SPINE - neoplasia

Question 1

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

Answer 1

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

Question 2

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

Answer 2

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 3

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

Answer 3

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

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

Question 4

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

Answer 4

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 5

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

Answer 5

54%

Question 6

Where are localised nephroblastomas in dog

Answer 6

T10-L3
Intradural-extramedullary
German Sheperd and Golden Retriever 6m-2y

Question 7

Imaging features 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 T1-weighted gradient echo sequence was significantly associated with benign masses.
Presence of bone sclerosis was significantly associated with osteosarcomas compared with other malignant masses.

Question 8

features associated with agressive lesion in multifocal vert lesion

Answer 8

high T2/STIR (non ag variable T2 low STIR)
SC compression (cortical interruption) ++
new bone formation

paravert muscles change ++
lymphadenomegaly

spinal pain

Question 9

MRI/histo fact assoc with hight grade PNST

Answer 9

MRI: large volume
severe perif enhancement

histo:
high mitotic index,
transperineurial growth,
necrosis, hemmorraghe

Question 10

MRI signs maligancy/osteosarcoma of solitary vert neoplasia

Answer 10

MALIGNANCY
involvement vert body
hyper T2/STIR/T1/T1GE
cortical destruction
fracture

OSTEOSARCOMA
bone sclerosis

Question 11

spinal lymphoma in cat:
1. localisation
2. % involvement of paraspinal tissue/vert
3. histopath assoc with neg prognosis

Answer 11

1. epidural, focal, >1 vert body, lumbar, circumpherencial
2. 75% but cortical sparing
3. necrosis (lesion not T2 hyper)