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Nasal and ocular amyloidosis in a 15-year-old horse.

Østevik L, Gunnes G, de Souza GA, Wien TN, Sørby R - Acta Vet. Scand. (2014)

Bottom Line: Peptides from immunoglobulin kappa-like light chains were detected and are suggestive of AL amyloidosis, however the results were inconclusive and a final identification of the amyloid protein could not be made.Nasal amyloidosis is a clinical entity of localized amyloid deposits in the horse.Localized amyloidosis involving the conjunctiva of the horse is previously described in only seven cases and the present case is the first case of combined, localized nasal and corneal amyloidosis in the horse.The present case however, shows that rapid recurrence and progression of nasal amyloidosis to involve ocular tissues can occur and lead to recurrent respiratory obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Basic Sciences & Aquatic Medicine, Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo, N-0033, Norway. liv.ostevik@nmbu.no.

ABSTRACT
Localized nasal, conjunctival and corneal amyloidosis was diagnosed in a 15-year-old pony with nasal and conjunctival masses and severe dyspnoea. Multiple swellings had been evident in the nostrils for at least two years and had gradually increased in size before presentation due to dyspnoea and exercise intolerance. Surgical debulking of the masses was performed and histological examination revealed large amounts of extracellular, hyaline, eosinophilic, Congo red positive material in the lamina propria of the nasal mucosa. A tentative diagnosis of localized nasal amyloidosis was made. The treatment relieved the clinical signs, however, the nasal masses recurred and bilateral conjunctival, papillary masses developed. The horse was euthanized. Nodular nasal and papillary conjunctival masses consisting of rubbery, grey to yellow tissue were found at necropsy. At the limbus this tissue infiltrated and expanded the cornea. The masses consisted of amyloid and moderate infiltrates of T lymphocytes and B lymphocytes were present in the tissue. No predominance of either cell type was observed and no distinct neoplastic mass could be identified. Ultrastructural examination of the nasal mucosa and cornea confirmed the presence of abundant extracellular deposits of non-branching fibrils ranging from 9-11 nm in diameter consistent with amyloid. Immunohistochemistry of amyloid revealed no labelling for AA amyloid, and no peptides representing serum amyloid A (SAA) were detected by microscopic laser dissection and subsequent mass spectrometry. Peptides from immunoglobulin kappa-like light chains were detected and are suggestive of AL amyloidosis, however the results were inconclusive and a final identification of the amyloid protein could not be made.Nasal amyloidosis is a clinical entity of localized amyloid deposits in the horse. Localized amyloidosis involving the conjunctiva of the horse is previously described in only seven cases and the present case is the first case of combined, localized nasal and corneal amyloidosis in the horse. In several reported cases surgical excision has provided clinical improvement and return to normal levels of exercise, while medical treatment has had no effect. The present case however, shows that rapid recurrence and progression of nasal amyloidosis to involve ocular tissues can occur and lead to recurrent respiratory obstruction.

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Amyloid masses in the right rostral nasal cavity. Nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction were observed (arrows). The proliferative tissue was rubbery, yellow to white and poorly demarcated from the surrounding nasal mucosa.
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Fig1: Amyloid masses in the right rostral nasal cavity. Nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction were observed (arrows). The proliferative tissue was rubbery, yellow to white and poorly demarcated from the surrounding nasal mucosa.

Mentions: The mare was in normal body condition. A bilateral, nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction was evident (Figure 1). A nodule measuring 2×1×1 cm was present in the right nostril, as well as diffuse thickening of the rostral nasal mucosa. Similar milder changes were observed in the left nostril. There were bilateral, irregular, papillary proliferations in the ocular conjunctiva (Figure 2) and intense conjunctival hyperaemia. The proliferative tissue was rubbery, yellow to white and was protruding above the eyelid margins expanding the conjunctiva, causing marked disruption of the normal contour of the eyelids. At the limbus the cornea was expanded by a similar pale tissue. No other gross abnormalities were noted. Tissue samples for histology were collected from grossly abnormal tissue including the ocular globe, conjunctivae, and nasal mucosa, as well as sections from myocardium, lung, liver and kidney. Tissue samples were fixed in 4% buffered formaldehyde, routinely processed, embedded in paraffin, sectioned at 2 μm and stained with haematoxylin and eosin. Sections from the cornea, conjunctivae, nasal mucosa, liver and kidney were also stained with Congo red according to Pucthler et al. [20].Figure 1


Nasal and ocular amyloidosis in a 15-year-old horse.

