PMC10196241_01
Radiographic image (A), ultrasonography (B, F), post-contrast CT (C, D, E) in a dog with lymphatic anomaly. (A) The tubular structure of soft tissue opacity (asterisk) in the caudoventral abdomen, (B) Ultrasonographic image shows multiple anechoic structures in the ovary and uterus, (C) Multilobulated cystic lesions originating from the left sublumbar lymph node expand through the pelvic canal to the left gluteus medius muscle, (D, E) Multiple cystic lesions were observed extensively in contact with the urinary bladder (UB), ovary, uterine, rectum, making it difficult to determine the origin and (F) Ultrasound image 6 months post-surgery, the size of cystic lesions remaining around the bladder was similar to that of 6 months prior.
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F1
Therefore, the small intestine was cranially displaced (Figure 1A). Abdominal US (ACUSON juniper, Siemens Healthineers, Erlangen, Germany) using 3.6-12.9 MHz linear transducers identified multiloculated anechoic structures with acoustic enhancement at the ovarian and uterine locations (Figure 1B), which was similarly observed near the urinary bladder (UB). The septa of the cystic structures were connected to the uterine wall, and the margin of the uterus was spiculated (Figures 1D, E). A multilobulated cystic structure similar to that observed in the uterus was also observed at the location presumed to be the left sublumbar lymph node, which expanded to the left gluteus medius muscle through the pelvic canal (Figure 1C).
Intra-operative photographs of the ovary and uterus and histopathological findings after hematoxylin and eosin staining of the ovary, uterine horn, and urinary bladder. (A) The multiple thin-walled cystic structures expand the uterine smooth muscle, ovary and are see on the serosa. Cyst-like lesions and adjacent organs adhered to each other, so it was difficult to clearly demarcate and remove the lesions, (B) left ovary, approximately five cyst-like structures are seen peripheral to the ovum (*) (x20), (C) left uterine horn, the structures multifocally expand the myometrium. Most were empty and contained intraluminal pale eosinophilic proteinaceous material. Low to moderate numbers of neutrophils are noted bordering the vasculature with no associated necrosis, inflammation, or reactive vessels (x20). (D) Within the smooth muscle wall of the urinary bladder, the structures are lined by spindle cells (long arrow) and hypertrophied cuboidal cells (short arrow) (x20).
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F2
Grossly, multiple pale yellow, clear-to-serous cystic structures were observed in the ovary and uterus (Figure 2A). The ovary contained cyst-like lesions within the mesovarium and the ovarian parenchyma (Figure 2B). The uterus exhibited cyst-like leisons penetrating the myometrium (Figure 2C). The UB contained cystic structures within its smooth muscle wall (Figure 2D).
Lyve-1 immunostaining of the ovary, uterine horn, urinary bladder, and normal canine lymph node. (A) In the normal canine lymph node (control tissue), strong immunoreactivity is seen within lymphatics with nonspecific staining of leukocytes within the lymphatics (short arrow). Neither the arterioles nor interstitial leukocytes show immunoreactivity (long arrow) (x20). (B) In the urinary bladder, Lyve-1 reveals strong cytoplasmic immunoreactivity within the spindle cells both lining the cystic spaces (short arrow) and within the endothelial cells lining blood-filled vascular spaces (long arrow) (x20). (C) In the left ovary, Lyve-1 reveals strong cytoplasmic immunoreactivity lining the cystic spaces (short arrows). Intermediate immunoreactivity is also noted within endothelial cells lining blood-filled vascular spaces (Long arrows) (x20). (D) In nonspecific staining of leukocytes is seen (short arrows) in the left uterine horn, cells lining the cystic spaces show intermediate to strong immunoreactivity to Lyve-1 (long arrow) (x20).
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F3
Rather, they exhibit intermediate to strong cytoplasmic immunoreactivity for LYVE-1, supporting endothelium lined spaces supportive of GLA (Figures 3A-C). The control tissue showed strong immunoreactivity in the lymphatics, but the arterioles showed no immunoreactivity (Figure 3A). However, intermediate immunoreactivity is also noted within endothelial cells lining blood-filled vascular spaces (Figures 3B, C).