Peri-orbital mass in a bearded dragon
Case Information
A 9-year-old female bearded dragon (Pogona vitticeps) was presented to the exotic animal service at Cornell University Hospital for Animals (CUHA) with a 2-year history of intermittent swelling around the right eye. The owners had initially noticed an injury, possibly a scratch, which evolved into the swelling. A purulent and hemorrhagic discharge was associated with the swelling on several occasions. Two weeks prior to presentation, the referring veterinarian flushed the eye with saline and prescribed an antibiotic-based ointment (Terramycin®). The swelling did not improve and the animal became inappetent.
Upon examination, the patient was bright and alert and vital signs were within normal limits. A firm, large, suppurative, bleeding, and ulcerated mass was noted over the right eye, obscuring the globe. Blood was taken for clinical pathologic testing. A complete blood count (CBC) revealed a mild left shift in heterophils (band heterophil concentration of 0.3 x 103/μL) as the only abnormality, which was interpreted as inflammation. No serum biochemical abnormalities were detected.
A full-body computerized tomography (CT) scan revealed a large heterogeneous soft tissue mass (1.8 cm length x 2.1 cm height x 1.8 cm width), which was mildly contrast-enhancing, in the right peri-orbital subcutaneous tissue. The mass displaced the eye medially. No abnormalities of the globe or adjacent bone were detected (Figure 1). No other lesions were detected.
A fine needle aspirate of the mass was performed. Direct smears were prepared from the aspirate and submitted for cytologic analysis. After examining the provided images (Figures 2-5), answer the questions below.
- Based on the tissue cells in the aspirate and location of your mass, what is your top differential diagnosis for the mass in the bearded dragon?
- How would you interpret the cell population depicted in Figure 4?
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