Loderstedt S, Walmsley G L, Summers B A, Cappello R, Volk H A
Department of Veterinary Clinical Sciences, Royal Veterinary College, London, UK.
J Small Anim Pract. 2010 Jul;51(7):387-92. doi: 10.1111/j.1748-5827.2010.00931.x. Epub 2010 Jun 1.
A five-year eight-month-old Maltese terrier was presented with a 3-week history of progressive paraparesis and pelvic limb ataxia. Neurological examination was consistent with a lesion involving the T3-L3 spinal cord segments. Myelogram and magnetic resonance imaging revealed a spherical, intradural-extramedullary mass lesion at T13/L1. A dorsal laminectomy, durotomy and debulking of the mass were performed. Histopathologic examination revealed a highly cellular tissue, most likely of mesenchymal origin, infiltrated by many lymphocytes, macrophages and neutrophils. The pathological diagnosis of an inflammatory pseudotumour was made. Postsurgical analgesia was achieved with opioids and 2 mg/kg carprofen twice daily for 5 days. When the histopathological diagnosis was made, a tapering course of 1 mg/kg prednisolone twice daily was prescribed, with dose reduction by approximately 50% every 4 to 6 weeks over a 4-month period. Magnetic resonance imaging was repeated at 22, 32 and 85 weeks postsurgery; no signs of regrowth could be detected and the patient recovered with residual mild paraparesis. Inflammatory pseudotumour has not been documented previously at this site in dogs and, although rare, should be considered in the differential diagnosis of a focal mass lesion affecting the spinal cord. Surgical debulking and immunomodulatory therapy can be curative.
一只5岁8个月大的马尔济斯犬出现了3周的进行性轻截瘫和后肢共济失调病史。神经学检查结果与涉及T3 - L3脊髓节段的病变相符。脊髓造影和磁共振成像显示在T13/L1处有一个球形的硬膜内髓外肿块病变。进行了背部椎板切除术、硬脊膜切开术和肿块减压术。组织病理学检查显示为一种细胞丰富的组织,很可能起源于间充质,有许多淋巴细胞、巨噬细胞和中性粒细胞浸润。做出了炎性假瘤的病理诊断。术后使用阿片类药物镇痛,并每天两次给予2mg/kg卡洛芬,持续5天。在做出组织病理学诊断后,开出了每天两次1mg/kg泼尼松龙的逐渐减量疗程,在4个月内每4至6周剂量减少约50%。术后22周、32周和85周重复进行磁共振成像;未检测到复发迹象,患者恢复,但仍有轻度轻截瘫。炎性假瘤此前在犬的该部位未见报道,尽管罕见,但在影响脊髓的局灶性肿块病变的鉴别诊断中应予以考虑。手术减压和免疫调节治疗可能治愈。