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- Tracheal neoplasia-refine your ddx
Alexis Berrocal, Tatiane Terumi Negrão Watanabe, […], and Daniel Felipe Barrantes Murillo
Background
Tracheal neoplasia is a rare condition in dogs and cats and is minimally addressed in standard veterinary references. The anatomical and histological complexity of the trachea allows for diverse tumor origins, yet clinical and pathological data remain scattered. This study aimed to consolidate existing knowledge by conducting a comprehensive literature review and multi-institutional retrospective analysis to detail the demographic, clinical, and pathological features of tracheal tumors in these species.
Methods
The study combined data from two sources: a multi-institutional retrospective review of pathology archives from five veterinary institutions (2005–2024) and a literature review of tracheal neoplasia cases reported between 1961 and 2024. Cases were included if they described primary tracheal tumors in dogs or cats, with sufficient information on tumor type, anatomical location, and signalment. Data were analyzed descriptively using frequency counts and percentages for categorical variables and means for continuous variables such as age.
Results
A total of 165 tracheal tumor cases were analyzed: 68 in dogs and 97 in cats. In dogs, the most common neoplasms were osteochondroma (24%), plasma cell tumor (18%), chondrosarcoma (13%), malignant epithelial tumors (11%), and chondroma (6%). Most tumors were located in the cervical trachea (43%), and the mean age at diagnosis was 6.7 years. In cats, lymphoma (44%) and malignant epithelial tumors (43%) were most prevalent, with the cervical trachea affected in 38% of cases and a mean diagnosis age of 10.7 years. Domestic shorthairs constituted the majority of feline cases (62%). Clinical signs included cough, dyspnea, and respiratory distress. Surgical excision was the most common treatment, with occasional use of radiation and chemotherapy, particularly for lymphomas.
Limitations
The study's retrospective nature led to missing data in some cases, including incomplete breed, sex, and outcome information. Additionally, inconsistencies in diagnostic methods and a lack of standardized follow-up protocols limited the ability to assess long-term outcomes comprehensively. Some tumor classifications were based on limited histological or immunohistochemical evaluation.
Conclusions
Tracheal tumors in dogs and cats, although rare, encompass a wide histological spectrum. Dogs are more frequently affected by cartilaginous tumors such as osteochondroma, while cats more commonly develop lymphoma and adenocarcinoma. Most neoplasms occur in the cervical trachea and manifest with nonspecific respiratory symptoms. Surgical excision remains the cornerstone of treatment, especially for benign and localized malignancies. This study provides the most extensive compilation of tracheal neoplasia data to date and emphasizes the need to consider a broad differential diagnosis when evaluating tracheal masses in small animals.
Macroscopic, histological, and immunohistochemical features of tracheal neoplasia in cats. (a–c) Tracheal carcinoma in a 12-year-old, castrated male, domestic shorthair cat. Case 26. (a) The neoplastic polygonal cells are arranged in broad trabeculae and lobules separated by a fibrous stroma with multiple mitotic figures (arrowheads). Hematoxylin and eosin (HE). (b) Neoplastic cells have strong cytoplasmic immunolabeling for cytokeratin AE1/AE3. Cytokeratin AE1/AE3 immunohistochemistry (IHC). (c) Neoplastic cells lack immunolabeling for vimentin. Vimentin IHC. (d–f) Tracheal lymphoma in a 10-year-old, female spayed, domestic longhair cat. Case 42. (d) A 7.1 cm × 4.2 cm × 2.0 cm, infiltrative, pale tan-white, firm, solid neoplasm infiltrates and expands the tracheal wall (asterisks). (e) The submucosa, cartilaginous rings, and adventitia of the trachea are infiltrated and expanded by sheets of neoplastic lymphocytes sustained by fine fibrovascular stroma (asterisks). HE. (f) Neoplastic lymphocytes are large, with scant pale eosinophilic cytoplasm, irregular round nuclei with coarsely to dense chromatin and one prominent nucleolus. HE.
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