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Lymphangiosarcoma in a Dog.
Abstract
Lymphangiosarcoma was seen in the subcutis of right chest in a 11-year-old female Poodle. No metastasis was observed clinically. Tumor cells were vimentin positive and formed irregular space or slit without erythrocytes in the tumor tissue. Lymphocytic foci and edema were seen in the stroma. Only a few tumor cells had factor VIII-related antigen. Electronmicroscopically, tumor cells did not accompany with basement membrane and intercellular junctional complex.
... It has been reported 33 cases of LSA until this moment [1,[3][4][5][6][8][9][10][11][12][13][14][15][16][18][19][20][21][22]24]. There is no sexual predisposition for this kind of tumor. ...
... However, a retrospective study [23] revealed that most part of reported cases were males (9 males -56.25%). Nonetheless, in recent literature, females were more affected, in accordance with the present report (18 females -55%) [3,4,9,12,14,16,19,21,24]. ...
... The predominant age group for this type of neoplasm is above five years old [3,8,10,[12][13][14][15][16][19][20][21], unlike this case, in which the patient was three years old. There is no racial predisposition for LSA, but it has been noticed that it occurs more in medium to large breeds [1,[3][4][5][6][8][9][10]12,13,16,20,21,24]. ...
Background: Lymphangiosarcoma (LSA) is a rare, highly malignant and infiltrative neoplasm of the lymphatic endothelium of dogs and cats. It is mostly reported in medium to large breed dogs, over 5-year-old, with no sexual predisposition. Affected animals present fluctuating and diffuse swelling, covering both dermis and subcutaneous tissue, spreading through lymphatic and haematic vessels. Histologically, LSA is characterized by connected channels devoid of conspicuous haematic elements. Treatment depends on location of the neoplasm, staging, and possibility of curative surgical excision. Chemotherapy and radiotherapy can increase survival time. In this report, we describe a rare case of vulvar LSA in a dog. This is the first Brazilian report of LSA in dogs so far.Case: A 3-year-old, female, mixed breed dog was presented for evaluation of vesicle-bullous lesions in the vulvar and perivulvar region with progressive growth along 6 month. Histopathology revealed neoplastic proliferation in the superficial dermis, advancing through the profound dermis. The histological lesion pattern was consistent with angiosarcoma, which united along with macroscopic pattern of the tumor, and the presence of multiple anastomosed vascular structures without erythrocytes within it at microscopy, was compatible with LSA. No evidence of metastasis or lymphadenopathy was found on survey radiography and ultrasound. We performed a surgical excision, and remaining wound was reconstructed with an advancement skin flap. Despite wide surgical resection, neoplastic cells could be found in surgical borders, as well as a metastatic inguinal lymph node. Postoperative chemotherapy based on doxorubicin as a single agent was administrated. Disease free interval (DFI) was one month after surgery, when small bullous lesions were observed near the surgical site, and histopathological exam confirmed LSA. Three months after the surgical procedure, the patient presented with worsening of the lesions, anorexia, and apathy. The owner opted for euthanasia. Total survival time was five months.Discussion: The LSA occurs often in dogs above five years old, unlike this case, in which the patient was 3 years old. Several anatomic locations were cited in other reports. In this case, the lesion was in both the vulvar and perivulvar regions, which is an uncommon location of LSA, described as secondarily affected region in one report only. Despite absence of metastasis in this case, lungs, kidneys, bone marrow, and spleen can be affected. Histopathologic exam is the golden standard for a definitive diagnose of LSA. Diagnosing LSA may be challenging due to its resemblance to hemangiosarcoma, and confirmation is only possible if histopathology detects an absence of red blood cells in the lymphatic channels. Prognosis is poor due to LSA aggressive and infiltrative features. Doxorubicin demonstrated good clinical response in other dogs. Chemotherapy protocols, whether alone or in combination with cyclophosphamide, have been proving to be promising in dogs with soft tissue sarcomas, such as LSA. Surgical approach is the most appropriate and it may be associated with radiotherapy or chemotherapy, especially if complete resection of the tumor is not possible. In this report, even though it was a young animal, the location and extension of the lesion did not contribute to the good prognosis, even after adding adjuvant chemotherapy to the treatment.
