Clinical relevance of splenic nodules or heterogeneous splenicparenchyma assessed by cytologic evaluation of fine-needlesamples in 125 dogs (2011-2015)

Igor Yankin, Sarah Nemanic, Silvia Funes, Helio de Morais, Elena Gorman, Craig Ruaux

Splenic nodules and heterogeneous splenic parenchyma are frequently detected during abdominal ultrasounds in dogs. Although often benign, their clinical relevance remains uncertain, particularly for lesions that lack associated splenomegaly. This study aimed to determine if specific ultrasonographic findings correlate with clinically significant cytologic diagnoses and to develop a scoring system for guiding decisions on fine-needle cytology.

Methods
A retrospective review was conducted on 125 dogs undergoing ultrasound-guided splenic fine-needle cytology between 2011 and 2015. Data included ultrasound features (e.g., nodule size, number, echogenicity, parenchymal heterogeneity, and peritoneal fluid) and cytological diagnoses. Dogs were categorized into two groups based on the clinical relevance of cytology results. Statistical analyses identified significant ultrasound predictors of clinically relevant findings, informing a scoring rubric with a diagnostic utility assessed via receiver operator characteristic (ROC) analysis.

Results
Clinically Relevant Diagnoses: Found in 20% of cases (25/125), including malignancies (e.g., lymphoma, hemangiosarcoma) and inflammatory conditions.
Ultrasound Features Associated with Clinical Relevance:
Nodule size of 1–2 cm (p = 0.01).
Presence of peritoneal fluid (p = 0.002).
Multiple targetoid nodules (p = 0.01).
Scoring System:
A cutoff score of >5 demonstrated a specificity of 92% but low sensitivity (56%) for detecting clinically relevant lesions.
Lowering the cutoff to >4 increased sensitivity to 84% but reduced specificity to 58%.
ROC Analysis: The area under the curve (AUC) was 0.804, indicating moderate diagnostic performance.

Limitations
Retrospective design introduced potential biases, including incomplete image acquisition and lack of histopathological confirmation for all cases.
Sampling limitations could have impacted cytologic accuracy.
The study focused on cytology rather than comparing it to histopathology as the diagnostic gold standard.

Conclusions
Ultrasound-guided fine-needle cytology identified clinically significant splenic pathologies in 20% of dogs with nodules or heterogeneous parenchyma. Features such as nodule size (1–2 cm), peritoneal fluid, and targetoid nodules can help identify cases warranting further investigation. The proposed scoring rubric may aid clinicians in decision-making but requires refinement for improved sensitivity and specificity.

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