A 23-month-old, 400-kg female quarterhorse was referred to the Louisiana State University Veterinary Teaching Hospital for recumbency due to rear limb paresis. Eleven days earlier, the owner had noticed transient abnormal head and neck posture, but no other abnormalities were noted until the animal suddenly became recumbent 3 days prior to referral. On physical examination, the horse was alert. Cranial nerve responses were normal, as were reflexes and cutaneous sensations of the forelimbs. There was paresis of the rear limbs, but patellar and withdrawal reflexes and sensory perception were intact. Tail control and anal muscle tone were normal. A complete blood count (CBC) revealed mature neutrophilia (16,400 white blood cells/μl, 90% segmenters), hyperfibrinogenemia (800 mg/dl), and hyperproteinemia (9.0 g/dl). With the exception of a slight elevation in creatine phosphokinase, the chemistry panel was normal, including calcium levels. Cerebrospinal fluid collected from the lumbosacral space was normal. A thoracolumbar spinal cord lesion was suspected and the horse was treated accordingly. No change in condition was seen in 24 hr and the animal was euthanized. Within the vertebral canal at the level of the first lumbar vertebra was an elongated, tan-white subperiosteal mass measuring 2 x 5 cm (Fig. 1). This mass had a glistening smooth surface (periosteum) and compressed the spinal cord at that point. Cross section of the first lumbar vertebra revealed destruction of the vertebral body and replacement by soft tan-white tissue. This tissue displaced and replaced trabecular bone in the vertebral body and at the base of the dorsal spinous process. Focal destruction of the cortex presumably allowed formation of the subperiosteal mass, which protruded into the vertebral canal. The spleen weighed 22 kg and contained a 30-cm-diameter round mass (Fig. 2). The surface of the splenic mass was smooth and mottled in color from red to tan to dark purple. There were 5 thick, sessile, discoid plaques present on the splenic mass and the adjacent capsule. The plaques were pale tan, 4-8 cm in diameter, flattopped, and elevated 2-4 cm above the capsular surface. Cut section of the mass and plaques revealed multiple coalescing round nodules of moderately soft tan tissue (Fig. 3). Nodules varied in size from 0.5 to 2 cm in diameter and were occasionally separated from one another by hemorrhage, giving the tissue an overall marbled tan and red appearance. Approximately 50% of the center of the mass was necrotic, as characterized by friable yellow-tan tissue and a 9-cm-diameter area of liquification necrosis. Mesenteric lymph nodes were enlarged and many contained multiple discrete cortical nodules up to 1.5 cm in diameter.