Concurrent thoracic mesothelioma and thyroid C-cell adenoma with amyloid deposition in an aged horse

Our plain-English summary of Concurrent thoracic mesothelioma and thyroid C-cell adenoma with amyloid deposition in an aged horse, by J.S. Fortin, A.B. Royal, K. Kuroki (Veterinary Medicine and Science, 2018).

The study

• Authors: J.S. Fortin, A.B. Royal, K. Kuroki
• Journal: Veterinary Medicine and Science
• Published: 2018;4(1):63-70
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A 21-year-old American Saddlebred mare died with a history of weight loss and breathing difficulties of 1 month duration. Post-mortem examination revealed a copious pleural effusion with multifocal to coalescing numerous white to grey nodular masses on the serosal surface of the pericardium, lungs and thoracic cavity. In addition, the left thyroid gland was markedly enlarged. A thoracic mesothelioma and C-cell adenoma with amyloid deposits of the left thyroid gland were diagnosed by histopathology and confirmed by immunohistochemistry employing antibodies against cytokeratin (CK), vimentin and calcitonin. Amyloid deposits in the thyroid tumour were confirmed by Congo red staining with apple-green birefringence under polarized light. Mesothelioma remains an uncommon neoplasm encountered in aged horses. Discussion includes the diagnostic challenge of differentiating carcinomatosis from mesothelioma by histology and differentiating reactive and neoplastic mesothelial cells by cytology.

In plain English

This article was a veterinary case report about one animal: a 21-year-old American Saddlebred mare that was found dead after a month of reduced eating, weight loss, breathing difficulty and fatigue. Her body was examined at the University of Missouri in November 2016. It was not a study of asbestos. The article does not report an asbestos-exposure history, and the authors noted that in horses, mesotheliomas are not known to be associated with asbestos exposure. At post-mortem, about 10 litres of fluid was found in the chest. Many white-grey nodules up to 2 cm across covered the pericardium, lungs and rib cage. Microscope and staining tests identified the chest tumour as an epithelioid mesothelioma with a mostly tubular pattern. The enlarged left thyroid held a C-cell adenoma, with no features of malignancy, that contained amyloid deposits. No spread to lymph nodes or internal organs was seen. The authors concluded that the horse died of cardiorespiratory failure from the fluid and the widespread chest tumour. They said the case highlights diagnostic challenges when tumour samples are examined.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single animal, post-mortem and laboratory examination)
• Who was studied: One 21-year-old, 546 kg American Saddlebred mare, examined after death at the Veterinary Medical Diagnostic Laboratory, University of Missouri, Columbia, Missouri, USA, in November 2016
• Exposure: No asbestos or other fiber exposure is reported for this horse. The history given was a prior diagnosis of recurrent airway obstruction ('heaves') treated with oral corticosteroids, a diet of senior feed and hay, and contact with other horses and an alpaca. In the discussion the authors stated that mesotheliomas in horses are not known to be associated with asbestos exposure.
• Main results:
  • About 10 litres of fluid was found in the horse's chest cavity
  • The surfaces of the pericardium, lung lobes and rib cage were covered with many white-grey nodules up to 2 cm in diameter
  • The chest tumour cells strongly expressed both pan-cytokeratin and vimentin, which supported a diagnosis of mesothelioma
  • The mesothelioma was of the epithelioid subtype, with a predominantly tubular pattern
  • The chest tumour cells tested negative for calcitonin, which argued against spread of the thyroid tumour to the chest
  • The left thyroid mass was a C-cell adenoma. Its cells stained positive for calcitonin, and material in the tumour stained positive with Congo red, confirming amyloid
  • No metastases to lymph nodes or internal organs were seen
  • The authors concluded that the horse died of cardiorespiratory failure caused by the fluid and the widespread chest mesothelioma
• The authors' conclusion: The authors concluded that concurrent tumours, a mesothelioma and a C-cell adenoma with amyloid deposits, occurred in an aged horse. They said the case highlights diagnostic challenges for clinicians and pathologists examining aspirated or fixed tumour samples.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Deposition, Autopsy, Pleural Effusion, Serosal Surface, Pericardium, Histopathology, Immunohistochemistry.

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