Østevik L, Gunnes G, de Souza GA, Wien TN, Sørby R - Acta Vet. Scand. (2014)

Amyloid masses in the right rostral nasal cavity. Nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction were observed (arrows). The proliferative tissue was rubbery, yellow to white and poorly demarcated from the surrounding nasal mucosa.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4223893&req=5

Fig1: Amyloid masses in the right rostral nasal cavity. Nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction were observed (arrows). The proliferative tissue was rubbery, yellow to white and poorly demarcated from the surrounding nasal mucosa.
Mentions: The mare was in normal body condition. A bilateral, nodular to diffuse thickening of the nasal mucosa at the mucocutaneous junction was evident (Figure 1). A nodule measuring 2×1×1 cm was present in the right nostril, as well as diffuse thickening of the rostral nasal mucosa. Similar milder changes were observed in the left nostril. There were bilateral, irregular, papillary proliferations in the ocular conjunctiva (Figure 2) and intense conjunctival hyperaemia. The proliferative tissue was rubbery, yellow to white and was protruding above the eyelid margins expanding the conjunctiva, causing marked disruption of the normal contour of the eyelids. At the limbus the cornea was expanded by a similar pale tissue. No other gross abnormalities were noted. Tissue samples for histology were collected from grossly abnormal tissue including the ocular globe, conjunctivae, and nasal mucosa, as well as sections from myocardium, lung, liver and kidney. Tissue samples were fixed in 4% buffered formaldehyde, routinely processed, embedded in paraffin, sectioned at 2 μm and stained with haematoxylin and eosin. Sections from the cornea, conjunctivae, nasal mucosa, liver and kidney were also stained with Congo red according to Pucthler et al. [20].Figure 1

Bottom Line: Peptides from immunoglobulin kappa-like light chains were detected and are suggestive of AL amyloidosis, however the results were inconclusive and a final identification of the amyloid protein could not be made.Nasal amyloidosis is a clinical entity of localized amyloid deposits in the horse.Localized amyloidosis involving the conjunctiva of the horse is previously described in only seven cases and the present case is the first case of combined, localized nasal and corneal amyloidosis in the horse.The present case however, shows that rapid recurrence and progression of nasal amyloidosis to involve ocular tissues can occur and lead to recurrent respiratory obstruction.

View Article: PubMed Central - PubMed

Affiliation: Department of Basic Sciences & Aquatic Medicine, Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences, Oslo, N-0033, Norway. liv.ostevik@nmbu.no.

ABSTRACT
Localized nasal, conjunctival and corneal amyloidosis was diagnosed in a 15-year-old pony with nasal and conjunctival masses and severe dyspnoea. Multiple swellings had been evident in the nostrils for at least two years and had gradually increased in size before presentation due to dyspnoea and exercise intolerance. Surgical debulking of the masses was performed and histological examination revealed large amounts of extracellular, hyaline, eosinophilic, Congo red positive material in the lamina propria of the nasal mucosa. A tentative diagnosis of localized nasal amyloidosis was made. The treatment relieved the clinical signs, however, the nasal masses recurred and bilateral conjunctival, papillary masses developed. The horse was euthanized. Nodular nasal and papillary conjunctival masses consisting of rubbery, grey to yellow tissue were found at necropsy. At the limbus this tissue infiltrated and expanded the cornea. The masses consisted of amyloid and moderate infiltrates of T lymphocytes and B lymphocytes were present in the tissue. No predominance of either cell type was observed and no distinct neoplastic mass could be identified. Ultrastructural examination of the nasal mucosa and cornea confirmed the presence of abundant extracellular deposits of non-branching fibrils ranging from 9-11 nm in diameter consistent with amyloid. Immunohistochemistry of amyloid revealed no labelling for AA amyloid, and no peptides representing serum amyloid A (SAA) were detected by microscopic laser dissection and subsequent mass spectrometry. Peptides from immunoglobulin kappa-like light chains were detected and are suggestive of AL amyloidosis, however the results were inconclusive and a final identification of the amyloid protein could not be made.Nasal amyloidosis is a clinical entity of localized amyloid deposits in the horse. Localized amyloidosis involving the conjunctiva of the horse is previously described in only seven cases and the present case is the first case of combined, localized nasal and corneal amyloidosis in the horse. In several reported cases surgical excision has provided clinical improvement and return to normal levels of exercise, while medical treatment has had no effect. The present case however, shows that rapid recurrence and progression of nasal amyloidosis to involve ocular tissues can occur and lead to recurrent respiratory obstruction.

Show MeSH
Related in: MedlinePlus