Evaluation of cytological diagnostic accuracy for canine splenic neoplasms: An investigation in 78 cases using STARD guidelines

PLoS One. 2019 Nov 7;14(11):e0224945. doi: 10.1371/journal.pone.0224945. eCollection 2019.


Cytology represents a useful diagnostic tool in the preliminary clinical approach to canine splenic lesions, and may prevent unnecessary splenectomy. However, few studies have evaluated diagnostic accuracy of cytology in the diagnosis of canine splenic neoplasms. The aim of this study was to determine overall accuracy, sensitivity, specificity, positive and negative predictive values (i.e. diagnostic accuracy indexes) of cytology for canine splenic neoplasms following Standards for the Reporting of Diagnostic Accuracy Studies (STARD) guidelines. A consecutive series of canine splenic cytological samples was retrospectively retrieved from the database of the Diagnostic Pathology Service of the Department of Veterinary Medicine (DIMEVET-University of Milan). Histopathology was set as the diagnostic reference standard. Cytological cases were enrolled when slides were available for review and when the same lesion was submitted for histopathology. Seventy-eight (78) lesions were included in the study. By histopathology, 56 were neoplastic and 22 were non-neoplastic. Cytology had an overall accuracy of 73.08% (95% C.I. 61.84%-82.50%), sensitivity of 64.29% (95% C.I. 50.36%-76.64%), specificity of 95.45% (95% C.I. 77.16%-99.88%), and positive and negative predictive values of 97.3% (95% C.I. 84.01%-99.60%) and 51.22% (95% C.I. 42.21%-60.15%), respectively. Low sensitivity and negative predictive value were balanced by very high specificity and positive predictive value. When positive for neoplasia, cytology represents a useful diagnostic tool to rule in splenic neoplasia, prompting surgery independently from other diagnostic tests. Conversely, a negative cytological result requires additional investigations to confirm the dog to be disease free.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Confidence Intervals
  • Cytodiagnosis*
  • Dogs
  • Likelihood Functions
  • Practice Guidelines as Topic*
  • Prevalence
  • Splenic Neoplasms / diagnosis*
  • Splenic Neoplasms / epidemiology
  • Splenic Neoplasms / pathology
  • Splenic Neoplasms / veterinary*

Grant support

The authors received no specific funding for this work. All the authors were employed by the Università degli Studi di Milano at the time by which the study was conducted and concluded. One of the authors [A.F.] is currently employed by IDEXX Laboratories (Wetherby, West Yorkshire, UK). This Company did not provide support in the form of salary for any of the authors at the time by which the study was conducted, neither had any additional role in the study design, research material supply, data collection and analysis, decision to publish, or preparation of the manuscript.