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Topic:Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is a type of malignant tumor that arises from squamous epithelial cells, commonly affecting horses' skin, eyes, and mucous membranes. It is one of the most frequently diagnosed cancers in equine species. This carcinoma is associated with prolonged exposure to ultraviolet light, particularly in areas with minimal pigmentation or hair coverage. SCC can present as ulcerated lesions or proliferative masses and may lead to local tissue destruction and metastasis if untreated. Diagnosis typically involves clinical examination, biopsy, and histopathological analysis. Treatment options vary depending on the tumor's location and stage and may include surgical excision, cryotherapy, or chemotherapy. This section aggregates peer-reviewed studies and scholarly articles that explore the pathogenesis, risk factors, diagnostic methods, and treatment approaches for squamous cell carcinoma in horses.
Equus caballus papillomavirus 8 (EcPV8) associated with multiple viral plaques, viral papillomas, and squamous cell carcinoma in a horse.
Equine veterinary journal    December 17, 2018   Volume 51, Issue 4 470-474 doi: 10.1111/evj.13046
Peters-Kennedy J, Lange CE, Rine SL, Hackett RP.Equus caballus papillomavirus 8, a recently discovered virus, has been reported to cause generalised papillomavirus in horses. Objective: To describe a case in which multiple viral plaques, viral papillomas, squamous cell carcinoma (SCC) in situ and invasive squamous cell carcinoma (ISCC) were associated with EcPV8 in a horse. Methods: Case report. Methods: A 16-year-old mixed breed horse presented with dozens of raised crusted papular to nodular lesions over a course of 4 years. Masses had been surgically excised four times and cisplatin beads and emulsion were implanted on three different ...
Rhomboid blepharoplasty and cryotherapy for the treatment of a squamous cell carcinoma on the lower eyelid in a horse.
Clinical case reports    November 11, 2018   Volume 7, Issue 1 40-46 doi: 10.1002/ccr3.1907
Jeanes EC, Koll-Hampp S, Dawson C, Dunkel B, Tetas Pont R.A rhomboid blepharoplasty can be used to achieve functional and cosmetic eyelid reconstruction at the medial canthus in the horse. Combination of a rhomboid blepharoplasty with cryotherapy is a treatment option for eyelid ocular squamous cell carcinomas.
Molecular Detection of Equus caballus Papillomavirus Type 2 in Genital Swabs From Healthy Horses in the Republic of Korea.
Journal of equine veterinary science    October 21, 2018   Volume 72 97-100 doi: 10.1016/j.jevs.2018.10.015
Lee SK, Lee JK, Lee I.Equus caballus papillomavirus type 2 (EcPV-2) is implicated in genital neoplasms in horses, including equine penile papillomas, penile intraepithelial neoplasia, and squamous cell carcinoma (SCC). This virus seldom regresses spontaneously and can result in the development of SCC, which may result in significant clinical damage and economic cost. However, the prevalence of this virus is unknown in clinically unaffected horses. The aim of this study was to determine the prevalence of EcPV-2 DNA in genital swabs from healthy horses in the Republic of Korea and to investigate genetic variability w...
Limbal squamous cell carcinoma in a Rocky Mountain Horse: Case report and investigation of genetic contribution.
Veterinary ophthalmology    September 20, 2018   Volume 22, Issue 2 201-205 doi: 10.1111/vop.12612
Knickelbein KE, Lassaline ME, Bellone RR.To document a case of limbal squamous cell carcinoma (SCC) in a Rocky Mountain Horse stallion determined to be homozygous for the genetic risk factor (DDB2 c.1013C>T) strongly associated with the disease in Haflinger and Belgian horses, and to determine the frequency of this allele in a larger population of Rocky Mountain Horses. Methods: One privately owned Rocky Mountain Horse and 84 Rocky Mountain Horses screened for allelic frequency. Methods: A complete ophthalmic examination was performed on a Rocky Mountain Horse stallion for assessment of a mass affecting the right eye. A clinical diag...
Genetic risk for squamous cell carcinoma of the nictitating membrane parallels that of the limbus in Haflinger horses.
