Cytology Q&A 07

This question was provided by Manson Publishing as part of the OVAL Project. See more Cytology Q&A.

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A ten-year-old entire male Beagle presents with multiple nodular enlargements surrounding the anus. This is associated with ulceration and bleeding and is accompanied by a disagreeable odour. Fine needle aspiration is performed and smears prepared (Wright’s, ×100 oil).

Question	Answer		Article
What is the most likely diagnosis?	The clinical signs, signalment and cytological observations are most consistent with perianal adenoma. This tumour is most common in older, sexually intact dogs (>8 years of age). Multiple tumours in the area around the anus are common, as are bleeding and ulcerative lesions. These tumours are rarely malignant in males.		Link to Article
What therapy would you recommend?	Surgical excision is recommended. Castration will arrest tumour growth and should be done at the same time, as this tumour is testosterone dependent. Oestrogen therapy is recommended in cases in which the tumour cannot be completely removed, and it may also be used following surgery as adjunct therapy. Antibiotic therapy may be needed if concomitant infection is suspected. Note: The cytological features of perianal adenoma are classic in this case. The cells are typically large and resemble hepatocytes and are referred to as ‘hepatoid’. They typically have round, central nuclei with single, distinct nucleoli and moderate to abundant, oval to angular cytoplasm. They usually occur in cohesive groups. In some cases, small ‘reserve’ cells also may be apparent mixed with the larger hepatoid cells. There may be concurrent inflammation and/or haemorrhage. Perianal adenocarcinoma is less common and exhibits more bizarre and/or variable features compatible with malignancy. It may present as a relatively undifferentiated malignancy cytologically and require surgical biopsy and histological evaluation to confirm cell type of origin.		Link to Article