ROSE is a method for fast sample evaluation that does not compromise sensitivity and specificity in the hospital environment when establishing the diagnosis and the therapeutic protocol. The technique is already well-established in human medicine as it operates within the standard operational procedure, reducing the rates of inconclusive results and cancelled cytopathology assays in the hospital environment. However, its application is scarce in Veterinary Medicine, including in hospitals where intensive care is available. This study aims at conducting a case-by-case assessment of inconclusive and cancelled examinations in the Cytopathology Outpatient Clinic at UNESP (HV), Botucatu, Brazil, from 2012 to 2016 and ascertains the causes. For this purpose, a retrospective study was conducted for 9587 examinations in canines, of which 4.1% and 10.44% were inconclusive and cancelled, respectively. These results are not in line with ROSE, which foresees a total rate of 5% for these occurrences. The reasons for these high rates in the outpatient clinic were the lack of a Standard Operating Procedure (SOP) and the relative inexperience of the residents in a university hospital. Therefore, with the adoption of the ROSE protocol for veterinary cytopathological examinations, together with adequate training for the outpatient professionals responsible for the examinations, the goals set forth by the ROSE protocol would be met and the rates of inconclusive and cancelled examinations would decrease considerably. Lastly, this study hopes to contribute towards the diagnosis and therapeutic protocols of the main diseases affecting dogs.
A 10-year old male dog was examined due to a buphthalmia in the left eye and a nodule in the two testicles. Due to the limited resources of the owner and loss of visual acuity of the patient, the enucleation and castration were chosen as treatment. Microscopic analysis of the testicular tissue revealed neoplastic germ cells. Morphologically, neoplastic cells were characterized by distinct cell borders, scarce and eosinophilic cytoplasm, large round nucleus, with thick chromatin and a prominent nucleolus. Binucleated and multinucleated neoplastic cells were also frequently observed. In 10 high power fields (400x), 62 typical and atypical mitosis were counted. Similar neoplastic cells were identified within the vessels of the retina, sclera and in the sub-epithelial conjunctive tissue of the eyelid. The neoplastic cells observed in the testicle and in the eye were positive for PAS. By immunochemistry technique was identified an intense immunostaining of the neoplastic cells for Vimentin and Ki-67 in both testicular and ocular tissue. While, discrete immunoreactivity was identified to c-KIT from the neoplastic cells in both organs. Based on morphological, histochemical and immunohistochemical analysis, it was possible to characterize the ocular lesion as seminoma metastasis.
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