Journal of Veterinary Diagnostic Investigation

http://vdi.sagepub.com/ Intrapericardial Neoplasia in Dogs

C. Girard, P. Hlie and M. Odin J VET Diagn Invest 1999 11: 73 DOI: 10.1177/104063879901100112 The online version of this article can be found at: http://vdi.sagepub.com/content/11/1/73

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J Vet Diagn Invest 11:7378 (1999)

Intrapericardial neoplasia in dogs

C. Girard, P. Helie, M. Odin
Abstract. A retrospective study was conducted from 1,919 necropsies of dogs, and 52 cases were selected on the basis of primary or metastatic neoplasia in the pericardium, the heart base, or the myocardium. Primary intrapericardial neoplasms were more frequent than intrapericardial metastases. Hemangiosarcomas were the most frequent primary neoplasms, followed by chemodectomas. Lymphomas were the most frequent metastatic neoplasms, followed by brosarcomas and rhabdomyosarcomas. Other neoplasms, either primary or metastatic, occurred rarely.

Neoplasms affecting the pericardium, the heart base or the myocardium are infrequent in the dog, representing only a small proportion of necropsy cases.6,27 Hemangiosarcomas4,13,27 and chemodectomas2,4,27,28 are the most frequently observed. Other mesenchymal and epithelial tumors have been sporadically reported.1,4,7,8,11,12,14,15,17,18,20,23,2527 Ratios of primary intrapericardial versus metastatic neoplasms and of metastatic mesenchymatous versus epithelial neoplasms are unknown. A 6-year retrospective study was done to determine the incidence of primary or metastatic intrapericardial neoplasia in the dog. The relative frequency of primary versus metastatic and metastatic mesenchymatous versus epithelial neoplasms affecting the pericardium, the heart base, and the pericardium were also investigated. Materials and methods
Selection of cases. Necropsies were performed on 1,919 dogs over a 6-yr period (January 1990 to December 1995) at the Faculty of Veterinary Medicine, University of Montreal. Neoplasms were diagnosed in 184 cases, and 52 of these were selected for study based on their intrapericardial localization. Light microscopy. Tissues were xed in buffered 10% formalin, embedded in parafn, sectioned at 5 m, and stained with hematoxylin, phloxin, and saffron (HPS). Giemsa, periodic acidSchiff, phosphotungstic acidhematoxylin, Gridleys reticulin and/or Grimelius stains were used on selected sections. Immunoperoxidase. Monoclonal antibodiesa were used to detect the presence of desmin, vimentin, alpha-smooth muscle actin (SMA), myoglobin, and cytokeratin and polyclonal antibodies were used for calcitonin, thyroglobulin, muramidase, alpha-1 antitrypsin, kappa-lambda light chains,a and factor VIII-related antigenb on selected neoplasms to conrm the diagnosis. Sections were cut at 5 m and mounted on
From the Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, PQ J2S, Canada (Girard, Helie), and BioResearch Laboratories, Senneville, PQ, Canada (Odin). Received for publication May 14, 1997.
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slides precoated with poly-D-lysine. Sections were stained by the avidinbiotin complex method using standard reagents.c Sections were deparafnized in successive xylene immersions, dehydrated through graded ethanols, and rehydrated in distilled water. Endogenous peroxidase activity was blocked with 3% hydrogen peroxide diluted in methanol. Sections were incubated overnight at 4 C with appropriate primary antibody in a humidied chamber, followed by incubation at room temperature in a humidied chamber with appropriate biotinylated antibodies. Sections were then covered with freshly prepared avidinbiotinperoxidase solution. Except for the background staining reduction step, all incubation steps were followed by washes in phosphate-buffered saline. Aminoethylcarbazoleb was used as chromogen, and sections were counterstained with Mayers hematoxylin.d

Results Primary or metastatic intrapericardial neoplasia was diagnosed in 52 dogs (22 females and 30 males), representing 2.7% of canine cases submitted for necropsy and 28.3% of all canine neoplasms diagnosed over the 6-year period. The age range of dogs with intrapericardial neoplasia was 217 years, with an average of 9.8 years. Primary intrapericardial neoplasms. Primary intrapericardial neoplasms were observed in 34 dogs (Table 1). Hemangiosarcomas were the most frequent, representing 40.4% of intrapericardial neoplasms. Fifteen neoplasms involved the right auricular epicardium, 3 were within the right auricular wall, and 3 protruded into the auricular lumen. Metastases to the ventricles and/or left auricle were observed in 6 dogs at necropsy and in 3 additional dogs on microscopic examination. Extrapericardial metastases were found in all but 1 dog. Nine chemodectomas were diagnosed, representing 17.3% of intrapericardial neoplasms (Table 1). Seven were between the pulmonary artery and ascending aorta, 1 was in the right auricular wall, and another protruded into the right auricular lumen. Metastases, either pulmonary or renal, were found in 2 dogs. Mi-

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Table 1.

