Watson Adam T, Penninck Dominique, Knoll Joyce S, Keating John H, Sutherland-Smith James
Department of Clinical Sciences, Tufts Cumming School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
Vet Radiol Ultrasound. 2011 May-Jun;52(3):317-22. doi: 10.1111/j.1740-8261.2010.01778.x. Epub 2010 Dec 28.
The safety and diagnostic value of combined splenic fine-needle aspiration (FNA) and needle core biopsy (NCB) is unknown. Forty-one dogs with splenic lesions were studied prospectively. Safety was assessed in 38 dogs and no complications were encountered. Initially, clinical and anatomic pathologists reviewed each FNA and NCB sample, respectively, without knowledge of the other's results. Diagnoses were categorized as neoplastic, benign, inflammatory, normal, or nondiagnostic. The level of agreement between sampling methods was categorized as complete, partial, disagreement, or not available. Test correlation was performed in 40 dogs. Nondiagnostic results occurred in 5/40 NCB (12.5%) and no FNA samples. Neoplasia was diagnosed in 17/40 dogs (42.5%), benign changes in 20/40 dogs (50%), inflammatory disorders in 0/40 dogs, and normal 2/40 dogs (5%). One of the 40 dogs (2.5%) had a diagnosis that was equivocal for neoplasia on both tests and therefore was not categorized. Of the 35 dogs that had diagnostic samples, cytopathologic and histopathologic diagnoses agreed completely in 18/35 dogs (51.4%), partially in 3/35 dogs (8.6%), and were in disagreement in 14/35 dogs (40.0%). Pathologists collaboratively reviewed diagnoses that were in disagreement or partial agreement and altered their individual diagnoses in 6/17 dogs (35.3%) to be within partial or complete agreement, respectively. Percutaneous FNA and NCB can be performed safely in dogs with sonographic splenic changes. Results suggest that adding NCB to FNA provides complementary information in dogs with suspected splenic neoplasia. This combined protocol may improve detection of splenic neoplasia and provide neoplastic subclassification.
脾脏细针穿刺抽吸活检（FNA）联合针芯活检（NCB）的安全性及诊断价值尚不清楚。对41只患有脾脏病变的犬进行了前瞻性研究。对38只犬评估了安全性，未出现并发症。最初，临床病理学家和解剖病理学家分别在互不了解对方结果的情况下审查每个FNA和NCB样本。诊断分为肿瘤性、良性、炎症性、正常或无法诊断。将采样方法之间的一致程度分为完全一致、部分一致、不一致或无法获得。对40只犬进行了检验相关性分析。5/40例（12.5%）NCB样本结果无法诊断，FNA样本均无此情况。40只犬中17只（42.5%）诊断为肿瘤，20只（50%）为良性改变，0只（0%）为炎症性疾病，2只（5%）正常。40只犬中有1只（2.5%）在两项检查中肿瘤诊断均不明确，因此未分类。在35只获得诊断性样本的犬中，细胞病理学和组织病理学诊断完全一致的有18/35只（51.4%），部分一致的有3/35只（8.6%），不一致的有14/35只（40.0%）。病理学家共同审查了不一致或部分一致的诊断，并将其中6/17只（35.3%）犬的个人诊断分别改为部分一致或完全一致。经皮FNA和NCB可安全用于脾脏有超声改变的犬。结果表明，对疑似脾脏肿瘤的犬，在FNA基础上加做NCB可提供补充信息。这种联合方案可能会提高脾脏肿瘤的检出率并进行肿瘤亚分类。
