Case of the month #1

by Francesco Cian (DipECVCP)

This fine needle aspirate (FNA) is from a well-defined solitary mass on the tail in a ferret of unknown sex and age. What is your diagnosis?

Fig 1A-D well-defined solitary mass on the tail in a ferret, Wright Giemsa, 10-50x.
The sample is characterized by adequate cellularity and preservation. The background is pinkish and granular with a small number of red blood cells. There is a main population of polygonal-shaped cells present as both individualized elements and arranged in small groups. Cytoplasm is moderate to abundant, often vacuolated, with irregular borders. Nuclei are mostly round and centrally located, with coarse granular chromatin, and often round, visible nucleoli. Anisocytosis and anisokaryosis are moderate. A few leukocytes are also noted.
INTERPRETATION

Compatible with chordoma

INSIGHT

The morphology of these cells is typical of physaliferous cells. The term “Physaliphorous” is a combination of two words – the Greek word “Physallis,” meaning “bubble,” and “Phoros,” meaning “bearing.” Thus, physaliferous cells literally mean cells having a bubbly or vacuolated appearance.

Fig 2. well-defined solitary mass on the tail in a ferret, Wright Giemsa, 100x.

These cells are typically observed in chordoma, a rare neoplasm derived from embryologic remnants of the notochord. This neoplasm is found in several species. However, it is most commonly seen in ferrets, particularly at the level of the distal column, where small remnants of the notochord may persist. Possible differentials based on cell morphology include liposarcoma, myxosarcoma, mucinous adenocarcinoma, and sebaceous carcinoma. Histopathology and immunohistochemistry may help achieving a final diagnosis in cases where cytological evaluation is not definitive. These tumours tend to grow quite slowly, and surgical excision is often curative. Metastatic disease has been rarely described. In this specific case, the lesion was surgically removed, and tail amputated, but the owner declined histopathological examination. At 3 months from the surgery, the ferret has fully recovered with no recurrence of the disease noted. Have you even encountered a case like this?

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