Faecal Occult Blood Test

Case of the Month (Emma Scurrell April 2011)

‘Lung-digit’ syndrome in a cat 

A 10-year-old DSH cat presented for a single swollen digit on the left foreleg. A fine needle aspirate was taken (fig.1) and following the results, the digit was amputated and submitted for histopathology (figs. 2&3).


 Fig 1. This is a fine needle aspirate specimen from the swollen digit (stained with modified Wrights-Giemsa) which reveals a cohesive cluster of pleomorphic neoplastic epithelial cells. These cells have a high N:C ratio and contain large nuclei (compare them to the size of the RBCs in the background) with prominent nucleoli. This is indicative of a carcinoma.


Fig 2. An H&E section of the skin overlying the amputated digit. The dermis is extensively infiltrated by nests and glandular acini of neoplastic epithelial cells which similarly infiltrate the underlying third phalanx associated with osteolysis. 

 

Fig 3 An H&E section of the neoplasm at higher magnification. This section is focused on a glandular structure which is lined by neoplastic pseudostratified columnar epithelium. Note that some of the columnar cells are ciliated (red arrow). The black arrows point to goblet cells which are characterised by intracytoplasmic basophilic mucinous material. 






Final Diagnosis

Metastatic adenocarcinoma to the digit 

Discussion

Adenocarcinomas affecting the digit of cats are not common but can either be primary (e.g. apocrine or eccrine origin) or metastatic. The morphological features of the neoplasm in this case including the presence of ciliated pseudostratified columnar epithelium (consistent with respiratory origin) and goblet cells are typical of metastatic disease. Primary pulmonary carcinomas are the most common neoplasms which can be associated with metastasis to the digits in cats. In some cases, multiple digits may be simultaneously affected and this should raise the suspicion of metastatic disease. Metastasis to the digits often occurs prior to the onset of clinical signs of respiratory disease however radiographs should confirm the presence of a pulmonary mass. 

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011




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Faecal Occult Blood Test