Case of the Week: Shamrock

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Case History

A 13-year old, female, Irish Terrier dog named Shamrock presented for 6 weeks of pelvic limb lameness, 3 weeks of softer feces. Polyuria/polydypsia (normal blood biochemistry and ionized calcium) Bilateral, symmetrical inguinal lymphadenopathy/mammary neoplasia.
FNA of a subcutaneous inguinal mass, possible mammary origin or lymph node, was submitted.

Microscopic Features

High cellularity sample with a neoplastic epithelial cell population.

Individual epithelial cells with rounded cytoplasmic inclusions, often appearing pink and displacing the nuclei.

Interpretation: Epithelial neoplasm; probable urothelial carcinoma (TCC).

What is unique about this case? This mass had no known association with the bladder, but when the clinical pathologist saw the cytoplasmic inclusions, a feature unique to urothelial cells, he was able to contact the clinician via Scopio’s chat feature to suggest imaging of the bladder and expedite clinical planning.

What are those inclusions? Melamed-Wolinska bodies are intracytoplasmic inclusions that can be seen in the urothelial/transitional cells that line the bladder, ureters, and urethra. These were first described in human urine sediment examination in 1961. The following reference provides a brief description, background, and images: Ayra P, Khalbuss WE, Monaco SE, Pantanowitz L. Melamed‐Wolinska bodies. Diagnostic Cytopathology, Vol 40, No 2., 2011.

What is urothelial carcinoma (TCC)? Transitional cell carcinoma, now commonly referred to as urothelial cell carcinoma, is a cancer originating from urothelial cells, often at the trigone of the bladder. Scottish Terriers have a known breed predisposition, but this tumor type can occur in any breed. Interestingly, UCC/TCC can metastasize to remote cutaneous sites. When this occurs, Melamed-Wolinska bodies give the pathologist an indication that there may be primary bladder tumor. Further information regarding transitional/urothelial cell carcinomas in dogs and humans can be found in this helpful online resource provided by Purdue’s Comparative Oncology Program.

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

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