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Dermatology Tea Time Teaser

Weimeraner puppy with lip lesions

Paul Sands BSc BVetMed CertVD MRCVS sets you a dermatology challenge

A 12 week old Weimaraner puppy was presented for a second opinion. It had developed a raised inflamed mass on its top lip, and despite antibiotic therapy, the mass remained unchanged. Whilst on treatment, a second similar looking mass developed on the other side of the top lip. The owner reported that these lumps did not seem to bother the puppy who otherwise appeared to be in good health and had no other evidence of skin or oral cavity disease.

Questions:

  1. What are your differential diagnoses in this case?
  2. What further diagnostic tests could you perform?
  3. What treatment options are available if appropriate?

Answers:

Question 1:

Lesions resulting from trauma eg chewing or playing, with or without secondary infection. Infection may have been resistant to the antimicrobial used.

Skin tumours e.g. histiocytomas, mast cell tumours.

Question 2:

Diagnostic tests could include:

Biopsy (incisional or excisional) for histopathology +- tissue culture.
Cytology, either fine needle aspirate or by simply scraping the surface of the masses and staining for cytology.

In this case, surface and fine needle aspirate cytology was carefully performed and well tolerated in the conscious, gently restrained patient.

Under oil immersion microscopy, a population of round cells with round or oval nuclei were seen. Cytoplasms were medium to large and slightly basophilic or pale grey. There was no evidence of purple cytoplasmic granules frequently seen in mast cell neoplasia.

Question 3:

Both nodules could be excised under general anaesthetic if they were shown or suspected to be malignant.

In this case, cytology suggested a diagnosis of Canine Cutaneous Histiocytoma, a benign, normally solitary skin tumour commonly affecting the head, limbs and truncal skin of young dogs.

As the majority of these tumours undergo spontaneous regression, it was agreed to withdraw antibiotic therapy and the lesions completely resolved over the following 4-6 weeks.

 

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