Intrapericardial neoplasms in 52 dogs.

Primary neoplasms Hemangiosarcoma Chemodectoma Rhabdomyoma Epithelial thymoma Ectopic thyroid carcinoma Mesothelioma Metastasic neoplasms Lymphoma Fibrosarcoma Rhabdomyosarcoma Disseminated malignant histiocytosis Melanoma Mastocytoma Phaeochromocytoma Adenocarcinoma Prostatic Gastric Pulmonary Mammary

21 9 1 1 1 1 6 2 2 1 1 1 1 1 1 1 1

croscopic examination revealed closely packed round to polyhedral cells, subdivided in lobules by a delicate brovascular stroma (Fig. 1a). Grimelius stain revealed intracytoplasmic argyrophilic granules in neoplastic cells (Fig. 1b). All tumors were negative for the presence of calcitonin. Less frequent primary intrapericardial neoplasms included rhabdomyoma, epithelial thymoma, ectopic thyroid carcinoma, and mesothelioma. Grossly, the rhabdomyoma was an inltrative soft, white mass bulging into the right auricular lumen (Fig. 2a). Histologically, the neoplasm was composed of intertwined bundles of elongated cells inltrating the right auricle (Fig. 2b). Vimentin, desmin, and myoglobin were demonstrated in neoplastic cells and surrounding cardiocytes. SMA was not found in neoplastic cells or in normal cardiocytes. The epithelial thymoma was an approximately 5cm-diameter mass that partially surrounded the aorta at the heart base. Numerous small, white papillary masses were observed on the epicardium. Masses corresponded histologically to trabeculae and islets of neoplastic dyskeratotic epithelial cells. Cytokeratin was demonstrated in neoplastic cells. The mesothelioma consisted of a hard, brownish 54- 3-cm epicardial mass on the right ventricle and a spherical reddish 2.5-cm-diameter mass on the parietal surface of the pericardium, near the heart base. Neoplastic cells were positive for cytokeratin and vimentin and negative for factor VIII-related antigen (Fig. 3). The ectopic thyroid carcinoma was composed of 3 well-delineated, lobulated, yellow to red 1.52.5-cmdiameter masses at the heart base. One mass was cystic and contained a thick opaque material. Neoplastic cells were faintly positive for thyroglobulin and calcitonin.

Figure 1. Chemodectoma in an 11-year-old English bull mastiff. a. The mass is subdivided by a thin brovascular stroma. Cells are polyhedral with a nely granular cytoplasm. HPS stain. b. Presence of intracytoplasmic, agyrophilic granules. Grimelius stain.

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Figure 2. Rhabdomyoma in a 2-year-old crossbred dog. a. The lumen of the right auricle is lled with a soft white mass. b. The mass is composed of elongated cells, without evidence of crossstriation. HPS stain.

Figure 3. Pericardial mesothelioma in an 11-year-old German shepherd dog. Immunoperoxidase is positive for cytokeratin (a) in neoplastic cells and faintly positive for vimentin (b).

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Figure 5. Metastatic rhabdomyosarcoma in an 6-year-old chow chow. Masses of poorly differentiated neoplastic cells compress and inltrate adjacent structures. HPS stain.

Figure 4. Metastatic brosarcoma in an 13-year-old Bernese mountain dog. a. The neoplasm is inltrative, with compression atrophy of the cardiomyocytes (arrow). HPS stain. b. Immunoperoxidase for desmin. Neoplastic cells are negative and cardiocytes are positive.

Intrapericardial metastases. Intrapericardial metastases from several neoplasms occurred in 18 dogs (Table 1). Six lymphomas inltrated the intrapericardial tissues. Four inltrated the ventricles, 2 were localized at the heart base, and 1 was on the pericardial sac. Exophytic, whitish hard masses protruded into the lumen of the pulmonary artery in 1 dog. Two brosarcomas, 1 subcutaneous and 1 gingival, metastasized to the heart. Metastases corresponded to multiple hard, whitish nodules 110 mm in diameter on the epicardium of ventricles and right auricle in 1 dog. Fusiform neoplastic cells caused compression atrophy of the cardiocytes (Fig. 4a). Neoplastic cells were positive for vimentin but negative for desmin and myoglobin (Fig. 4b). Single or multiple cardiac metastases from 2 rhabdomyosarcomas were found in the endocardium and/ or the wall of all 4 compartments. Masses were white, rm, and 12 cm in diameter. The neoplastic cells were fusiform and poorly differentiated (Fig. 5). They were positive for vimentin and desmin and faintly positive or negative for the presence of myoglobin. In one case of disseminated malignant histiocytosis,

