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Correlation of ultrasonographic appearance of lesions and cytologic and histologic diagnoses in splenic aspirates from dogs and cats: 32 cases (2002–2005)

Elizabeth A. BallegeerDepartments of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Lisa J. ForrestDepartments of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Ryan M. DickinsonPathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Melissa M. SchuttenPathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Fern A. DelaneyDepartments of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Karen M. YoungPathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Abstract

Objective—To determine the accuracy of cytologic diagnosis, compared with histologic diagnosis, in determination of disease in ultrasound-guided fine-needle aspirates of splenic lesions.

Design—Retrospective study.

Sample Population—Splenic specimens from 29 dogs and 3 cats.

Procedures—Records were searched for dogs and cats that had undergone ultrasound-guided splenic aspiration. Criteria for inclusion were ultrasonographic identification of splenic lesions and cytologic and histologic evaluation of tissue from the same lesion. Cytologic samples were obtained by fine-needle aspiration, and histologic specimens were obtained via surgical biopsy, ultrasound-guided biopsy, or necropsy.

Results—Cytologic diagnoses corresponded with histologic diagnoses in 19 of 31 (61.3%) cases and differed in 5 of 31(16.1%) cases, and 1 aspirate was inadequate for evaluation. In 7 of 31 (22.6%) cases, histologic evaluation of tissue architecture was required to distinguish between reactive and neoplastic conditions. On the basis of histologic diagnosis in 14 animals with nonneoplastic conditions, the cytologic diagnosis was correct in 11 cases, not definitive in 2 cases, and incorrect in 1 case. In 17 animals with malignant neoplastic diseases, the cytologic diagnosis was correct in 8 cases, not definitive but consistent with possible neoplasia in 5 cases, and incorrect in 4 cases. Multiple similar-appearing nodules were significantly associated with malignancy, whereas single lesions were more often benign.

Conclusions and Clinical Relevance—Ultrasound-guided aspiration of splenic lesions is a minimally invasive tool for obtaining specimens for cytologic evaluation. Although cytologic diagnoses often reflect histologic results, if missampling or incomplete sampling occurs or tissue architecture is required to distinguish between reactive and neoplastic conditions, accurate diagnosis with fine-needle aspiration may not be possible.

Abstract

Objective—To determine the accuracy of cytologic diagnosis, compared with histologic diagnosis, in determination of disease in ultrasound-guided fine-needle aspirates of splenic lesions.

Design—Retrospective study.

Sample Population—Splenic specimens from 29 dogs and 3 cats.

Procedures—Records were searched for dogs and cats that had undergone ultrasound-guided splenic aspiration. Criteria for inclusion were ultrasonographic identification of splenic lesions and cytologic and histologic evaluation of tissue from the same lesion. Cytologic samples were obtained by fine-needle aspiration, and histologic specimens were obtained via surgical biopsy, ultrasound-guided biopsy, or necropsy.

Results—Cytologic diagnoses corresponded with histologic diagnoses in 19 of 31 (61.3%) cases and differed in 5 of 31(16.1%) cases, and 1 aspirate was inadequate for evaluation. In 7 of 31 (22.6%) cases, histologic evaluation of tissue architecture was required to distinguish between reactive and neoplastic conditions. On the basis of histologic diagnosis in 14 animals with nonneoplastic conditions, the cytologic diagnosis was correct in 11 cases, not definitive in 2 cases, and incorrect in 1 case. In 17 animals with malignant neoplastic diseases, the cytologic diagnosis was correct in 8 cases, not definitive but consistent with possible neoplasia in 5 cases, and incorrect in 4 cases. Multiple similar-appearing nodules were significantly associated with malignancy, whereas single lesions were more often benign.

Conclusions and Clinical Relevance—Ultrasound-guided aspiration of splenic lesions is a minimally invasive tool for obtaining specimens for cytologic evaluation. Although cytologic diagnoses often reflect histologic results, if missampling or incomplete sampling occurs or tissue architecture is required to distinguish between reactive and neoplastic conditions, accurate diagnosis with fine-needle aspiration may not be possible.

Contributor Notes

Dr. Ballegeer's present address is Veterinary Specialty Center of Texas, 115 E Old Settlers Blvd, Round Rock, TX 78664.

Presented at the Annual American College of Veterinary Radiology Conference, Chicago, November 2005.

The authors thank Dr. Randi Drees for assistance with translation of German articles and Dr. Mark Markel for assistance with statistical analysis.

Address correspondence to Dr. Ballegeer.