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1.
Vet Pathol ; : 3009858241240443, 2024 Apr 05.
Article in English | MEDLINE | ID: mdl-38577816

ABSTRACT

Histologic grading of canine cutaneous mast cell tumors (cMCTs) has prognostic and therapeutic implications, yet validation for subcutaneous MCTs (scMCTs) is lacking. For scMCTs with or without dermal invasion, determining their biological behavior remains poorly standardized and sometimes sparks controversy. This prospective study aimed to assess the prognostic utility of the 2-tier histologic grading system in MCTs with different growth models (GMs) and explore the prognostic impact of the GM itself. We assessed 6 histologic GM categories: solely cMCT (C-SC0), cMCT with superficial (C-SC1) or deep subcutaneous (C-SC2) involvement, solely scMCT (SC-C0), and scMCT with deep (SC-C1) or superficial (SC-C2) infiltration of the dermis. Ninety-one MCTs from 76 dogs undergoing excision and regional/sentinel lymphadenectomy were examined. GM classification identified 11 (12%) C-SC0 tumors, 12 (13%) C-SC1, 15 (16%) C-SC2, 21 (23%) SC-C0, 15 (16%) SC-C1, and 17 (19%) SC-C2. Mitotic count, 2-tier grade, nodal involvement, surgical margins, and outcome were stratified according to GM. scMCTs lacking dermal invasion, historically associated with a benign clinical course, had a poor prognosis in 10% of cases. cMCTs exhibiting deep subcutaneous involvement included the largest percentage of high-grade tumors (33%), had the highest occurrence of overt nodal metastases (33%), and had the lowest 1-year survival rate (86%). Histologic grade was confirmed as a relevant prognostic factor, surpassing nodal involvement and histologic margin status. The 2-tier histologic grading enabled the identification of all MCTs with aggressive biological behavior, regardless of their cutaneous or subcutaneous location.

2.
Biomed Tech (Berl) ; 68(6): 563-571, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-37295779

ABSTRACT

This study aims compare the spatiotemporal and kinematic running parameters obtained by the WalkerView (Tecnobody, Bergamo, Italy) with those recorded by a optoelectronic 3D motion capture system. Seventeen participants were simultaneously recorded by the WalkerView and a motion capture system during running tests on the WalkerView at two different speeds (i.e., 8 km/h and 10 km/h). Per each parameter and speed the Root Mean Square Error (RMSE), the intraclass correlation coefficient (ICC), and the mean of the difference (MOD) and limits of agreement (LOAs) indexes obtained from Bland-Altman analysis were used to compare the two systems. ICCs show an excellent agreement for the mean step time and the cadence at both testing speeds (ICC=0.993 at 8 km/h; ICC=0.998 at 10 km/h); a lower agreement was found for all the kinematic variables. Small differences for some spatio-temporal parameters and greater differences for the kinematic variables were found. Therefore, WalkerView could represent a practical, accessible, and less expensive tool for clinicians, researchers, and sports trainers to assess the characteristics spatio-temporal parameters of running in non-laboratory settings.


Subject(s)
Gait , Running , Humans , Biomechanical Phenomena , Exercise Test , Motion Capture , Reproducibility of Results
3.
Vet Clin Pathol ; 52(2): 341-345, 2023 Jun.
Article in English | MEDLINE | ID: mdl-36444855

ABSTRACT

A 10-year-old mixed-breed male dog was referred for a subcutaneous mass on the ventral neck. Based on total-body computed tomography (TBCT), the mass was located in the left thyroid lobe. Further alterations included enlargement of the ipsilateral mandibular and prescapular lymph nodes (LNs). Surgical excision of the mass and enlarged LNs was performed. Histopathology and immunohistochemistry were consistent with a medullary (C-cell) thyroid carcinoma, with no evidence of nodal metastases. Surgery was considered curative, and no medical treatment was provided. Periodic follow-up rechecks were unremarkable. After 18 months, the dog exhibited lethargy, vomiting, anorexia, and hind leg stiffness. TBCT revealed polyostotic osteopathy, and cytology suggested a metastatic endocrine carcinoma. Due to the dog's poor clinical condition and prognosis, the owner elected euthanasia, and a necropsy was performed. Based on gross pathology, histopathology, and immunohistochemistry, multiple metastases of the previous thyroid carcinoma were diagnosed, involving the occipital bone, multiple vertebrae, left sacral wing, fourth right rib, left scapula, left humerus, intrathoracic LNs, lung, spleen, and adrenal glands. This report describes a case of medullary thyroid carcinoma with distant multiorgan metastases and massive bone involvement after a disease-free interval of 18 months.