Animal genetics    July 12, 2018   Volume 49, Issue 5 457-460 doi: 10.1111/age.12695
Singer-Berk M, Knickelbein KE, Vig S, Liu J, Bentley E, Nunnery C, Reilly C, Dwyer A, Drögemüller C, Unger L, Gerber V, Lassaline M, Bellone RR.Squamous cell carcinoma (SCC) is the most common cancer affecting the equine eye, with a higher incidence documented in Haflinger horses. Recently, a missense variant in the gene damage specific DNA binding protein 2 (DDB2, p.Thr338Met) on ECA12 was identified as a risk factor for the development of limbal SCC in Haflinger horses. SCC also occurs on the nictitating membrane; therefore, investigating the role of this missense variant in nictitating membrane SCC is warranted. In this study, a common ancestor was identified among Haflinger horses affected with limbal SCC or with nictitating membr...
Isolated limb perfusion electrochemotherapy for the treatment of an advanced squamous cell carcinoma of the hoof in a mare.
Open veterinary journal    June 28, 2017   Volume 7, Issue 2 192-196 doi: 10.4314/ovj.v7i2.18
Spugnini EP, Bolaffio C, Scacco L, Baldi A.A twenty-year-old female saddle horse was referred for evaluation of a seven month, non-healing erosive lesion of the right hind hoof with proliferation and bleeding of the underlying soft tissues. This lesion had been twice surgically treated as a canker but rapidly recurred. Histological examination of the second excision revealed a well-differentiated squamous cell carcinoma. At presentation, the horse was mildly depressed, lame and partially non-weight-bearing on the right hind leg, which exhibited a 10 x 10 cm erosive and proliferative lesion remodeling the hoof. After completing staging ...
Papillomavirus infection and squamous cell carcinoma in horses.
Veterinary journal (London, England : 1997)    May 31, 2017   Volume 223 48-54 doi: 10.1016/j.tvjl.2017.05.007
Sykora S, Brandt S.Squamous cell carcinoma (SCC) is a common disease that seriously impairs the health and welfare of affected horses and other equids. In humans, almost all cervical carcinomas, a high percentage of anogenital SCCs and a subset of SCCs of the head and neck are caused by high-risk human papillomavirus (hrHPV) infection. Since hrHPV-induced human cancers and equine SCC have similar cytological and histopathological features, it has been hypothesised that equine SCCs could also be induced by papillomaviruses. This review provides an overview of the current evidence for an aetiological association b...
A missense mutation in damage-specific DNA binding protein 2 is a genetic risk factor for limbal squamous cell carcinoma in horses.
International journal of cancer    May 8, 2017   Volume 141, Issue 2 342-353 doi: 10.1002/ijc.30744
Bellone RR, Liu J, Petersen JL, Mack M, Singer-Berk M, Drögemüller C, Malvick J, Wallner B, Brem G, Penedo MC, Lassaline M.Squamous cell carcinoma (SCC) is the most common cancer of the equine eye, frequently originating at the limbus, with the potential to invade the cornea, cause visual impairment, and result in loss of the eye. Several breeds of horses have a high occurrence of limbal SCC implicating a genetic basis for limbal SCC predisposition. Pedigree analysis in the Haflinger breed supports a simple recessive mode of inheritance and a genome-wide association study (N = 23) identified a 1.5 Mb locus on ECA12 significantly associated with limbal SCC (Pcorrected = 0.04). Sequencing the most physiologicall...
Equine papillomavirus type 2: An equine equivalent to human papillomavirus 16?
Veterinary journal (London, England : 1997)    May 3, 2017   Volume 225 3-8 doi: 10.1016/j.tvjl.2017.04.014
Sykora S, Jindra C, Hofer M, Steinborn R, Brandt S.In horses, squamous cell carcinomas (SCC) commonly affect the external genitals. There is growing evidence that equine papillomavirus type 2 (EcPV2) infection promotes disease development. To assess the possible association of EcPV2 with equine SCCs of the head (HSCC), 15 HSCC DNA samples were screened by E6/E7, E2, and LCR PCR and amplicons were analysed for sequence variations. The physical form of EcPV2 in HSCC, genital lesions, and smegma from horses with SCC was then addressed using EcPV2 immunocapture PCR (IC/PCR) for detection of virion, and E6 vs. E2 qPCR to investigate possible integr...
