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九只猫肺纤维化的影像学和组织病理学特征

Radiographic and histopathologic characteristics of pulmonary fibrosis in nine cats.

作者信息

Evola Maria G, Edmondson Elijah F, Reichle Jean K, Biller David S, Mitchell Colleen W, Valdés-Martínez Alejandro

机构信息

Animal Specialty and Emergency Center, West Los Angeles, CA, 90025.

出版信息

Vet Radiol Ultrasound. 2014 Mar-Apr;55(2):133-40. doi: 10.1111/vru.12106. Epub 2013 Sep 17.

Abstract

Pulmonary fibrosis is a progressive fatal interstitial lung disease that is often idiopathic, occurs in multiple species, and may be caused by a number of inciting factors. The purpose of this retrospective, multicenter study was to describe the radiographic and histopathologic characteristics of idiopathic and induced pulmonary fibrosis in a group of cats. Cats with thoracic radiographs and histopathologically confirmed pulmonary fibrosis were recruited using the American College of Veterinary Radiology list serve. A board-certified veterinary radiologist and diagnostic imaging intern reviewed radiographs and recorded characteristics by consensus. Findings from additional imaging modalities were also recorded when available. All histopathology samples were re-reviewed by a veterinary pathology resident. A total of nine cats met inclusion criteria. All patients had a broad range of radiographic characteristics that included broncho-interstitial pattern, alveolar pattern, pulmonary masses, pulmonary bullae, pleural effusion, and cardiomegaly. Cats with available echocardiographic studies had characteristics that included right ventricular dilation and hypertrophy and pulmonary arterial hypertension interpreted to be secondary to primary lung disease. Cats with available CT studies had characteristics that included focally increased soft tissue attenuation, masses, and ventral consolidation that exhibited no improvement with dorsal versus ventral recumbency. Histopathology showed pulmonary fibrosis, type II pneumocyte hyperplasia, and smooth muscle hypertrophy in all patients. Epithelial metaplasia was present only in one patient. Findings from the current study indicated that cats with pulmonary fibrosis have highly variable radiographic characteristics and that these characteristics may mimic other diseases such as asthma, pneumonia, pulmonary edema, or neoplasia.

摘要

肺纤维化是一种进行性致命的间质性肺病,通常为特发性,可发生于多个物种,且可能由多种诱发因素引起。这项回顾性多中心研究的目的是描述一组猫特发性和诱发性肺纤维化的影像学和组织病理学特征。通过美国兽医放射学会的邮件列表招募了胸部X光片和组织病理学确诊为肺纤维化的猫。一名获得董事会认证的兽医放射科医生和诊断成像实习生共同审查X光片并记录特征。如有其他成像方式的检查结果也一并记录。所有组织病理学样本均由一名兽医病理学住院医师重新审查。共有9只猫符合纳入标准。所有患者都有广泛的影像学特征,包括支气管间质性模式、肺泡模式、肺部肿块、肺大疱、胸腔积液和心脏肥大。有超声心动图检查结果的猫具有包括右心室扩张和肥大以及被解释为继发于原发性肺病的肺动脉高压等特征。有CT检查结果的猫具有包括局部软组织密度增加、肿块和腹侧实变等特征,仰卧位与俯卧位对比无改善。组织病理学显示所有患者均有肺纤维化、II型肺泡上皮细胞增生和平滑肌肥大。仅1例患者出现上皮化生。本研究结果表明,患有肺纤维化的猫具有高度可变的影像学特征,这些特征可能与哮喘、肺炎、肺水肿或肿瘤等其他疾病相似。

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