Stilwell Justin M, Rissi Daniel R
Athens Veterinary Diagnostic Laboratory and Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA.
J Vet Diagn Invest. 2019 Jan;31(1):122-127. doi: 10.1177/1040638718820949. Epub 2018 Dec 19.
A 7-y-old sow with a large mass in the right upper thoracic limb was submitted for autopsy. Grossly, the mass encompassed the right humerus, elbow, and proximal radius and ulna. On cut surface, the mass was solid, lobulated, pale tan, and firm, with multifocal areas of necrosis and mineralization; it replaced the brachial musculature, invading and causing extensive humeral and ulnar osteolysis. The periosteum was roughened and irregular, and there was minor invasion into the elbow joint. Histologically, the mass was composed of densely cellular interweaving streams and bundles of pleomorphic spindle cells embedded in a scant fibrovascular stroma. There was moderate-to-strong, diffuse cytoplasmic or membranous immunoreactivity to claudin-1, laminin, and vimentin; weak-to-moderate, multifocal cytoplasmic and nuclear immunoreactivity to S100 and Sox-10, respectively, and weak cytoplasmic immunoreactivity for neuron-specific enolase. No neoplastic immunolabeling was detected with CD204, CD18, desmin, glial fibrillary acidic protein, ionized calcium-binding adapter molecule 1, melan A, neurofilament, nerve growth factor receptor, smooth muscle actin, or muscle pan-actin. A specific immunomarker for definitive diagnosis of a malignant nerve sheath tumor (MNST) and its differentiation from other nerve tumors or other spindle cell tumors is still lacking in veterinary medicine, and case-by-case or interspecies differences in immunohistochemistry (IHC) expression can occur even when applying a broad diagnostic IHC panel. However, the gross, histologic, and IHC features in our case were consistent with a MNST, an exceedingly rare neoplasm of pigs.
一头7岁的母猪因右上肢上部有一巨大肿物而被送检进行尸检。大体上,肿物包绕右肱骨、肘关节以及桡骨和尺骨近端。在切面,肿物质地坚实,呈分叶状,浅棕褐色,质地硬,有多处坏死和矿化区域;它取代了肱部肌肉组织,侵犯并导致肱骨和尺骨广泛骨质溶解。骨膜粗糙且不规则,肘关节有轻微侵犯。组织学上,肿物由密集的细胞交织束和多形性梭形细胞束组成,包埋于少量纤维血管间质中。对闭合蛋白-1、层粘连蛋白和波形蛋白有中度至强的弥漫性细胞质或膜免疫反应;分别对S100和Sox-10有弱至中度的多灶性细胞质和核免疫反应,对神经元特异性烯醇化酶有弱细胞质免疫反应。未检测到CD204、CD18、结蛋白、胶质纤维酸性蛋白、离子钙结合衔接分子1、黑素A、神经丝、神经生长因子受体、平滑肌肌动蛋白或肌肉泛肌动蛋白的肿瘤免疫标记。在兽医学中,仍缺乏用于明确诊断恶性神经鞘瘤(MNST)及其与其他神经肿瘤或其他梭形细胞肿瘤鉴别的特异性免疫标记物,即使应用广泛的诊断性免疫组化(IHC)检测板,免疫组化(IHC)表达也可能存在个案差异或种间差异。然而,我们病例的大体、组织学和免疫组化特征与MNST相符,MNST是猪极罕见的一种肿瘤。