Haddad Jamie L, Goldschmidt Michael H, Patel Reema T
Department of Pathobiology, School of Veterinary Medicine, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Vet Clin Pathol. 2010 Jun;39(2):241-6. doi: 10.1111/j.1939-165X.2009.00209.x. Epub 2010 Jan 15.
An 8-year-old female spayed domestic shorthair cat had an abdominal mass palpated as an incidental finding on physical examination. Cytologic findings in ultrasound-guided fine-needle aspirates of the mass were most compatible with a sarcoma, with abundant mineralized material and mixed inflammation. The mass was removed surgically and on gross examination was white-tan, firm, associated with the mesentery, and when transected contained a gauze sponge in its center. On histopathologic examination, an area of central necrosis with mineralization and numerous refractile fibers consistent with sponge material was surrounded by dense fibrous connective tissue (gossypiboma). Within the connective tissue was a population of highly pleomorphic spindle cells consistent with a fibrosarcoma. Immunohistochemically, most neoplastic cells stained strongly positive for vimentin and a low number of cells were positive for smooth muscle actin. The results were consistent with a fibrosarcoma arising at the site of a retained surgical sponge. At a follow-up visit 2 months postoperatively, ultrasonographic and cytologic evidence of metastasis was found in the spleen and mesentery. To our knowledge, this is the first report of malignant transformation at the site of a retained surgical sponge in a cat and the first report of a fibrosarcoma arising within a gossypiboma in a domestic animal.
一只8岁已绝育的雌性家养短毛猫在体格检查时偶然发现腹部有一肿块。对该肿块进行超声引导下细针穿刺抽吸的细胞学检查结果最符合肉瘤,有大量矿化物质和混合性炎症。肿块经手术切除,大体检查呈灰白色、质地坚硬,与肠系膜相连,切开后中央含有一块纱布海绵。组织病理学检查显示,中央坏死区伴有矿化,有许多与海绵材料一致的折光性纤维,周围是致密的纤维结缔组织(棉纤维瘤)。结缔组织内有一群高度多形性的梭形细胞,符合纤维肉瘤。免疫组化显示,大多数肿瘤细胞波形蛋白染色强阳性,少数细胞平滑肌肌动蛋白阳性。结果符合在残留手术海绵部位发生的纤维肉瘤。术后2个月随访时,在脾脏和肠系膜发现了转移的超声和细胞学证据。据我们所知,这是猫体内残留手术海绵部位发生恶性转化的首例报告,也是家畜棉纤维瘤内发生纤维肉瘤的首例报告。