Neoplasia in 125 donkeys (Equus asinus): literature review and a survey of five veterinary schools in the United States and Canada. Davis CR, Valentine BA, Gordon E, McDonough SP, Schaffer PA, Allen AL, Pesavento P.A diagnosis of neoplasia was noted in 125 of 357 donkeys (35%) in our review of medical records from 5 veterinary schools in the United States and Canada. Equine sarcoid was the most common tumor in our study, accounting for 72% of all tumors and 82% of cutaneous tumors. Soft-tissue sarcomas were the second most common skin tumors. All other types of neoplasia were rare. Important differences in the occurrence of neoplasia in donkeys compared to horses included the rarity or absence of squamous cell carcinoma in any organ system and gray horse melanoma. Lymphosarcoma, the most common malignant...
Establishment of an in vitro equine papillomavirus type 2 (EcPV2) neutralization assay and a VLP-based vaccine for protection of equids against EcPV2-associated genital tumors.
Virology    October 28, 2015   Volume 486 284-290 doi: 10.1016/j.virol.2015.08.016
Schellenbacher C, Shafti-Keramat S, Huber B, Fink D, Brandt S, Kirnbauer R.The consistent and specific presence of Equus caballus papillomavirus type 2 (EcPV2) DNA and mRNA in equine genital squamous cell carcinoma (gSCC) is suggestive of an etiological role in tumor development. To further validate this concept, EcPV2-neutralizing serum antibody titers were determined by an EcPV2 pseudovirion (PsV) neutralization assay. Furthermore, an EcPV2 L1 virus-like particle (VLP)-based vaccine was generated and its prophylactic efficacy evaluated in vivo. All 6/6 gSCC-affected, but only 3/20 tumor-free age-matched animals revealed EcPV2-neutralizing serum antibody titers by P...
What’s New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids.
Veterinary pathology    October 12, 2015   Volume 53, Issue 2 390-398 doi: 10.1177/0300985815608674
Miller MA, Moore GE, Bertin FR, Kritchevsky JE.Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n = 116) with that in equids ≥20 years of age (n = 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous...
Equine Genital Squamous Cell Carcinoma: In Situ Hybridization Identifies a Distinct Subset Containing Equus caballus Papillomavirus 2.
Veterinary pathology    May 12, 2015   Volume 52, Issue 6 1067-1072 doi: 10.1177/0300985815583095
Zhu KW, Affolter VK, Gaynor AM, Dela Cruz FN, Pesavento PA.Equus caballus papillomavirus 2 (EcPV2) has been proposed as an etiologic agent for genital squamous cell carcinoma (SCC), the most common malignant tumor of the horse penis. EcPV2 is commonly detected by polymerase chain reaction (PCR) on normal horse genitalia; therefore, unraveling the virus' role in oncogenic transformation requires other methods of detection. In this study, a highly sensitive multiple-probe chromogenic in situ hybridization (ISH) technique was designed to recognize the E6/E7 oncogenes of EcPV2. ISH demonstrated abundant virus within 6 of 13 penile and preputial SCCs, wher...
A database survey of equine tumours in the United Kingdom.
Equine veterinary journal    March 19, 2015   Volume 48, Issue 3 280-284 doi: 10.1111/evj.12421
Knowles EJ, Tremaine WH, Pearson GR, Mair TS.Survey data on equine tumours are sparse compared with other species and may have changed over time. Objective: To describe the most frequently diagnosed equine tumours recorded by a diagnostic pathology laboratory over 29 years, to identify background factors associated with tumour type, and to identify any changes in the tumours diagnosed or the background of cases submitted during the study period. Methods: Observational; cross-sectional analysis of records of a diagnostic pathology laboratory. Methods: The records of all neoplastic equine histology submissions to the University of Bristol ...
Limbal squamous cell carcinoma in Haflinger horses.
Veterinary ophthalmology    October 14, 2014   Volume 18, Issue 5 404-408 doi: 10.1111/vop.12229
Lassaline M, Cranford TL, Latimer CA, Bellone RR.To describe the prevalence of LSCC in Haflinger horses and to analyze affected horses' pedigrees investigating the genetic mode of inheritance. Methods: Fifteen horses met inclusion criterion of (i) being of the Haflinger breed, as confirmed by North American Haflinger Registry pedigree and (ii) being diagnosed with LSCC, as confirmed by clinical examination by a veterinary ophthalmologist or by histopathology. Pedigrees could not be obtained for four additional horses diagnosed with LSCC that had been identified as Haflingers. Methods: Retrospective medical record review of all 19 horses was ...