Subject(s)
Carcinoma, Neuroendocrine , Dog Diseases , Thyroid Neoplasms , Male , Dogs , Animals , Thyroidectomy/methods , Thyroidectomy/veterinary , Thyroid Neoplasms/veterinary , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Carcinoma, Neuroendocrine/diagnosis , Carcinoma, Neuroendocrine/veterinary , Lymph Nodes/pathology , Dog Diseases/diagnosis , Dog Diseases/surgery
4.
J Vet Intern Med ; 36(4): 1398-1408, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35633064

ABSTRACT

BACKGROUND: Risk factors for oral squamous cell carcinoma (OSCC) in cats are derived from a single study dated almost 20 years ago. The relationship between inflammation of oral tissues and OSCC is still unclear. OBJECTIVES: To investigate previously proposed and novel potential risk factors for OSCC development, including oral inflammatory diseases. ANIMALS: Hundred cats with OSCC, 70 cats with chronic gingivostomatitis (CGS), 63 cats with periodontal disease (PD), and 500 controls. METHODS: Prospective, observational case-control study. Cats with OSCC were compared with an age-matched control sample of client-owned cats and cats with CGS or PD. Owners of cats completed an anonymous questionnaire including demographic, environmental and lifestyle information. RESULTS: On multivariable logistic regression, covariates significantly associated with an increased risk of OSCC were rural environment (OR: 1.77; 95% CI: 1.03-3.04; P = .04), outdoor access (OR: 1.68; 95% CI: 1.07-2.63; P = .02), environmental tobacco smoke (OR: 1.77; 95% CI: 1.05-3; P = .03), and petfood containing chemical additives (OR: 1.98; 95% CI: 1.04-3.76; P = .04). Risk factors shared with CGS and PD were outdoor access and petfood containing chemical additives, respectively. A history of oral inflammation was reported in 35% of cats with OSCC but did not emerge as a risk factor. CONCLUSIONS AND CLINICAL IMPORTANCE: The study proposes novel potential risk factors for OSCC in cats. Although a history of inflammatory oral disease was not significantly more frequent compared with random age-matched controls, OSCC shared several risk factors with CGS and PD.


Subject(s)
Carcinoma, Squamous Cell , Cat Diseases , Head and Neck Neoplasms , Mouth Neoplasms , Stomatitis , Animals , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/veterinary , Case-Control Studies , Cat Diseases/epidemiology , Cat Diseases/etiology , Cats , Head and Neck Neoplasms/veterinary , Inflammation/veterinary , Mouth Neoplasms/etiology , Mouth Neoplasms/pathology , Mouth Neoplasms/veterinary , Prospective Studies , Risk Factors , Squamous Cell Carcinoma of Head and Neck/veterinary , Stomatitis/veterinary
5.
Vet Pathol ; 59(5): 768-772, 2022 09.
Article in English | MEDLINE | ID: mdl-35400236

ABSTRACT

Lymph node (LN) metastasis in canine mast cell tumor (MCT) can affect prognosis and postsurgical treatment recommendations; however, routine histological single-section examination may underestimate the incidence of metastases. This prospective study aimed at determining whether longitudinal step-sectioning of the entire LN allows for a more reliable detection of metastases. Dogs with MCT undergoing resection of the primary tumor and regional lymphadenectomy were enrolled. Formalin-fixed LNs were bisected longitudinally, both halves were embedded in paraffin and histological sections prepared at 200 µm steps. The nodal mast cells were classified according to the Weishaar classification. First-section evaluation (FSE; ie, examination of the first section obtained from the blocks) and whole LN step-section evaluation (SSE) were compared. Fifty-eight LNs were included. The median number of sections per LN was 6 (range, 3-28). FSE with toluidine blue (TB) revealed 27 (47%) nonmetastatic (HN0), 14 (24%) premetastatic (HN1), 9 (15%) early metastatic (HN2), and 8 (14%) overtly metastatic (HN3) LNs. SSE with TB resulted in upgrading the LN status in 2 cases (HN2 to HN3; HN0 to HN1). Evaluation of the first section plus an additional step-section resulted in 100% accuracy. Compared with SSE with TB, the accuracy of FSE with HE was 98% for HN3 LNs and 74% for HN2 LNs. FSE appears to reliably allow for the detection of LN metastasis in MCT, although examination of a further parallel section at a 200 µm step may increase the accuracy. A metachromatic stain is recommended for the identification of early metastases.


