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EQUINE VETERINARY EDUCATION / AE / OCTOBER 2014
a)
b)
c)
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Fig 3: Transverse CT images (bone window) at the level of the caudal aspect of the second vertebra (C2) (a), mid (b) and caudal (c) aspects of the third cervical vertebra (C3). Right is at the left, dorsal at the top. a) Discrete hypodense foci are present in the vertebral body of C2 (arrows). The contrast column is normal at this level. b) The vertebral body shows several hypodense foci, the transverse processes and ventral aspect of the vertebral arch are also involved in the process. The contrast column is circumferentially thinned and shows an ovoid shape due to lateral compression. c) The ventral floor of the vertebral canal is interrupted (arrowhead). The left aspect of the vertebral body shows an irregular defect (asterisk). The contrast column is circumferentially thinned and the body of C3 shows multiple hypodense areas.
a) b) 1 3 1 3
2 500 µm
2 500 µm
Fig 4: Section of the third cervical vertebra (a) and mass in the epidural space (b) stained with haematoxylin-eosin (bar 500 mm). a) showing proliferation of large blood-filled vascular spaces lined by single layers of endothelial cells (1) and necrotic bone tissue (2). (normal bone tissue: 3). b) the mass is surrounded by the dura mater (1), the mass itself consists of a large amount of adipose tissue (2) and blood-filled vascular spaces (3).
Plasmacellular myeloma, fibrosarcoma, lymphosarcoma
and melanoma have been described at the level of the vertebral canal and can cause vertebral compression, while haemangiosarcoma is a rare cause of neurological signs in horses. Three other case reports described a haemangiosarcoma as the cause of spinal cord compression. In these cases, osteolysis of the vertebralbodies was present and a cervical myelogram showed an extradural space-occupying lesion. Also in these cases the musculature adjacent to the cervical vertebrae was involved (Kennedy and Brown 1993; Newton-Clarke et al. 1994; MacGillivray et al.2003).Inthe previously described cases, cervical myelography could show
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the extra-dural extension of the mass, located dorsally or ventrally, resulting in a clear dorsal or ventral deviation of the contrast columns. In our case, however, the mass was located laterally. On myelography lateral compressive lesions cause widening of the spinal cord and narrowing of the contrast medium column on the lateral projection. These lesions are difficult to confirm with a ventrodorsal projection in the horse because of numerous superimpositions and increased scattered radiation, both of which decrease radiographic detail (Tucker and Gavin 2002). As also demonstrated in this case, CT myelography may be useful in distinguishing lateral compressive lesions of the spinal cord from an intramedullary lesion. Lateral
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