SPINE - neoplasia

Question 1

Which breed is predisposed to nephroblastoma?

Answer 1

German Shepherd

Question 2

nephroblastoma :
1. median age
2. localisation
3. special stain

Answer 2

1. 14m
2. T9-L3
3. 80% stain positive for WT-1

Question 3

What is the MRI appearance of vertebral multiple myeloma causing neurological signs?

Answer 3

Multiple expansile vertebral lesions **without extension beyond the outer cortical limits **of affected vertebrae + extradural material causing SC compression
Iso/Hyper T2 & T1
Variable but homogeneous contrast-enhancement

Question 4

In cranial thoracic myelopathies (T1-T6) in cats, what is the most common cause? The most common location?

Answer 4

Neoplasia (43%)
Followed by inflammatory (24%) and anomalous (19%)

T3-T4 (29%)
Followed by T2-T3 (19%) and T5-T6 (19%)

Question 5

In nephroblastoma, what are the 3 cellular components? Which IHC markers can be used?

Answer 5

Blastemal: vimentin+, WT1+
Epithelial: cytokeratin+
Mesenchymal: vimentin+

WT1 = Wilms’ tumor 1 protein -> useful to differentiate blastemal cells from round cell neoplasia (eg lymphoma) or tumours of neuroendocrine origin.

Question 6

Where are localised nephroblastomas in dogs? Which breeds are overrepresented?

Answer 6

T10-L3  intradural-extramedullary
German Shepherd & Golden Retriever (6m-2y)

Question 7

Which imaging features are associated with malignancy in solitary vertebral neoplasia?

Answer 7

Hyperintense signal on T2w, STIR, T1w and T1w GE
Involvement of the vertebral body
Evidence of cortical destruction
Fractures only seen in the group of malignant masses

Hypointensity on T1w GE was significantly associated with benign masses.
Presence of bone sclerosis was significantly associated with osteosarcomas compared with other malignant masses.

Question 8

In cervical myelopathies, what is the percentage of dogs for which the lateralization of Horner signs matches with the lateralization of MRI changes?

Answer 8

54%