Subject(s)
Dog Diseases , Animals , Dog Diseases/diagnosis , Dog Diseases/pathology , Dog Diseases/surgery , Dogs , Lymph Node Excision/methods , Lymph Node Excision/veterinary , Lymph Nodes/pathology , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/pathology , Neoplasm Staging , Prospective Studies
6.
Vet Comp Oncol ; 19(3): 501-509, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33624422

ABSTRACT

Feline oral squamous cell carcinoma (FOSCC) is a frequent and progressively invasive tumour. Early lesions are difficult to recognize based on the sole clinical examination and may be misinterpreted as non-neoplastic. Mutations of TP53 and epigenetic alterations of specific genes are present in FOSCC and may be early detected. Aim of this prospective study was to investigate the DNA methylation pattern of a 17-gene panel and TP53 mutational status of FOSCC cytological samples obtained by oral brushing. Results were compared with a control group, in order to validate this non-invasive procedure for the screening of FOSCC. In FOSCC, the same analyses were carried out on the corresponding histological sample, if available. Thirty-five FOSCC and 60 controls were included. Mutations of TP53 were detected in 17 FOSCC brushings (48%) and in none of the controls (P < .001). Six genes (ZAP70, FLI1, MiR124-1, KIF1A, MAGEC2 and MiR363) were differentially methylated in FOSCC and were included in a methylation score. An algorithm based on TP53 mutational status and methylation score allowed to differentiate FOSCC from controls with a 69% sensitivity and a 97% specificity (accuracy, 86%). In 19 FOSCC histological samples, TP53 mutational status was fully concordant with brushings and a positive methylation score was observed in all cases. These results are promising for the identification of FOSCC by oral brushing, although some factors may limit the accuracy of this technique and further studies are required to assess its reproducibility in clinical practice.


Subject(s)
Cat Diseases , DNA Methylation , Mouth Neoplasms , Squamous Cell Carcinoma of Head and Neck , Tumor Suppressor Protein p53 , Animals , Cat Diseases/diagnosis , Cat Diseases/genetics , Cats , Mouth Neoplasms/diagnosis , Mouth Neoplasms/genetics , Mouth Neoplasms/veterinary , Mutation , Prospective Studies , Reproducibility of Results , Squamous Cell Carcinoma of Head and Neck/diagnosis , Squamous Cell Carcinoma of Head and Neck/genetics , Squamous Cell Carcinoma of Head and Neck/veterinary , Tumor Suppressor Protein p53/genetics
7.
Animals (Basel) ; 10(10)2020 Oct 13.
Article in English | MEDLINE | ID: mdl-33066257

ABSTRACT

This investigation focused on an episode of chronic mortality observed in juvenile Huso huso sturgeons. The examined subjects underwent pathological, microbiological, molecular, and chemical investigations. Grossly severe body shape deformities, epaxial muscle softening, and multifocal ulcerative dermatitis were the main observed findings. The more constant histopathologic findings were moderate to severe rarefaction and disorganization of the lymphohematopoietic lymphoid tissues, myofiber degeneration, atrophy and interstitial edema of skeletal epaxial muscles, and degeneration and atrophy of the gangliar neurons close to the myofibers. Chemical investigations showed a lower selenium concentration in affected animals, suggesting nutritional myopathy. Other manifestations were nephrocalcinosis and splenic vessel wall hyalinosis. Septicemia due to bacteria such as Aeromonas veronii, Shewanella putrefaciens, Citrobacter freundii, Chryseobacterium sp., and pigmented hyphae were found. No major sturgeon viral pathogens were detected by classical methods. Next-generation sequencing (NGS) analysis confirmed the absence of viral pathogens, with the exception of herpesvirus, at the order level; also, the presence of Aeromonas veronii and Shewanella putrefaciens was confirmed at the family level by the metagenomic classification of NGS data. In the absence of a primary yet undetected biological cause, it is supposed that environmental stressors, including nutritional imbalances, may have led to immune system impairment, facilitating the entry of opportunistic bacteria and mycotic hyphae.

