Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK.
Vet Rec. 2013 Apr 6;172(14):362. doi: 10.1136/vr.100812. Epub 2013 Jan 12.
Histopathological changes are reported in the livers of cats with congenital portosystemic shunts (CPSS) before and after surgical attenuation. Medical records, portovenograms and liver biopsies from cats treated surgically for CPSS were reviewed. Biopsies were graded for histopathological features characteristic of CPSS. Of 40 cats with CPSS included in the study, all had portal vein hypoplasia and arteriolar hyperplasia at initial surgery, 20 (50 per cent) had hepatocyte swelling with microvesicular vacuolar change, 17 (42.5 per cent) had fibrosis, 12 (30 per cent) had hepatocyte swelling with macrovesicular vacuolar change, 8 (20 per cent) had biliary hyperplasia and 2 (5 per cent) had haemosiderin within Küpffer cells. Cats with macrovesicular vacuolar change were significantly older than cats without (P = 0.001), with median ages of 18.5 months and 8.5 months, respectively. Twenty-five cats had partial attenuation of the CPSS at initial surgery, and 16 of these had follow-up biopsy samples. There were no significant differences in the histopathological features of biopsies before and after partial attenuation. From first to second surgery, there was a significant improvement in intrahepatic vasculature on portovenography both before (P = 0.001) and after (P = 0.039) temporary complete attenuation. Following partial CPSS attenuation, there was no significant change in histopathological features despite an improvement in intrahepatic vasculature on portovenography.
先天性门体分流(CPSS)猫在手术减流前后的肝脏组织病理学变化。对接受 CPSS 手术治疗的猫的病历、门腔静脉造影和肝活检进行了回顾。对具有 CPSS 特征的组织病理学特征进行了分级。在研究中纳入的 40 例 CPSS 猫中,所有猫在初次手术时均存在门静脉发育不良和小动脉增生,20 例(50%)存在肝细胞肿胀伴微泡性空泡变,17 例(42.5%)存在纤维化,12 例(30%)存在肝细胞肿胀伴大泡性空泡变,8 例(20%)存在胆管增生,2 例(5%)存在库普弗细胞内含铁血黄素。存在大泡性空泡变的猫比没有大泡性空泡变的猫年龄明显更大(P = 0.001),中位年龄分别为 18.5 个月和 8.5 个月。25 例猫在初次手术时进行了部分减流,其中 16 例有随访活检样本。部分 CPSS 减流前后的组织病理学特征无显著差异。从第一次手术到第二次手术,门静脉造影显示肝内血管均有显著改善(术前 P = 0.001,术后 P = 0.039)。在部分 CPSS 减流后,尽管门静脉造影显示肝内血管改善,但组织病理学特征无明显变化。