Kook P H, Grest P, Raute-Kreinsen U, Leo C, Reusch C E
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland.
J Small Anim Pract. 2010 Jun;51(6):333-6. doi: 10.1111/j.1748-5827.2010.00916.x. Epub 2010 May 10.
A 12-year-old Rottweiler cross Labrador was presented with anorexia and weakness. Adrenal insufficiency was diagnosed with hyponatraemia, hyperkalaemia and undetectable resting and post-ACTH cortisol and aldosterone concentrations. The only abnormal diagnostic imaging result was bilateral adrenomegaly. Cytologic findings of liver, spleen and peripheral lymph nodes were normal. The dog responded initially to standard replacement therapy but relapsed shortly afterwards. The owners opted for euthanasia and allowed only removal of both adrenal glands. Microscopically, infiltrative polymorphic proliferations of densely packed tumour cells arranged as nests, intermingled with multifocal areas of necrosis and inflammatory cells were found. Silver staining revealed a few non-neoplastic adrenomedullary cells, whereas neoplastic cells did not stain. Immunohistochemistry was negative for neuron-specific enolase, vimentin, cytokeratin, synaptophysin, chromogranin A, S-100 protein, CD 56, 79 and 3. The final diagnosis was highly anaplastic bilateral adrenal neoplasia. This is the first report of bilateral adrenal malignancy presenting as clinical hypoadrenocorticism in a dog.
一只12岁的罗威纳犬与拉布拉多犬的杂交犬出现厌食和虚弱症状。通过低钠血症、高钾血症以及静息和促肾上腺皮质激素刺激后皮质醇和醛固酮浓度检测不到，诊断为肾上腺功能不全。唯一异常的诊断性影像学结果是双侧肾上腺肿大。肝脏、脾脏和外周淋巴结的细胞学检查结果正常。这只狗最初对标准替代疗法有反应，但不久后复发。主人选择实施安乐死，仅允许摘除双侧肾上腺。显微镜下发现，肿瘤细胞密集排列成巢状，呈浸润性多形性增生，伴有多灶性坏死和炎症细胞区域。银染色显示有一些非肿瘤性肾上腺髓质细胞，而肿瘤细胞不着色。免疫组化检测神经元特异性烯醇化酶、波形蛋白、细胞角蛋白、突触素、嗜铬粒蛋白A、S-100蛋白、CD 56、79和3均为阴性。最终诊断为高度间变性双侧肾上腺肿瘤。这是首例以临床肾上腺皮质功能减退表现的双侧肾上腺恶性肿瘤在犬类中的报道。