8.
Cells ; 9(9)2020 09 13.
Article in English | MEDLINE | ID: mdl-32933205

ABSTRACT

BACKGROUND: Ultra-conserved non-coding elements (UCNEs) are genomic sequences that exhibit > 95% sequence identity between humans, mammals, birds, reptiles, and fish. Recent findings reported their functional role in cancer. The aim of this study was to evaluate the DNA methylation modifications of UNCEs in squamous cell carcinoma (SCC) from different mammal species. METHODS: Fifty SCCs from 26 humans, 17 cats, 3 dogs, 1 horse, 1 bovine, 1 badger, and 1 porcupine were investigated. Fourteen feline stomatitis and normal samples from 36 healthy human donors, 7 cats, 5 dogs, 5 horses, 2 bovines and 1 badger were collected as normal controls. Bisulfite next generation sequencing evaluated the DNA methylation level from seven UCNEs (uc.160, uc.283, uc.416, uc.339, uc.270, uc.299, and uc.328). RESULTS: 57/59 CpGs were significantly different according to the Kruskal-Wallis test (p < 0.05) comparing normal samples with SCC. A common DNA hypermethylation pattern was observed in SCCs from all the species evaluated in this study, with an increasing trend of hypermethylation starting from normal mucosa, through stomatitis to SCC. CONCLUSIONS: Our findings indicate that UCNEs are hypermethylated in human SCC, and this behavior is also conserved among different species of mammals.


Subject(s)
Carcinoma, Squamous Cell/genetics , Conserved Sequence/genetics , DNA Methylation/genetics , Epigenesis, Genetic , Evolution, Molecular , Horses/genetics , Mouth Neoplasms/genetics , Mustelidae/genetics , Porcupines/genetics , Aged , Animals , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/veterinary , Cats , Cattle , CpG Islands/genetics , Dogs , Female , Humans , Male , Mouth Neoplasms/pathology , Mouth Neoplasms/veterinary , Prospective Studies , Retrospective Studies
9.
Vet Comp Oncol ; 18(4): 825-837, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32506786

ABSTRACT

Feline oral squamous cell carcinoma (FOSCC) is characterized by high local invasiveness and early bone lysis. The late diagnosis largely limits the efficacy of therapy and increases treatment-related morbidity. The aim of this exploratory study was to assess the methylation pattern of 10 candidate genes and TP53 mutational status in histologic samples of FOSCC. Results were compared with normal oral mucosa and oral inflammatory lesions, in order to establish a gene panel for FOSCC detection. For 10 cats, the above analyses were also performed on oral brushing samples, in order to explore the utility of these methods for screening purposes. Thirty-one FOSCC, 25 chronic inflammatory lesions and 12 controls were included. TP53 mutations were significantly more frequent in the FOSCC (68%) than in the non-neoplastic oral mucosa (3%; P <.001). Based on lasso regression analysis, a step-wise algorithm including TP53, FLI1, MiR124-1, KIF1A and MAGEC2 was proposed. The algorithm allowed to differentiate FOSCC with 94% sensitivity and 100% specificity (accuracy, 97%). When applying the proposed algorithm on 10 brushing samples, accuracy decreased to 80%. These results indicate that the altered DNA methylation of specific genes is present in FOSCC, together with a significant proportion of TP53 mutations. Such alterations are infrequent in normal oral mucosa and chronic stomatitis in cats, suggesting their involvement in feline oral carcinogenesis and their utility as diagnostic biomarkers. Further studies on a high number of brushing samples will be needed to assess the utility of a screening test for the early detection of FOSCC.


