Case of the Week: Llywelyn

Case of the Week: Llywelyn

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Case History

A 12-year old, M/N, Welsh Corgie named Llywelyn (“Lou”) presented to a neurologist for further evaluation of hindlimb ataxia of 1 to 2 months duration. T-L spine MRI performed, hemilamenctomy performed. History of mass on abdominal wall. FNA of abdominal mass was submitted.

Scopio Practice Tip

This case is a nice example of using the multiple region of interest (multi-ROI) feature to scan a thick sample that also has areas of uneven staining. The very thick blue areas and understained pink areas are difficult to visualize microscopically (via both digital scanners and traditional microscopes). It is helpful to have adjacent cellularity where there are areas of monolayer that are well stained with preserved cytomorphology. Creating more than one ROI for an area of interest also tends to decrease total scan time while increasing scan quality!

Webcam images with user chosen scan area denoted by thin green line.

Microscopic Features

Mesenchymal cells with atypia, pink matrix, and mitotic figure.

Interpretation: Probable sarcoma.

Case follow up: The mass was an incidental finding and Lou had surgery to repair a disc herniation, with plans to remove and biopsy the abdominal mass following recovery.

Why “probable” sarcoma? Proliferation and atypia of mesenchymal cells can be tricky. Reactive fibroplasia (granulation tissue, scirrhous responses) can cytologically mimic sarcomas. Biopsy is often recommended to confirm malignancy and complete lesion composition prior to aggressive interventions.

Case of the Week patient information has been altered for client confidentiality.

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