... Lymphangiosarcoma is a rare malignant cutaneous tumor that derives from the lymphatic endothelium in humans and domestic animals [1-5, 8, 9, 11-13]. Only a small number of case reports have described canine lymphangiosarcoma [1,4,9,11,14]. In dogs, lymphangiosarcoma tends to localize in the subcutis along the ventral midline and limbs, with major reported locations of the inguinal region, cervical region, hind limb and forelimb [1,4,9,11,14]. ...
... Only a small number of case reports have described canine lymphangiosarcoma [1,4,9,11,14]. In dogs, lymphangiosarcoma tends to localize in the subcutis along the ventral midline and limbs, with major reported locations of the inguinal region, cervical region, hind limb and forelimb [1,4,9,11,14]. ...
... However, in the present case, a lack or greatly reduced presence of erythrocytes, lymphoplasmacytic infiltration in the tumor, absence of pericytes and lack of Weibel-palade bodies in the neoplastic cells suggest the tumor to be a lymphangiosarcoma, not a hemangiosarcoma [3,15]. Moreover, unclear or discontinuous basement membrane as seen by electron microscopy or PAS staining in the present case was consistent with previous descriptions of lymphangiosarcoma in animals [2, 3,[9][10][11]. The granular immunoreactivity for laminin around neoplastic vascular channels might indi- cate discontinuous basement membrane in agreement with ultrastructural finding. ...
A 12-year-old mixed-breed neutered female dog was referred with cutaneous tumors at the
left auricle. Histologically, the cutaneous tumor located in the dermis comprised numerous
clefts and cavernous channels lined by neoplastic endothelial cells with no erythrocytes.
Bone tissue without direct contact with neoplastic cells was seen in the well-developed
stromal connective tissue. The neoplastic endothelial cells exhibited mild to moderate
atypia. Immunohistochemically, neoplastic cells were positive for vimentin and negative
for cytokeratin and factor VIII-related antigen. Basement membrane around the neoplastic
lumens was positive for laminin in a linear or granular pattern. Ultrastructural
examination revealed discontinuous basement membrane beneath the tumor cells.
Histopathological features of this case were consistent with lymphangiosarcoma, and
stromal ossification was characteristic.
... The characteristic normal histological lymphatic phenotype has been designated as staining negative for PAL-E (vesicular component in blood vessel endothelium), PECAM, CD34, basement membrane components laminin and Type IV collagen and von Willebrand's factor (vWf or factor VIII-related antigen), and positive for VEGFR-3, alkaline phosphatase, 5'endonuclease, podoplanin, junctional protein desmoplakin, LYVE-1 (a homologue of the hyaluronan receptor CD44) 33 , vimentin 26 and proliferating cell nuclear antigen (PCNA) 26 . However, these staining characteristics may vary with species, vessel calibre, stage of embryonal development, level of gene expression and a variety of physiological as well as pathological conditions, such as neoplasia 33 . ...
... The characteristic normal histological lymphatic phenotype has been designated as staining negative for PAL-E (vesicular component in blood vessel endothelium), PECAM, CD34, basement membrane components laminin and Type IV collagen and von Willebrand's factor (vWf or factor VIII-related antigen), and positive for VEGFR-3, alkaline phosphatase, 5'endonuclease, podoplanin, junctional protein desmoplakin, LYVE-1 (a homologue of the hyaluronan receptor CD44) 33 , vimentin 26 and proliferating cell nuclear antigen (PCNA) 26 . However, these staining characteristics may vary with species, vessel calibre, stage of embryonal development, level of gene expression and a variety of physiological as well as pathological conditions, such as neoplasia 33 . ...
... Endothelial expression of glycoconjugates has been studied in normal human vascular and lymphatic endothelium, normal dog vascular endothelium, human and canine haemangiosarcoma 5 , a canine lymphangiosarcoma using only UEA-1 and Arachis hypogaea (PNA) 26 (neither vascular endothelium nor LAS cells were positive for UEA-1, but vascular endothelium picked up PNA), and a canine lymphangiosarcoma using 20 lectins to compare differences in phenotypic characteristics with 4 canine haemangiosarcomas 5 . In the latter study, only the lymphangiosarcoma stained with Con A, UEA-1, PNA, RCA-1 and sWGA, whereas PHA-E only stained the haemangiosarcomas. ...