Expression of epidermal growth factor receptor and human epidermal growth factor receptor 2 in periocular squamous cell carcinomas of horses.
American journal of veterinary research    September 26, 2014   Volume 75, Issue 10 912-917 doi: 10.2460/ajvr.75.10.912
Hendrix DV, Newkirk KM.To determine whether epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) are expressed in periocular squamous cell carcinomas (SCCs) of horses. Methods: Biopsy specimens of SCCs from 46 horses. Methods: Pathology records were searched retrospectively for biopsy specimens of periocular SCCs obtained from horses. Slides of the specimens were reviewed histologically to confirm the SCC diagnosis and stained for EGFR and HER2 by immunohistochemical methods. For both EGFR and HER2, the immunohistochemical staining intensity and percentage of stain-positive cel...
Characterization and outcome following excision of masses in the nictitating membranes of horses: 50 cases (1998-2012).
Journal of the American Veterinary Medical Association    September 18, 2014   Volume 245, Issue 7 812-815 doi: 10.2460/javma.245.7.812
Scherrer NM, Lassaline-Utter M, McKenna BC.To determine the histologic findings associated with masses in the nictitating membranes (third eyelids) of horses and to identify prognostic factors associated with recurrence and the outcome. Methods: Retrospective case series. Methods: 50 horses with masses in a third eyelid. Methods: Medical records of horses with partial or complete excision of a third eyelid and submission for histologic evaluation between September 1998 and November 2012 were reviewed. Horses were included if follow-up information for at least 1 year after surgery was available. Information regarding signalment and trea...
Local photodynamic therapy delays recurrence of equine periocular squamous cell carcinoma compared to cryotherapy.
Veterinary ophthalmology    August 16, 2014   Volume 17 Suppl 1 37-45 doi: 10.1111/vop.12099
Giuliano EA, Johnson PJ, Delgado C, Pearce JW, Moore CP.(i) To report the successful treatment of 10 cases of equine periocular squamous cell carcinoma (PSCC) with surgical excision and photodynamic therapy (PDT) using verteporfin. (ii) To evaluate time to first tumor recurrence between PDT-treated horses and horses treated with surgical excision and cryotherapy. Methods: A total of 24 equine PSCC cases were included: group 1 (n = 14) had excision and cryotherapy (1993–2003), group 2 (n = 10), excision and local PDT (2006–2010). Evaluated data: signalment, treatment method, tumor location, size, and time to first recurrence. Groups were compare...
Comparison of the effect of two doses of omeprazole on the squamous gastric mucosa in thoroughbred racehorses.
The Veterinary record    August 5, 2014   Volume 175, Issue 10 249 doi: 10.1136/vr.102622
Sykes BW, Sykes K, Hallowell GD.No abstract available
Serum antibodies and DNA indicate a high prevalence of equine papillomavirus 2 (EcPV2) among horses in Switzerland.
Veterinary dermatology    May 21, 2014   Volume 25, Issue 3 210-e54 doi: 10.1111/vde.12129
Fischer NM, Favrot C, Birkmann K, Jackson M, Schwarzwald CC, Müller M, Tobler K, Geisseler M, Lange CE.The DNA of equine papillomavirus type 2 (EcPV2) is consistently found in equine papillomas and squamous cell carcinomas, indicating a causal association of EcPV2 in the pathogenesis of these tumours; however, little is known about the prevalence of this virus. Objective: The aim of this study was to determine the geno- and seroprevalence of EcPV2 in clinically healthy horses in Switzerland. Methods: Fifty horses presented to the equine department of the university clinic, displaying no skin or mucous membrane lesions or severe signs of other diseases, were sampled. Methods: Cytobrush samples ...
Expression of p53, Ki67, EcPV2- and EcPV3 DNA, and viral genes in relation to metastasis and outcome in equine penile and preputial squamous cell carcinoma.