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neoplastic cells inltrated the heart (Table 1). A whit23-cm-diameter mass was found in the ish 2pericardium. A 3-mm-diameter white mass was found in the interventricular septum. Small polygonal, round or fusiform cells with scant eosinophilic cytoplasm and a round to reniform nucleus inltrated the pericardium and the ventricular septum. Rare phagocytic multinucleated giant cells were also present. Neoplastic cells were positive for vimentin, muramidase, and alpha-1 antitrypsin. Metastases from a primary melanocytic ocular melanoma were found in the heart as whitish foci in the wall of the right ventricle. Multiple white, rm subepicardial, subendocardial, intraauricular, and intraventricular metastases from a systemic mast cell tumor were observed. The primary mass was not identied. Neoplastic cells contained metachromatic cytoplasmic granules and were found in subepicardial and subendocardial locations, occasionally inltrating subjacent myocardium. Cardiac metastases from a phaeochromocytoma were found in 1 dog and corresponded to whitish nodules from 0.5 mm to 3 cm in diameter on the epicardium and endocardium. The cytoplasm of neoplastic cells contained numerous argyrophilic granules. Metastases from prostatic, gastric, pulmonary, or mammary adenocarcinomas were observed in 1 dog each. Discussion In this retrospective study, intrapericardial neoplasia, either primary or metastatic, was uncommon in dogs, representing only 2.7% of the cases submitted for necropsy. However, 28.3% of all neoplasms diagnosed for this period involved intrapericardial tissues. In a similar retrospective study, percentages were 3.06% and 11.74%, respectively.27 Primary intrapericardial neoplasms were more frequent than metastases from extrapericardial neoplasms. Hemangiosarcomas were the most frequent intrapericardial neoplasms as reported previously and represented 40% of the cases in this study but 60% in another study.27 Cardiac localization of hemangiosarcoma was frequent and accounted for 75% of the hemangiosarcomas diagnosed at the Faculty of Veterinary Medicine of the University of Montreal. Previous studies reported cardiac localization in 2964% of the cases of hemangiosarcomas.4,9,19 It was not always possible to distinguish between primary right auricular hemangiosarcomas and metastatic hemangiosarcomas. Chemodectomas were the second most frequent intrapericardial primary neoplasms, as already reported,27 and were similar in location and histologic appearance to previous cases.21,28 They were slightly more frequent in our study than in other similar stud-

ies.27 Argyrophilia, as demonstrated by the Grimelius stain and absence of calcitonin immunoreactivity, conrmed the diagnosis.2,21,27 Primary intrapericardial sarcomas, excluding hemangiosarcoma, were not observed in this study. Only individual cases of such tumors have been previously reported,1,7,8,15,17,23,2527 reecting their rare occurrence. Intrapericardial metastases from extrapericardial neoplasms accounted for 35% of our cases; they were more frequent than previously reported.4,6,27 Malignant lymphomas were the most common secondary neoplasm and were third in occurrence after hemangiosarcomas and chemodectomas. Carcinomas were more frequently observed than malignant lymphomas in a similar retrospective study.27 Metastases were more commonly localized in ventricular walls than in auricular walls, which may be correlated with the bigger size of the ventricular arteries.3 Neoplasms at the heart base were chemodectomas or ectopic parathyroid or thyroid gland carcinomas.10,16,22,24 Lymphomas or epithelial thymomas were also identied in this location. Intracavitary heart neoplasms were hemangiosarcomas, chemodectomas, or rhabdomyomas. Immunoperoxidase was a useful technique for the diagnosis of primary or secondary intrapericardial neoplasms in the dog. This technique permits differention of chemodectomas from medullary thyroid carcinomas,22 and brosarcomas from poorly differentiated rhabdomyosarcomas. Acknowledgements
We thank Drs. Richard Drolet, Andre Lagace, Michel Morin, Rene Sauvageau, and Ernest Teuscher for the diag nosis of the cases and Jacinthe Cardin, Jules Deslandes, Jacques Lagace, Line Pepin, and Bibianne Pepin-Faille for technical help. This work was supported by Le Fonds du Centenaire, Faculte de Medecine Veterinaire de lUniversite de Montreal, St-Hyacinthe, Quebec, Canada.

Sources and manufacturers

a. b. c. d. BioGenex Laboratories, San Ramon, CA. Immunon, Pittsburgh, PA. Vectastain ABC kit, Vector Laboratories, Burlingame, CA. Sigma Diagnostics, St. Louis, MO.

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