Lymphangiosarcoma in dogs, an extremely rare tumour with only 16 cases reported in the literature, is reviewed. Lymphangiosarcoma in humans, also very rare, and known in post-mastectomy, chronically-lymphoedematous patients as 'Stewart-Treves' syndrome, is briefly outlined, as well as the various other causes of lymphoedema, both primary and secondary, which usually precede malignancy. Comparisons between human and canine lymphoedema are made when such references were found. The genetic links to primary lymphoedema and the manifestation thereof in humans are mentioned. Lymphangiosarcoma in the majority of human and canine patients is an aggressively malignant tumour with few patients surviving despite various attempted treatments. The tumour most commonly arises in the subcutaneous tissues and rapidly invades underlying tissues and may spread widely internally via haematogenous and lymphatic routes, with frequent pleural and chest involvement. The tumour has been reported mostly in medium- to large-breed dogs, in slightly more males than females, and in an age-range of 8 weeks to 13 years, with more cases aged 5 years and older. Methods of diagnosis, with the variations encountered, including routine histopathology, immunohistochemistry, electron microscopy, tissue culture characteristics and endothelial expression of glycocongugates, are discussed.
... 2 -16 Lymphangiosarcoma commonly presents in dogs as a subcutaneous mass or focal swelling. Lesions have been reported in the cervical region and thoracic inlet, 2,4,7 inguinal region, 3,6,9,13,15,16 hind limb, 9,16 axillary region and forelimb, 1,3,12,14 thoracic cavity and mediastinum, 8,11,16 thoracic subcutis, 10 and retroperitoneal space with vaginal prolapse. 5 Most reported cases occurred in large breed dogs including a Giant Schnauzer, 16 Standard Poodle, 10 Bouvier des Flandres, 9 Golden Retriever, 8 Doberman Pinscher, 6,14 pointer, 3 Chow Chow, 3 Bullmastiff, 5 Siberian husky, 2 Boxer, 15 and Chesapeake Bay retriever, 7 and one occurred in a Toy Poodle. ...
... Lesions have been reported in the cervical region and thoracic inlet, 2,4,7 inguinal region, 3,6,9,13,15,16 hind limb, 9,16 axillary region and forelimb, 1,3,12,14 thoracic cavity and mediastinum, 8,11,16 thoracic subcutis, 10 and retroperitoneal space with vaginal prolapse. 5 Most reported cases occurred in large breed dogs including a Giant Schnauzer, 16 Standard Poodle, 10 Bouvier des Flandres, 9 Golden Retriever, 8 Doberman Pinscher, 6,14 pointer, 3 Chow Chow, 3 Bullmastiff, 5 Siberian husky, 2 Boxer, 15 and Chesapeake Bay retriever, 7 and one occurred in a Toy Poodle. 11 Most cases had a short clinical course once a diagnosis was made, 3 -5,8,13,14 and commonly had evidence of metastasis at the time of diagnosis. ...
Lymphangiosarcoma (LAS) is an uncommon malignant neoplasia arising from lymphatic endothelium; little information exists regarding therapy. Single institutional retrospective review for canine LAS histopathology diagnoses over a 15-year period yielded 12 dogs. Ten dogs were presented for a mass and/or swelling at cervical, trunk or limb regions. Prior to diagnosis, 10 dogs received empiric wound therapy. Cytology performed in 10 consisted of mild inflammation. Survival ranged from 60, 168 and 876 days for three dogs with palliation; 90 days with prednisone in one; 182 days with chemotherapy in one; 240, 267, 487, 630 and 941 days for five receiving surgery; and 574 days for one receiving surgery, radiation and chemotherapy. One dog is alive with recurrence at 243 days following surgery and carboplatin chemotherapy. Clinical improvement existed in LAS dogs receiving multimodal therapies. Early tissue biopsies are recommended for progressive oedematous lesions of unknown origin.
