Splenic tumors

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Macroscopic view of a canine splenic sarcoma[1]

Splenic tumors are a common neoplasms of the canine spleen, the majority being differentiated or undifferentiated sarcomas or histiocytomas.

These tumors may originate as primary splenic tumors or as secondary manifestations of primary neoplasms in other organs or as systemic disease (e.g. lymphoma, dendritic-cell leukemia[2]).

Variant forms include:

Clinical signs in affected dogs are usually nonspecific and include a palpable abdominal mass, weight loss, polydipsia, lethargy and vomiting[16].

Secondary paraneoplastic symptoms may be evident such as pemphigus[17], immune-mediated hemolytic anemia[18], hypoalbuminemia and regenerative anemia[19].

Abdominal aspiration may reveal hemoperitoneum and peritonitis[20].

A presumptive diagnosis is frequently established on clinical history, chest radiographs, echocardiogram, CT scans[21] and abdominal ultrasonography[22]. An ultrasound-guided fine needle aspiration of the splenic mass will assist in establishing a conclusive diagnosis[23].

Histological examination is usually required for a definitive diagnosis, and in most cases, tissue samples are obtained during exploratory laparotomy.

A differential diagnosis would include splenic contracture post-anesthesia, splenic hematoma, mast cell tumor[24], splenitis and secondary lymphoma[25], mast cell tumor and hemangiosarcoma[26].

Prognosis is dependent upon the type of sarcoma, but splenectomy may improve survival rates if metastasis has not occurred[27]. Adjuvant chemotherapy with low-dose doxorubicin has shown promise with splenic hemangiosarcoma[28].

Hemangiosarcomas, which are the most frequently diagnosed, are often benign in dogs.

A rare complications of splenectomy in these cases is gastric dilatation-volvulus in large-breed dogs[29].

References

  1. Tufts University
  2. Allison RW et al (2008) Dendritic cell leukemia in a Golden Retriever. Vet Clin Pathol 37(2):190-197
  3. Gázquez A et al (2012) Widespread epithelioid angiosarcoma with ventricular wall involvement in a dog. Histol Histopathol 27(7):865-872
  4. Spangler WL et al (1994) Primary mesenchymal (nonangiomatous/nonlymphomatous) neoplasms occurring in the canine spleen: anatomic classification, immunohistochemistry, and mitotic activity correlated with patient survival. Vet Pathol 31(1):37-47
  5. Rossetto A et al (2011) Mesenchymal chondrosarcoma of the spleen: report of a case. Tumori 97(4):e10-15
  6. Cole PA (2012) Association of canine splenic hemangiosarcomas and hematomas with nodular lymphoid hyperplasia or siderotic nodules. J Vet Diagn Invest 24(4):759-762
  7. Boston SE et al (2011) Concurrent splenic and right atrial mass at presentation in dogs with HSA: a retrospective study. J Am Anim Hosp Assoc 47(5):336-341
  8. Day MJ et al (1995) A review of pathological diagnoses made from 87 canine splenic biopsies. J Small Anim Pract 36(10):426-433
  9. Moore AS et al (2012) Histologic and immunohistochemical review of splenic fibrohistiocytic nodules in dogs. J Vet Intern Med 26(5):1164-1168
  10. Moore PF et al (2006) Canine hemophagocytic histiocytic sarcoma: a proliferative disorder of CD11d+ macrophages. Vet Pathol 43(5):632-645
  11. Yearley JH et al (2007) Phagocytic plasmacytoma in a dog. Vet Clin Pathol 36(3):293-296
  12. Constantino-Casas F et al (2011) The clinical presentation and histopathologic-immunohistochemical classification of histiocytic sarcomas in the Flat Coated Retriever. Vet Pathol 48(3):764-771
  13. Rossi S et al (2009) Disseminated histiocytic sarcoma with peripheral blood involvement in a Bernese Mountain dog. Vet Clin Pathol 38(1):126-130
  14. Wang FI et al (2005) Disseminated liposarcoma in a dog. J Vet Diagn Invest 17(3):291-294
  15. Goldschmidt MH & Hendrick MJ (2002) Tumors of the skin and soft tissues. In: Tumors in domestic animals, ed. Meuten DJ, pp:45–117. Iowa State University Press, Ames, IA
  16. Weinstein MJ et al (1989) Nonangiogenic and nonlymphomatous sarcomas of the canine spleen: 57 cases (1975-1987). J Am Vet Med Assoc 195(6):784-788
  17. Elmore SA et al (2005) Paraneoplastic pemphigus in a dog with splenic sarcoma. Vet Pathol 42(1):88-91
  18. Mellanby RJ et al (2004) Immune-mediated haemolytic anaemia associated with a sarcoma in a flat-coated retriever. J Small Anim Pract 45(1):21-24
  19. Soare T et al (2012) Paraneoplastic syndrome in haemophagocytic histiocytic sarcoma in a dog. J Comp Pathol 146(2-3):168-174
  20. Ramirez O & Bliss S (1999) What is your diagnosis? Primary splenic tumor and suppurative peritonitis due to gallbladder rupture. J Am Vet Med Assoc 214(5):625-626
  21. Fife WD et al (2004) Comparison between malignant and nonmalignant splenic masses in dogs using contrast-enhanced computed tomography. Vet Radiol Ultrasound 45(4):289-297
  22. Ivancić M et al (2009) Contrast harmonic ultrasonography of splenic masses and associated liver nodules in dogs. J Am Vet Med Assoc 234(1):88-94
  23. Stefanello D et al (2009) Ultrasound-guided cytology of spleen and liver: a prognostic tool in canine cutaneous mast cell tumor. J Vet Intern Med 23(5):1051-1057
  24. Book AP et al (2011) Correlation of ultrasound findings, liver and spleen cytology, and prognosis in the clinical staging of high metastatic risk canine mast cell tumors. Vet Radiol Ultrasound 52(5):548-554
  25. Eberle N et al (2012) Splenic masses in dogs. Part 1: Epidemiologic, clinical characteristics as well as histopathologic diagnosis in 249 cases (2000-2011). Tierarztl Prax Ausg K Kleintiere Heimtiere 40(4):250-260
  26. Rossi F et al (2013) Metastatic cancer of unknown primary in 21 dogs. Vet Comp Oncol Jan 7
  27. Collard F et al (2010) Laparoscopic splenectomy for treatment of splenic hemangiosarcoma in a dog. Vet Surg 39(7):870-872
  28. Lana S et al (2007) Continuous low-dose oral chemotherapy for adjuvant therapy of splenic hemangiosarcoma in dogs. J Vet Intern Med 21(4):764-769
  29. Marconato L (2006) Gastric dilatation-volvulus as complication after surgical removal of a splenic haemangiosarcoma in a dog. J Vet Med A Physiol Pathol Clin Med 53(7):371-374