Equine veterinary journal    May 4, 2014   Volume 47, Issue 2 188-195 doi: 10.1111/evj.12245
van den Top JG, Harkema L, Lange C, Ensink JM, van de Lest CH, Barneveld A, van Weeren PR, Gröne A, Martens A.Equine penile and preputial squamous cell carcinoma (SCC) is a potentially lethal disease of which little is known regarding the relationship between tumour characteristics and prognosis. Objective: To assess the relationship between tumour differentiation grade (tumour subtype), presence of papillomaviruses, expression of viral genes (E2, E6, L1), nuclear proteins p53 and Ki67 and metastasis in equine penile and preputial SCC and to assess the relationship of tumour subtype, presence of papillomavirus type 2, p53 and Ki67 with survival. Methods: Retrospective case-control study using archived...
Detection of papillomavirus in equine periocular and penile squamous cell carcinoma. Newkirk KM, Hendrix DV, Anis EA, Rohrbach BW, Ehrhart EJ, Lyons JA, Kania SA.Squamous cell carcinoma (SCC) is the most common tumor arising in the periocular and penile areas of horses. Both ultraviolet radiation and papillomaviruses have been implicated in the pathogenesis of SCC in various species, including the horse. This retrospective study used polymerase chain reaction (PCR) to detect papillomavirus DNA in archival biopsy samples from equine periocular and penile SCC from 3 different geographic areas (northeast, southeast, and central United States). Forty-two periocular SCCs were tested; none contained papillomavirus DNA. Twenty-two penile SCCs were tested, and...
Expression of cyclo-oxygenases-1 and -2, and microsomal prostaglandin E synthase-1 in penile and preputial papillomas and squamous cell carcinomas in the horse.
Equine veterinary journal    December 5, 2013   Volume 46, Issue 5 618-624 doi: 10.1111/evj.12144
van den Top JG, Harkema L, Ensink JM, Barneveld A, Martens A, van de Lest CH, van Weeren PR, Gröne A.Penile and preputial papilloma and squamous cell carcinoma (SCC) are commonly diagnosed in horses. Papillomas have the potential to progress to potentially lethal SCC. Knowledge of pathogenetic mechanisms may help in prevention and definition of treatment targets. Methods: Retrospective study using archived material. Objective: To determine the expression of cyclo-oxygenase 1 (COX-1), cyclo-oxygenase 2 (COX-2) and microsomal prostaglandin E synthase-1 (mPGES-1) in penile and preputial normal tissue, papilloma and SCC in horses, and whether expression of these enzymes is influenced by degree of...
Verrucous hemangioma with pseudoepitheliomatous epidermal hyperplasia in an adult horse.
Veterinary pathology    November 27, 2013   Volume 51, Issue 5 992-995 doi: 10.1177/0300985813513039
Pérez-Écija A, Estepa JC, Barranco I, Rodríguez-Gómez IM, Mendoza FJ, Gómez-Laguna J.Verrucous hemangiomas are a rare specific variant of equine skin tumors not well described in the literature. An 8-year-old gelding presented a unilateral lesion on the pastern. Macroscopically, the mass showed a warty and verrucous surface with focal ulcerations. The histology showed a dermal proliferation of endothelial-layered capillaries and venules separated by a delicate stroma of scant fibroblasts and collagen deposition, with pseudoepitheliomatous hyperplasia (exuberant reactive irregular epithelial hyperplasia with tongue-like projections extending into the dermis, mimicking downgrowt...
Papillomavirus-associated diseases.
The Veterinary clinics of North America. Equine practice    October 1, 2013   Volume 29, Issue 3 643-655 doi: 10.1016/j.cveq.2013.08.003
Torres SM, Koch SN.This article reviews various aspects of 3 clinical disorders associated with papillomavirus in horses commonly known as classical viral papillomatosis, genital papillomas/papillomatosis, and aural plaques. Classical papillomatosis is usually asymptomatic and spontaneously resolves within 1 to 9 months; therefore, treatment is often not required. Genital papillomas/papillomatosis have not been reported to spontaneously resolve, and there is increasing evidence that genital papillomas may evolve to in situ or invasive squamous cell carcinomas. Horses with aural plaques may be asymptomatic or may...