Subject(s)
Cat Diseases/genetics , DNA Methylation/genetics , Genes, p53/genetics , Head and Neck Neoplasms/veterinary , Squamous Cell Carcinoma of Head and Neck/veterinary , Animals , Cat Diseases/pathology , Cats , Female , Head and Neck Neoplasms/genetics , Head and Neck Neoplasms/pathology , Italy , Male , Mucous Membrane/pathology , Squamous Cell Carcinoma of Head and Neck/genetics , Squamous Cell Carcinoma of Head and Neck/pathology
10.
PLoS One ; 14(4): e0215621, 2019.
Article in English | MEDLINE | ID: mdl-30998743

ABSTRACT

Squamous cell carcinoma is the most common malignant oral tumor in cats. The late presentation is one of the factors contributing to the detrimental prognosis of this disease. The immunohistochemical expression of the p53 tumor suppressor protein has been reported in 24% to 65% of feline oral squamous cell carcinomas, but no study has systematically evaluated in this tumor the presence of p53 encoding gene (TP53) mutations. The aim of this retrospective study was to determine whether p53 immunohistochemistry accurately reflects the mutational status of the TP53 gene in feline oral squamous cell carcinoma. Additionally, the prevalence of p53 dysregulation in feline oral squamous cell carcinoma was compared with that of feline non-neoplastic oral mucosa, in order to investigate the relevance of these dysregulations in cancer development. The association between p53 dysregulations and exposure to environmental tobacco smoke and tumor characteristics was further assessed. Twenty-six incisional biopsies of oral squamous cell carcinomas and 10 cases each of lingual eosinophilic granuloma, chronic gingivostomatitis and normal oral mucosa were included in the study. Eighteen squamous cell carcinomas (69%) expressed p53 and 18 had mutations in exons 5-8 of TP53. The agreement between immunohistochemistry and mutation analysis was 77%. None of non-neoplastic oral mucosa samples had a positive immunohistochemical staining, while one case each of eosinophilic granuloma and chronic gingivostomatitis harbored TP53 mutations. Unlike previously hypothesized, p53 dysregulations were not associated with exposure to environmental tobacco smoke. These results suggest an important role of p53 in feline oral tumorigenesis. Additionally, the immunohistochemical detection of p53 expression appears to reflect the presence of TP53 mutations in the majority of cases. It remains to be determined if the screening for p53 dysregulations, alone or in association with other markers, can eventually contribute to the early detection of this devastating disease.


Subject(s)
Carcinoma, Squamous Cell , Cat Diseases , Gene Expression Regulation, Neoplastic , Mouth Mucosa , Mouth Neoplasms , Tumor Suppressor Protein p53 , Animals , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Cat Diseases/genetics , Cat Diseases/metabolism , Cat Diseases/pathology , Cats , Eosinophilia/genetics , Eosinophilia/metabolism , Eosinophilia/pathology , Eosinophilia/veterinary , Gingival Diseases/genetics , Gingival Diseases/metabolism , Gingival Diseases/pathology , Gingival Diseases/veterinary , Humans , Mouth Mucosa/metabolism , Mouth Mucosa/pathology , Mouth Neoplasms/genetics , Mouth Neoplasms/metabolism , Mouth Neoplasms/pathology , Mouth Neoplasms/veterinary , Mutation , Prevalence , Retrospective Studies , Stomatitis/genetics , Stomatitis/metabolism , Stomatitis/pathology , Stomatitis/veterinary , Tongue Diseases/genetics , Tongue Diseases/metabolism , Tongue Diseases/pathology , Tongue Diseases/veterinary , Tumor Suppressor Protein p53/biosynthesis , Tumor Suppressor Protein p53/genetics
11.
BMC Vet Res ; 14(1): 309, 2018 Oct 12.
Article in English | MEDLINE | ID: mdl-30314485

