LeBlanc Casey J, Echandi Rita L, Moore Rebecca R, Souza Carlos, Grooters Amy M
Department of Pathobiology, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA.
Vet Clin Pathol. 2008 Mar;37(1):115-20. doi: 10.1111/j.1939-165X.2008.00015.x.
A 20-month-old castrated male Labrador Retriever with a 3-month history of anorexia, weight loss, and vomiting was evaluated. Plasma biochemical abnormalities included marked hyperglobulinemia and hypercalcemia. Serum levels of parathyroid hormone, parathyroid hormone-related protein, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were either low or within reference intervals. Gastric wall thickening and abdominal lymphadenomegaly were observed with abdominal ultrasonography. Cytologic evaluation of a sample obtained via fine-needle aspiration of the gastric wall revealed pyogranulomatous inflammation and numerous poorly stained hyphae. Partial gastrectomy was performed, and a diagnosis of gastric pythiosis was made by immunohistochemical staining of infected gastric tissue, as well as by immunoblot serology. This case demonstrates that diagnostic samples for cytologic evaluation can be obtained by fine-needle aspiration of Pythium insidiosum-infected tissues and that a presumptive diagnosis can be made by examination of a Romanowsky-stained smear. Furthermore, pythiosis should be considered as a differential diagnosis for hypercalcemia, especially in young dogs with inflammatory lesions that have a granulomatous component. The mechanism for the hypercalcemia in this dog was not determined; however, calcium concentrations normalized after surgical resection of the gastric lesion.
对一只20月龄的去势雄性拉布拉多猎犬进行了评估，该犬有3个月的厌食、体重减轻和呕吐病史。血浆生化异常包括明显的高球蛋白血症和高钙血症。甲状旁腺激素、甲状旁腺激素相关蛋白、25-羟基维生素D和1,25-二羟基维生素D的血清水平要么偏低，要么在参考区间内。腹部超声检查发现胃壁增厚和腹部淋巴结肿大。通过胃壁细针穿刺获取的样本进行细胞学评估，发现有脓性肉芽肿性炎症和大量染色不佳的菌丝。进行了部分胃切除术，并通过对感染胃组织进行免疫组化染色以及免疫印迹血清学检查，诊断为胃梨形虫病。该病例表明，通过对感染隐秘梨形虫的组织进行细针穿刺可获得用于细胞学评估的诊断样本，并且通过检查罗曼诺夫斯基染色涂片可做出初步诊断。此外，梨形虫病应被视为高钙血症的鉴别诊断之一，特别是在患有具有肉芽肿成分的炎性病变的幼犬中。该犬高钙血症的机制尚未确定；然而，胃病变手术切除后钙浓度恢复正常。
