What is the new (correct) name for a carcinoid?

VRU 2023

January 09, 2025

Alexandra N. MacLeod, Jean K. Reichle, David Szabo, Eli B. Cohen, Charles Artiles, Caroline V Fulkerson, Manabu Kurihara, John Mattoon

Background
Gallbladder neoplasia is an uncommon cause of biliary disease in dogs and cats, with neuroendocrine carcinoma being the most frequently reported type. Unlike human studies, where adenocarcinoma is the most common, veterinary literature lacks comprehensive ultrasonographic descriptions of gallbladder neoplasms. This study aimed to characterize the ultrasonographic features of gallbladder neoplasms in a small cohort of dogs and one cat, confirmed via histology or cytology.

Methods
This retrospective, multicenter case series involved 15 cases (14 dogs and 1 cat) spanning 2006–2021. Cases were included if ultrasonographic examinations were performed by certified veterinary radiologists, and diagnoses were histologically or cytologically confirmed. Recorded data included signalment, clinical signs, and ultrasound findings (e.g., mass shape, echogenicity, wall thickening, vascularity). Doppler imaging was used in 10 cases to assess vascularity.

Results

Patient Details: Animals were aged 6–15 years (mean: 10.7 years). Diagnoses included neuroendocrine carcinoma (53%), leiomyoma (20%), lymphoma, gastrointestinal stromal tumor (GIST), adenoma, and cholangiocellular carcinoma.

Ultrasound Features:
-All discrete masses were sessile, with sizes ranging from 0.85–4.5 cm (median: 1.75 cm).
-75% of neuroendocrine carcinomas presented as hyperechoic masses.
-Gallbladder wall thickening was observed in 33% of cases.
-Doppler imaging confirmed vascularity in all 10 evaluated cases.

Other Findings: Gallbladder “sludge” was present in 80% of cases. Only one case showed choleliths. Malignant masses were larger and more likely to involve the entire lumen.

Limitations
Small sample size (15 cases) limits generalizability.
Retrospective design introduces variability in data acquisition and reporting.
Not all cases underwent Doppler imaging, which could have biased vascularity assessments.

Conclusions
Gallbladder neoplasms in dogs and cats have variable ultrasonographic presentations. Neuroendocrine carcinoma was the most common type identified. Vascularity, assessed via Doppler, is a key feature distinguishing neoplastic masses from non-neoplastic debris. This study provides a foundation for improved ultrasonographic diagnosis but emphasizes the need for histopathology for definitive characterization. Further research with larger cohorts is recommended.

A, Sagittal ultrasonographic image of a dog diagnosed with neuroendocrine carcinoma obtained with an available ultrasound system (Logiq S8 Vet, GE, Boston MA) and an 10-MHz microconvex transducer. The mass is homogeneously hyperechoic, sessile in shape, arises from the dorsal gallbladder wall, and has no concurrent gallbladder wall thickening. The mass measures 1.7cm in greatest dimension. B, Transverse ultrasonographic image of the same dog obtained with an available ultrasound system (Philips Logiq S8 Vet, GE, Boston MA) and a 10-MHz microconvex transducer. Interrogation with color Doppler shows vascularity within the mass, differentiating the mass from avascular gallbladder “sludge”.

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