Cruz Cardona Janice A, Conley Kenneth J, Wellehan James F X, Farina Lisa L, Origgi Francesco C, Wamsley Heather L
Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608, USA.
J Am Vet Med Assoc. 2011 Jul 15;239(2):237-42. doi: 10.2460/javma.239.2.237.
A 9-year-old spayed female green iguana (Iguana iguana) was evaluated because of a distended coelom and weight loss. History included a single episode of egg binding and subsequent bilateral ovariosalpingectomy.
Physical examination revealed a mass within the coelomic cavity. Ultrasonography revealed a large, irregular mass with hypoechoic regions and coelomic effusion. Clinicopathologic derangements included heterophilia, monocytosis, lymphopenia, basophilia, hypocholesterolemia, hypoproteinemia, and hypercalcemia. Results of cytologic evaluation of the mass were suggestive of malignant epithelial neoplasia, but neoplastic cells were not found in the effusion. An ovarian tumor was suspected on the basis of clinical signs, clinicopathologic findings, and results of cytologic evaluation of the mass.
Surgical exploration revealed a large left ovary, a normal-appearing contralateral ovary, and a mass in the fat body, all of which were removed and submitted for histologic examination. The histologic diagnosis was granulosa cell tumor with metastasis to the fat body. The patient died 11 months after evaluation, and disseminated granulosa cell tumor was confirmed at necropsy; histologic examination at that time also identified systemic mastocytosis.
Granulosa cell tumors are uncommon in reptiles, and this was the first granulosa cell tumor described antemortem cytologically, histologically, and ultrastructurally in an iguana. Findings in this iguana underscored concerns associated with incomplete oophorectomy of iguanas; cytologic and histopathologic findings were similar to those observed in other domestic animals. Oophorectomy should be considered as an alternative to standard ovariosalpingectomy to avoid potential complications in pet reptiles, and use of microsurgical instruments and vascular clips is advised.
一只9岁已绝育的雌性绿鬣蜥（美洲鬣蜥）因腹腔膨胀和体重减轻前来就诊。病史包括一次卵嵌塞事件及随后的双侧卵巢输卵管切除术。
体格检查发现腹腔内有一个肿块。超声检查显示一个大的、不规则的肿块，伴有低回声区和腹腔积液。临床病理紊乱包括嗜异性粒细胞增多、单核细胞增多、淋巴细胞减少、嗜碱性粒细胞增多、低胆固醇血症、低蛋白血症和高钙血症。肿块的细胞学评估结果提示为恶性上皮性肿瘤，但积液中未发现肿瘤细胞。根据临床症状、临床病理发现及肿块的细胞学评估结果，怀疑为卵巢肿瘤。
手术探查发现一个大的左侧卵巢、外观正常的对侧卵巢以及脂肪体中有一个肿块，所有这些均被切除并送去做组织学检查。组织学诊断为颗粒细胞瘤伴脂肪体转移。该患者在评估后11个月死亡，尸检证实为弥漫性颗粒细胞瘤；当时的组织学检查还发现了全身性肥大细胞增多症。
颗粒细胞瘤在爬行动物中并不常见，这是第一例在鬣蜥中生前通过细胞学、组织学和超微结构描述的颗粒细胞瘤。这只鬣蜥的发现强调了与鬣蜥不完全卵巢切除术相关的问题；细胞学和组织病理学发现与其他家畜中观察到的相似。应考虑将卵巢切除术作为标准卵巢输卵管切除术的替代方法，以避免宠物爬行动物出现潜在并发症，建议使用显微手术器械和血管夹。
