic exam showed the same characters of MTB, which was considered grade II according to literature. Despite MTB is an uncommon neoplasm in clinic of dogs and cats, the epidemiological knowns as age, breed and localization, anatomopathological changes, and histopathological exam allows to have a diagnosis, showing the importance of including this neoplasm in differential diagnosis of bone tumor in dogs.

Ectopic cutaneous schistosomiasis - Case report

Schistosomiasis mansoni is a systemic disease caused by a helminth of the schistosoma genus. The disease is generally asymptomatic or gastrointestinal symptoms may predominate. Skin lesions related to the disease are rarely diagnosed, even in endemic areas. The authors report the case of a young girl diagnosed with cutaneous schistosomiasis with involvement of the abdomen, back and scapular region. Schistosoma eggs were found in the lesions by histopathologic exam. There was no evidence of systemic involvement. Schistosomiasis must be included in the list of differential diagnosis of skin damage, especially in endemic areas, due to the potential consequences, in case of late diagnosis and treatment.