canis - Articles
Liver: neoplasia
Introduction
Age predisposition
- Metastatic or systemic neoplasia: any age.
- Primary hepatobiliary neoplasia: older dogs >10 years:
- Median age of dogs with benign disease is greater than those with malignant tumors.
Sex predisposition
- Males for hepatocellular carcinoma.
Special risks
- May have coagulopathy due to liver dysfunction.
Age predisposition
- Metastatic or systemic neoplasia: any age.
- Primary hepatobiliary neoplasia: older dogs >10 years:
- Median age of dogs with benign disease is greater than those with malignant tumors.
Special risks
- May have coagulopathy due to liver dysfunction.
Pathogenesis
Etiology
- None determined for dogs; hepatitis B or C viral infection and cirrhosis are factors in people.
Predisposing factors
General- Intrahepatic bile duct carcinomas have been associated with liver fluke infestation.
Pathophysiology
- Normal hepatic architecture disrupted by neoplastic cells.
- If large areas of liver involved → hepatic dysfunction/failure.
- Neoplasm may obstruct biliary tree → jaundice.
- Neoplasm may cause portal hypertension → ascites.
- Primary hepatic tumors may be solitary lobar masses or multiple discrete nodules in more than one lobe.
- Metastatic neoplasms may be diffuse infiltrates or multifocal nodules.
Primary hepatobiliary tumors
- Hepatocellular carcinomamost common, less likely to metastasize.
- Bile duct adenocarcinoma(biliary cystadenoma or hepatobiliary cystoadenoma) is benign and the most common liver tumor. These are multicystic or spongiform structures containing clear or blood-tinged fluid.
- Bile duct carcinoma (cholangiocarcinoma) is the second most common primary malignant liver tumor. Approximately 60% have metastasized to lungs, lymph nodes and most commonly intestinal serosa (carcinomatosis) by the time of diagnosis.
- Other uncommon liver tumors are gall bladder adenocarcinoma, biliary carcinoid, hemangiosarcoma and leiomyosarcoma.
- Neoplasms of biliary tract origin are more common than those of hepatic cell origin.
- Tumors may be a single lobar mass or multiple discrete nodules involving one or more lobes.
- Vomiting may result from pressure on stomach or from hepatic dysfunction.
- Jaundice may result from hepatic dysfunction or obstruction of the biliary tree.
- Signs of liver failure are seen when the liver is extensively infiltrated, but not when the disease is confined to one lobe/area.
Metastatic neoplasia
- Infiltration may occur with:
- Lymphoma Lymphoma.
- Lymphoid leukemia Chronic lymphoid leukemia.
- Mast cell tumor Skin: mastocytoma.
- Plasma cell tumor.
- Myeloid leukemia Chronic myeloid leukemia.
- The infiltration is diffuse and non-encapsulated → generalized hepatomegaly and liver dysfunction.
- Solid tumors may metastasize to the liver → multiple nodules throughout liver:
- Pancreatic carcinoma Pancreas: neoplasia.
- Mammary adenocarcinomas Mammary gland: neoplasia.
- Intestinal adenocarcinomas Large intestine: neoplasia Small intestine neoplasia.
Myelipomas
- Tumor-like nodules composed of mature adipose tissue and bone marrow elements, may rarely occur in the liver.
Timecourse
- Often insidious onset.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Patnaik A K, Newman J et al (2005) Canine hepatic neuroendocrine carcinoma: an immunohistochemical and electron microscopic study. Vet Pathol 42 (2), 140-146 PubMed.
- Liptak J M, Dernell W S et al (2004) Massive hepatocellular carcinoma in dogs: 48 cases (1992-2002). JAVMA 225 (8), 1225-1230 PubMed.
- O'Brien R T, Iani M et al (2004) Contrast harmonic ultrasound of spontaneous liver nodules in 32 dogs. Vet Radiol Ultrasound 45 (6), 547-553 PubMed.
- Wang K Y, Panciera D L et al (2004) Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990-2000). JAVMA 224 (1), 75-78 PubMed.
- Cohen M, Bohling M W et al (2003) Evaluation of sensitivity and specificity of cytologic examination: 269 cases (1999-2000). JAVMA 222 (7), 964-967 PubMed.
- Cuccovillo, A, Lamb C R (2002) Cellular features of sonographic target lesions of the liver and spleen in 21 dogs and a cat. Vet Radiol Ultrasound 43 (3), 275-278 PubMed.
- Vörös K, Vrabély T, Papp L et al (1991) Correlation of ultrasonographic and pathomorphological findings in canine hepatic diseases. J Small Anim Pract 32 (12), 627-634 VetMedResource.