Surgical Management of Penile and Preputial Neoplasms in Equine with Special Reference to Partial Phallectomy.
Journal of veterinary medicine    September 8, 2013   Volume 2013 891413 doi: 10.1155/2013/891413
Rizk A, Mosbah E, Karrouf G, Abou Alsoud M.Penile and preputial neoplasia in horses occurs infrequently and represents diagnostic and therapeutic challenges. The present study was carried out on a total number of 21 equids (14 stallions and 7 donkeys) suffered from different penile and preputial neoplasia. Diagnosis of neoplasms was based up on history of the case, clinical examination as well as histopathological evaluation. Animals with penile and preputial neoplasms were underwent local excision and partial phallectomy with a slightly modified version of the techniques described by William's. The diagnosed neoplasms were penile and ...
Comparison of the levels of Equus caballus papillomavirus type 2 (EcPV-2) DNA in equine squamous cell carcinomas and non-cancerous tissues using quantitative PCR.
Veterinary microbiology    June 20, 2013   Volume 166, Issue 1-2 257-262 doi: 10.1016/j.vetmic.2013.06.004
Knight CG, Dunowska M, Munday JS, Peters-Kennedy J, Rosa BV.Equus caballus papillomavirus type 2 (EcPV-2) infection has been associated with equine genital squamous cell carcinomas (SCCs). However, quantitative PCR (qPCR) has not been performed to determine viral copy numbers within these lesions. Additionally, the frequency with which EcPV-2 can be detected in other common sites of equine SCC development remains uncertain. The aim of this study was to develop a qPCR assay to estimate the viral load in a variety of equine tissue samples. These included 40 SCC lesions, 19 penile non-SCC or precursor disease lesions, and 222 tissues without observable le...
Cutaneous neoplastic lesions of equids in the central United States and Canada: 3,351 biopsy specimens from 3,272 equids (2000-2010).
Journal of the American Veterinary Medical Association    December 14, 2012   Volume 242, Issue 1 99-104 doi: 10.2460/javma.242.1.99
Schaffer PA, Wobeser B, Martin LE, Dennis MM, Duncan CG.To identify epidemiological trends in cutaneous neoplasms affecting equids in central North America and compare them with previously reported trends. Methods: Retrospective case series. Methods: 3,351 cutaneous biopsy specimens from 3,272 equids with a neoplastic diagnosis. Methods: Diagnostic reports from 2 diagnostic laboratories (Colorado State University and Prairie Diagnostic Services Inc) were reviewed for frequency of specific lesions and epidemiological trends. Variables included in analyses (if known) were age, sex, breed, geographic location, date of diagnosis, location of neoplasm o...
EcPV2 DNA in equine papillomas and in situ and invasive squamous cell carcinomas supports papillomavirus etiology.
Veterinary pathology    October 11, 2012   Volume 50, Issue 4 686-692 doi: 10.1177/0300985812463403
Lange CE, Tobler K, Lehner A, Grest P, Welle MM, Schwarzwald CC, Favrot C.Equine penile papillomas, in situ carcinomas, and invasive carcinomas are hypothesized to belong to a continuum of papillomavirus-induced diseases. The former ones clinically present as small grey papules, while the latter 2 lesions are more hyperplasic or alternatively ulcerated. To test the hypothesis that these lesions are papillomavirus-induced, samples of 24 horses with characteristic clinical and histologic findings of penile papillomas or in situ or invasive squamous cell carcinomas were collected. As controls, 11 horses with various lesions--namely, Balanoposthitis (6 cases), melanoma ...
[Diagnostic assessment of peritoneal fluid cytology in horses with abdominal neoplasia].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    April 25, 2012   Volume 40, Issue 2 85-93 
Recknagel S, Nicke M, Schusser GF.To evaluate the diagnostic value of peritoneal fluid (PF) cytology for clinical diagnosis of abdominal neoplasia in horses. Methods: Ten horses with histopathologically confirmed abdominal neoplasia, in which a PF analysis was performed, were included in this retrospective study. PF was analyzed for total protein concentration and a nucleated cell count was performed. Using cytological criteria of malignancy, the PF samples were evaluated regarding their probability of malignancy. Results: Cytologic classification of cells according to criteria of malignancy allowed a positive cytologic diagno...