ABSTRACT

BACKGROUND: Melanomas are rare in cats. The eye is the most commonly involved site, whereas few data are available about feline non-ocular melanomas (NOMs). Ki-67 thresholds with prognostic relevance have been established for canine melanomas, but not in cats. This study was undertaken to investigate the relationship between Ki-67 index, tumour characteristics, and clinical outcome in feline NOMs. Histologic samples were retrospectively reviewed. Amelanotic tumours were admitted upon immunohistochemical positivity for Melan A or S100. Evaluated parameters included morphological diagnosis, histotype, junctional activity, degree of pigmentation, vascular invasion, lymphocytic infiltrate, necrosis, mitotic count (MC) and Ki-67 index. Pigmented tumours were bleached before evaluation. Clinical and follow-up information were retrieved via telephone interviews with the referring veterinarians. RESULTS: Fifty tumours located in skin (n = 33) and mucosae (n = 17) were included. Forty-eight percent and 95% of amelanotic tumours (n = 21) stained positive for Melan A and S100, respectively. Most achromic tumours were mucosal (P < 0.001, Fisher's exact test) and presented a spindle cell morphology (P = 0.002; Fisher's exact test). MC and Ki-67 index were significantly correlated (P < 0.001; R = 0.67; Spearman's rank correlation); median values were 15 (range, 0-153) and 28% (range, 1-78%), respectively. Both were significantly higher in spindle cell melanomas, in tumours lacking junctional activity and in poorly-pigmented tumours. Follow-up information was available for 33 cats (66%). Variables related with a poor clinical outcome included mucosal location, tumour size, spindle, balloon and signet ring cell histotypes, low pigmentation, MC > 5, Ki-67 > 20% and lack of treatment administration. On multivariable analysis, only tumour histotype and treatment retained prognostic significance. CONCLUSIONS: Although the majority of feline NOMs behave aggressively, Ki-67 index, together with other parameters, may contribute to prognostic assessment. Prospective studies on homogeneous populations are warranted to identify reliable threshold values for this marker.


Subject(s)
Ki-67 Antigen/metabolism , Melanoma/veterinary , Mouth Neoplasms/veterinary , Skin Neoplasms/veterinary , Animals , Cat Diseases/pathology , Cat Diseases/therapy , Cats , Female , Male , Melanoma/pathology , Melanoma/therapy , Mouth Neoplasms/pathology , Mouth Neoplasms/therapy , Pigmentation , Prognosis , Retrospective Studies , Skin Neoplasms/therapy
12.
Vet Pathol ; 55(5): 645-653, 2018 09.
Article in English | MEDLINE | ID: mdl-29807508

ABSTRACT

Canine splenic lymphoid nodules are currently classified as indolent lymphomas (marginal zone lymphoma [MZL], mantle cell lymphoma [MCL]) or nodular hyperplasia (lymphoid [LNH] or complex [CNH] type). Their differentiation can be difficult on morphology, because of similar histologic appearance and poorly defined diagnostic criteria. Thirty-five surgical samples of splenic lymphoid nodules were reviewed in order to assess the diagnostic contribution of immunophenotyping, proliferative activity and clonality (PARR) in differentiating between hyperplastic and neoplastic lesions. Proliferative activity was evaluated by double immunolabeling for Ki-67 and CD79a, in order to separately assess the proliferative activity of B cells and non-B cells. Definitive diagnoses were MZL ( n = 11), MCL ( n = 4), LNH ( n = 10), and CNH ( n = 10). The overall concordance between histology and PARR was above 90%. Lymphomas had a significantly higher percentage of CD79a-positive areas (mean, 36.30%; P = .0004) and a higher B-cell proliferative activity (median Ki-67 index, 5.49%; P = .0012). The threshold value most accurately predicting a diagnosis of lymphoma was ≥28% of B-cell areas, with a Ki-67 index above 3%. Dogs were monitored for a median follow-up time of 870 days (IQR, 569-1225), and no relapses were documented. Overall median survival time was 1282 days. The combination of histology, immunohistochemistry and PARR can improve the diagnostic accuracy for canine splenic lymphoid nodules, although the long-term behavior of these lesions appears similar.


Subject(s)
Dog Diseases/pathology , Lymphoma, Follicular/veterinary , Splenic Neoplasms/veterinary , Animals , B-Lymphocytes/pathology , CD3 Complex/metabolism , CD79 Antigens/metabolism , Cell Proliferation , Dog Diseases/diagnosis , Dogs , Female , Ki-67 Antigen/metabolism , Lymphoma, Follicular/diagnosis , Lymphoma, Follicular/pathology , Male , Spleen/pathology , Splenic Neoplasms/diagnosis , Splenic Neoplasms/pathology
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