Diagnostic efficacy of imaging and biopsy methods for peritoneal mesothelioma in a calf

Our plain-English summary of Diagnostic efficacy of imaging and biopsy methods for peritoneal mesothelioma in a calf, by Y. Morita, S. Sugiyama, T. Tsuka, et al (BMC Veterinary Research, 2019).

The study

• Authors: Y. Morita, S. Sugiyama, T. Tsuka, Y. Okamoto, T. Morita, Y. Sunden, T. Takeuchi
• Journal: BMC Veterinary Research
• Published: 2019;15(1):461
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Peritoneal mesothelioma is a rare abdominal disease; that occasionally occurs congenitally in younger calves. Cytologic examination of peritoneal effusion (PE) was utilized to diagnose this disease, and was not diagnostic. Diagnostic accuracy has been elevated by recent use of ultrasonography (US), despite most diagnoses have been obtained post-mortem in slaughter houses or during clinical necropsy. In humans, ante-mortem diagnosis is highly associated with clinical use of computed tomography (CT) and laparoscopy together with imaging-assisted biopsy. The present report evaluates the diagnostic applicability of CT and laparoscopy as well as US via the practical application of these imaging modalities in an affected calf, and compares the cytologic and histologic findings among in PE, and specimens obtained from fine-needle aspiration and core-needle biopsy. In addition, the present results were reviewed in comparison with those of previous bovine and human reports.

Case Presentation: A 58-day-old male Japanese black calf presented first with scrotal swelling, followed by progressive abdominal distention. Abnormalities of the case included: 1) accumulation of anechoic PE inside the swollen scrotum and abdomen; 2) formation of multiple echogenic nodules within the peritoneal membrane based on US images; 3) presence of hyper-dense spots (suspected calcification) along the margins of the nodules; 4) anatomic connections between intra-abdominal nodular lesions and the swollen tunica vaginalis via the inguinal region based on CT images; 5) serosanguineous-colored and less-turbid characteristics of PE; and 6) formation of multiple nodules over all of the serosa of the rumen as well as the peritoneal wall based on laparoscopic views. Fine-needle aspiration and core-needle biopsy were successfully performed under US and laparoscopic observations, respectively. Histology findings of the core-needle biopsy specimen appeared more indicative (characterization of tubular structures comprised of cubical or columnar abnormal mesothelial cell linings) diagnostically of peritoneal mesothelioma than did findings of the fine-needle aspiration specimen.

Conclusions: To the best of our knowledge, this report is the first description of clinical applications of CT and laparoscopy to diagnose peritoneal mesothelioma in a calf. Laparoscopy enhanced the diagnostic accuracy due to clear gross visualization of the intra-abdominal abnormalities and applicability to imaging-guided core-needle biopsy.

In plain English

This case report described a 58-day-old male Japanese black calf whose scrotum swelled, followed by progressive swelling of the abdomen. The article does not mention asbestos or any other exposure. The authors examined the calf by ultrasound, computed tomography (CT) and laparoscopy. They compared abdominal fluid, fine-needle aspiration and core-needle biopsy samples. Ultrasound showed fluid in the scrotum and abdomen and multiple nodules arising from the abdominal lining. CT showed nodules connected to the swollen tissue around the testicles and small dense spots suggesting calcification. It did not show nodules on the omentum and organ surfaces in the cranial and middle abdomen, which the authors linked to poor image quality from the animal's breathing. Laparoscopy showed nodules over the rumen and the abdominal walls. Cytology of the fluid and the aspirate was of minimal value for diagnosis. The calf died one day after the examinations. Necropsy found more than 100 nodules, and the lesions were diagnosed as malignant mesothelioma. The authors concluded that core-needle biopsy gave higher diagnostic accuracy than fluid or aspirate specimens, and that laparoscopy should support such biopsy in cattle.

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, veterinary)
• Who was studied: One 58-day-old male Japanese black calf
• Exposure: Not described. The article does not mention asbestos or any other exposure. The study concerns diagnostic imaging and biopsy methods.
• Main results:
  • Ultrasound of the abdomen showed multiple echogenic nodules arising from the peritoneum.
  • CT showed nodules connected to the swollen tunica vaginalis via the inguinal region, and small hyperdense spots along the margins of the nodules.
  • CT did not show the nodules in the omentum and on the serosa of organs in the cranial and middle abdomen.
  • Laparoscopy showed multiple nodules over the serosa of the rumen and on the peritoneal walls.
  • The peritoneal effusion was clear and serosanguineous, with a low white blood cell level and a high LDH level. The authors judged it to be a transudate.
  • Cytology of the peritoneal effusion and of the ultrasound-guided fine-needle aspiration specimen was of minimal value for definitive diagnosis.
  • On microscopy, the core-needle biopsy and necropsy tissue showed proliferating cubical or columnar neoplastic cells forming papillary structures. The cells showed strong immunoreaction for cytokeratin and weak immunoreaction for vimentin.
  • The calf died 1 day after the examinations. Necropsy found more than 100 nodules on the peritoneum, and the lesions were diagnosed as malignant mesothelioma.
  • Neoplastic cells were not seen invading the substance of the testes.
• The authors' conclusion: The authors concluded that core-needle biopsy with a Tru-cut needle provided higher diagnostic accuracy than peritoneal effusion and fine-needle aspiration specimens, and that laparoscopy should be used to support core-needle biopsy in bovine cases. They described the report as, to their knowledge, the first clinical use of CT and laparoscopy to diagnose peritoneal mesothelioma in a calf.
• Limitations the authors state:
  • CT image quality was poor because of the animal's breathing motion, making serosal lesions hard to see.
  • The large amount of effusion may have hidden lesions on the serosa of abdominal organs during ultrasound.
  • The biopsy technique, in which the needle was inserted through the skin at a site separate from the trocar, was not simple. It was done on a recumbent animal under deep anesthesia.
  • Needle and port sites can facilitate tumor dissemination.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Biopsy, Peritoneal Mesothelioma, Autopsy, Fine-Needle Aspiration, Needle Biopsy, Tunica Vaginalis, Histology, Mesothelial Cells.

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• CT-guided core-needle biopsy in omental pathology — F. Pombo, E. Rodriguez, et al. (1997)
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• CT imaging of peritoneal carcinomatosis and its mimics — A.D. Diop, M. Fontarensky, et al. (2014)

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