Evaluation of cytological diagnostic accuracy for canine splenic neoplasms: An investigation in 78 cases using STARD guidelines

Abstract

Cytology represents a useful diagnostic tool in the preliminary clinical approach to canine splenic lesions, and may prevent unnecessary splenectomy. However, few studies have evaluated diagnostic accuracy of cytology in the diagnosis of canine splenic neoplasms. The aim of this study was to determine overall accuracy, sensitivity, specificity, positive and negative predictive values (i.e. diagnostic accuracy indexes) of cytology for canine splenic neoplasms following Standards for the Reporting of Diagnostic Accuracy Studies (STARD) guidelines. A consecutive series of canine splenic cytological samples was retrospectively retrieved from the database of the Diagnostic Pathology Service of the Department of Veterinary Medicine (DIMEVET—University of Milan). Histopathology was set as the diagnostic reference standard. Cytological cases were enrolled when slides were available for review and when the same lesion was submitted for histopathology. Seventy-eight (78) lesions were included in the study. By histopathology, 56 were neoplastic and 22 were non-neoplastic. Cytology had an overall accuracy of 73.08% (95% C.I. 61.84%-82.50%), sensitivity of 64.29% (95% C.I. 50.36%-76.64%), specificity of 95.45% (95% C.I. 77.16%-99.88%), and positive and negative predictive values of 97.3% (95% C.I. 84.01%-99.60%) and 51.22% (95% C.I. 42.21%-60.15%), respectively. Low sensitivity and negative predictive value were balanced by very high specificity and positive predictive value. When positive for neoplasia, cytology represents a useful diagnostic tool to rule in splenic neoplasia, prompting surgery independently from other diagnostic tests. Conversely, a negative cytological result requires additional investigations to confirm the dog to be disease free.

Peripheral Nerve Sheath Tumors Resembling Human Atypical Neurofibroma in Goldfish (Carassius auratus, Linnaeus, 1758)

“…In this study, a group of six cohabiting goldfish bearing similar skin nodules was investigated. In all cases, the lesions were consistent with a spindle cell tumor, showing histochemical and immunohistochemical properties consistent with a neurofibroma, with morphological features (i.e., nuclear atypia, hypercellularity, loss of neurofibroma architecture) similar to the variant atypical neurofibroma described in human beings [ 49 , 50 , 57 , 58 ].…”

“…The results of the cytological evaluation did not reflect the actual pathological condition underlying the skin nodules in four out of the six cases, being unable to correctly identify their neoplastic nature, probably due to the reduced exfoliation rate (i.e., the tendency of tissues and lesions to release cells during cytological sampling) previously associated with mesenchymal tumors [ 4 , 58 ].…”

Refining the “double two‐thirds” rule: Genotype‐based breed grouping and clinical presentation help predict the diagnosis of canine splenic mass lesions in 288 dogs

“…Since second opinion histopathology has been shown to give complete diagnostic disagreement in 19% small animal cancer cases, 60 it is likely that review of the histopathology would have changed a number of diagnoses in this study. It is also possible that some of the cytologic diagnoses were not representative of the lesion; cytology has been shown to be a specific (95%) but poorly sensitive (64%) predictor of the histopathological diagnosis of splenic lesions 61 . Both histopathological and cytological diagnoses may be further less secure because immunohistochemistry or immunocytochemistry were not routinely performed.…”

“…It is also possible that some of the cytologic diagnoses were not representative of the lesion; cytology has been shown to be a specific (95%) but poorly sensitive (64%) predictor of the histopathological diagnosis of splenic lesions. 61 Both histopathological and cytological diagnoses may be further less secure because immunohistochemistry or immunocytochemistry were not routinely performed.…”

Accuracy of B-mode ultrasound and ARFI elastography in predicting malignancy of splenic lesions in dogs: Preliminary study

“…Among the most diagnosed malignant and benign alterations in the spleen are hemangiosarcoma with an occurrence of 44.1% and nodular lymphoid hyperplasia affecting 20.1% of the animals³. The prognosis varies from favorable to reserved depending on the diagnosis of the splenic lesion 4 , which can be performed using ultrasound-guided ne-needle aspirate cytology or histopathological analysis of material collected by biopsies or splenectomy [5][6][7] .…”