Sicotte Véronique, Benamou Jérôme, Fifle Lyanne C, Planté Jérôme, Lacoste Hugues I, Joly Hugo, Stern Adam W
Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, QC, Canada.
J Am Vet Med Assoc. 2012 Dec 15;241(12):1639-44. doi: 10.2460/javma.241.12.1639.
A 5-year-old sexually intact male Giant Schnauzer was evaluated because of difficulty breathing and left pelvic limb swelling. Eighteen months previously, the patient had had intermittent left pelvic limb swelling, but the owner declined further testing at that time.
Physical examination revealed severe pitting edema of the left pelvic limb and prepuce and muffled heart sounds on thoracic auscultation. Results of thoracic radiography and thoracocentesis were consistent with chylothorax, and CT imaging of the thorax and abdomen revealed a mass involving the whole left sublumbar area.
In an attempt to treat the chylothorax, pleural omentalization and pericardectomy were performed. Histologic evaluation of several biopsy specimens harvested in the abdominal and thoracic cavities revealed disseminated lymphangiosarcoma. The patient recovered well from surgery, and mitoxantrone chemotherapy was administered. As of 10 months after surgery, the dog was clinically normal except for mild pelvic limb edema.
The combination of clinical signs, multiple imaging features, surgical findings, and histologic examination findings enabled the final diagnosis of lymphangiosarcoma. Clinical management that included medical and surgical treatments and chemotherapy resulted in improved quality of life and extended survival time in a dog with metastatic lymphangiosarcoma.
一只5岁未绝育的雄性巨型雪纳瑞犬因呼吸困难和左后肢肿胀前来就诊。18个月前,该犬左后肢曾间歇性肿胀,但当时主人拒绝进一步检查。
体格检查发现左后肢和包皮严重凹陷性水肿,胸部听诊心音减弱。胸部X线摄影和胸腔穿刺结果与乳糜胸相符,胸部和腹部CT成像显示一个肿块累及整个左腰区。
为治疗乳糜胸,实施了胸膜网膜固定术和心包切除术。对从腹腔和胸腔采集的多个活检标本进行组织学评估,结果显示为弥漫性淋巴管肉瘤。该犬术后恢复良好,并接受了米托蒽醌化疗。截至术后10个月,除左后肢轻度水肿外,该犬临床状态正常。
临床症状、多种影像学特征、手术发现和组织学检查结果相结合,最终确诊为淋巴管肉瘤。包括药物治疗、手术治疗和化疗在内的临床管理提高了一只患有转移性淋巴管肉瘤犬的生活质量并延长了其生存时间。