... In dogs and cats, lymphangiosarcoma is regularly associated with extensive edema and drainage of lymph through the skin or a cystic mass located on head [16,17], neck [16,18], cranial trunk [16,19], mammary region [20,21], axilla [22], inguinal area [12,13,[23][24][25][26][27], and extremities [11,12,26,[28][29][30], but has been reported to primarily arise from the mediastinum [31,32], pleura [33,34], retroperitoneum [35,36], and omentum [31]. Although a true sex predilection has yet to be confirmed within the veterinary literature, a recent retrospective study found that 75% of canines presenting with lymphangiosarcoma were spayed females [10]. ...
Abdominal ultrasonographical and computed tomography examinations of a 12-year-old neutered female toy poodle revealed a protruding mass, approximately 2 cm in diameter, at the apex of the bladder. The mass was firm and haemorrhagic with a homogeneously brownish–yellow cut surface. Microscopically, it was unencapsulated and located in the muscle layer with invasion of the extra-muscular layer. It was composed of spindloid to oval neoplastic cells that formed irregular clefts and diffuse sheets that dissected bundles of collagen. Immunohistochemically, the neoplastic cells were positive for vimentin and lymphatic vessel endothelial hyaluronan receptor 1 antigens, but negative for cytokeratin AE1/AE3, factor VIII-related antigen, CD31, CD34, Prox-1, S100, desmin, α-smooth muscle actin and MyoD1. Negative immunolabelling for laminin antigen supported the absence of evidence of a basal lamina on ultrastructural examination. Based on these findings, this tumour was identified as a lymphangiosarcoma. To the best of our knowledge, this case is the first report of lymphangiosarcoma arising from the bladder in a dog.
Lymphangiosarcoma was described in a 2-year-old male Miniature Poodle. A 5 cm by 3 cm slightly elevated tan ventral abdominal mass was surgically removed with a wide margin and submitted for diagnosis. The mass has being grown rapidly during the last six months. On histopathology, the mass was composed of anastomosing channels or empty spaces which were free of red blood cells and lined by flat to plump pleomorphic neoplastic cells. The neoplastic channels or spaces were invasive into the surrounding fat and muscle tissues. Mild perivascular lymphocytic infiltration was also noted. Immunohistochemically, the neoplastic cells were positive to vimentin and Factor VIII. Based on histopathology and immunohistochemistry, the tumor was diagnosed as lymphangiosarcoma. Recurrence or metastasis was not noted so far after surgery.
Diagnosis is often the most challenging part of dermatology. Diagnostic dermatology melds both clinical and histopathologic diagnosis by correlating the clinical and microscopic features of skin disease. This book is a heavily illustrated comprehensive overview of clinical dermatology and dermatopathology that will provide the reader with the tools to accurately diagnose skin disease in the dog and cat. The book will prove an indispensable reference for veterinary dermatologists, diagnostic pathologists, and small animal practitioners who seek to improve their skill in diagnostic dermatology. Completely revised second edition, with many new disease descriptions. Now with colour clinical photographs illustrating all of the non-neoplastic skin diseases (previous edition had black and white photographs only). Written by internationally renowned experts, it provides a comprehensive overview of clinical dermatology and dermatopathology for all those interested in skin diseases of dogs and cats.
A 7-year-old, 153.0-kg American Miniature mare presented for evaluation of keratoconjunctivitis of the right eye (OD). A superior palpebral conjunctival mass and stromal keratitis were diagnosed. The incisional biopsy diagnosis was a presumptive corneal hemangiosarcoma. Transpalpebral enucleation was performed, and histopathologic evaluation confirmed angiosarcoma of the conjunctiva, cornea, and extraocular muscles. The horse developed progressive epistaxis and orbital swelling following surgery. A systemic workup was performed 3 months after enucleation, revealing regrowth within the orbit and marked cranial cervical lymphomegaly, suggestive of metastasis. Humane euthanasia was performed, and necropsy confirmed a locally invasive periorbital tumor with metastasis to the submandibular tissue, submandibular lymph node, and thoracic inlet. Histopathologic evaluation of necropsy specimens revealed polygonal to spindle neoplastic cells lining neoplastic vascular channels lacking erythrocytes. Immunohistochemically, the neoplastic cells labeled strongly positive for PROX-1, vimentin, CD-31, VEGF, weakly positive for factor VIII-related antigen, and negative for collagen IV. Based on the clinical, histological, and immunohistochemical features of this tumor, a primary ocular lymphangiosarcoma with metastasis was diagnosed.
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