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Sternal Lymphadenopathy as a Prognostic Factor in Dogs with Splenic Malignancy

Ravinder S. Dhaliwal, DVM, MS, DACVIM (Oncology), DABVP (Canine and Feline), MedVet Silicon Valley, San Jose, California


|July 2022

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In the literature

Kelsey J, Balfour R, Szabo D, Kass PH. Prognostic value of sternal lymphadenopathy on malignancy and survival in dogs undergoing splenectomy. Vet Comp Oncol. 2022;20(1):1-7. doi:10.1111/vco.12700


Hemangiosarcoma is a malignancy that originates from vascular endothelial cells. The spleen is the most commonly affected primary organ in dogs, but additional sites have also been reported.1 Other splenic sarcomas (eg, fibrosarcoma, leiomyosarcoma, extraskeletal osteosarcoma, undifferentiated sarcomas) are nonangiomatous, nonlymphoid tumors of connective tissue. 

Several prognostic factors (eg, hemoabdomen, multiple splenic lesions, imaging findings, anemia, thrombocytopenia) have been evaluated in dogs with splenic hemangiosarcoma, with clinical stage of disease consistently correlated with overall survival time. Dogs with advanced clinical stage have poor outcomes compared with dogs with stage I disease.2,3

This retrospective study evaluated the clinical significance of sternal lymphadenopathy in 195 dogs undergoing splenectomy (most due to hemoabdomen), as well as prognostic significance in malignant splenic disease. Of these dogs, 102 (52.3%) were diagnosed with benign lesions, 74 (37.9%) were diagnosed with hemangiosarcoma, and 19 (10%) were diagnosed with malignancies other than hemangiosarcoma. 

Incidence of sternal lymphadenopathy was 12.8% overall, 16.2% in the hemangiosarcoma group, 15.8% in the nonhemangiosarcoma malignancy group, and 9.8% in the benign process group. 

Although sternal lymphadenopathy was not a predictor for malignancy in dogs with hemoperitoneum, dogs diagnosed with both hemangiosarcoma and sternal lymphadenopathy had shorter survival compared with dogs with hemangiosarcoma without sternal lymphadenopathy. Sternal lymphadenopathy may therefore have predictive value for survival of dogs with splenic malignancy.


Key pearls to put into practice:


Sternal lymphadenopathy is not a predictor of malignancy in dogs with splenic masses, with or without hemoperitoneum.



Etiology of sternal lymphadenopathy is unknown. Microscopic evaluation is needed to rule out reactive versus metastatic disease processes.



Dogs diagnosed with both splenic hemangiosarcoma and sternal lymphadenopathy on thoracic radiographs had shorter survival compared with dogs without radiographic evidence of sternal lymphadenopathy.


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