Unique cytologic and histologic features of a suspected cutaneous xanthoma in a dog

A 4-year-old spayed female American Staffordshire Terrier presented to the U-Vet Animal Hospital, Werribee, Australia, with a cutaneous mass that had been slowly growing over 12 months. Cytologic evaluation showed cohesive to individualized, vacuolated spindled cells often arranged in a perivascular pattern. The mass was completely excised, and the histopathologic examination demonstrated sheets of vacuolated spindled to round cells expanding the full thickness of the dermis. The cells demonstrated both Iba1 and CD18 antibody binding, leading to an initial interpretation of histiocytic sarcoma. Given the discordance with the clinical presentation, further immunohistochemistry (IHC) was performed. The cells demonstrated strong CD204 antibody binding and did not bind E-cadherin antibody, consistent with a dermal macrophage origin. Ki-67 antibody binding was regionally variable from <5% to 25%, with more regions that had low Ki-67 expression. A fasted serum biochemistry panel revealed hypertriglyceridemia and persistent hypercholesterolemia. Based on clinical, microscopic, biochemical, and IHC results, the final interpretation was an indolent dermal histiocytic proliferation of macrophage origin, with a preference for cutaneous xanthoma or reactive dermal fibrohistiocytoma.