Le Boedec Kevin, Roady Patrick J, O'Brien Robert T
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
J Feline Med Surg. 2014 Oct;16(10):858-63. doi: 10.1177/1098612X14527963. Epub 2014 Mar 20.
An 11-year-old cat presented for respiratory distress and weight loss. Thoracic radiographs were interpreted as a diffuse bronchointerstitial pattern with bronchiectasis and a mild ventral alveolar pattern on the lateral views. Computed tomography revealed a severe diffuse reticular pattern, relatively hyperattenuating in subpleural regions, with diffuse traction bronchiectasis and some degree of honeycombing. Despite the absence of basal predominance, this pattern was considered to be suggestive of usual interstitial pneumonia (UIP). Other differentials (other types of interstitial lung disease, infectious pneumonitis, neoplasia, or early edema or hemorrhage) were considered less likely based on history and other test results. The cat was discharged without any treatment, and euthanased 5 months later. Post-mortem histological analysis of the lung revealed end-stage lung, with extensive fibrosis that was more severe in subpleural regions, fibroblastic foci and honeycombing, suggestive of UIP. A probable diagnosis of idiopathic pulmonary fibrosis (IPF) was made. The diffuse distribution of the lesions was atypical compared with previous tomographic and histologic descriptions of IPF in cats. This case report suggests a heterogeneity of the pulmonary fibrotic disorders in cats that warrants further investigation for better characterization and classification.
一只11岁的猫因呼吸窘迫和体重减轻前来就诊。胸部X光片显示为弥漫性支气管间质性病变，伴有支气管扩张，侧位片上有轻度腹侧肺泡病变。计算机断层扫描显示严重的弥漫性网状病变，在胸膜下区域相对密度增高，伴有弥漫性牵拉性支气管扩张和一定程度的蜂窝状改变。尽管没有以肺底部为主，但这种表现被认为提示为寻常型间质性肺炎（UIP）。根据病史和其他检查结果，其他鉴别诊断（其他类型的间质性肺病、感染性肺炎、肿瘤或早期水肿或出血）可能性较小。这只猫未经任何治疗出院，5个月后实施安乐死。肺的尸检组织学分析显示为终末期肺，胸膜下区域有广泛的纤维化且更为严重，有成纤维细胞灶和蜂窝状改变，提示为UIP。做出了特发性肺纤维化（IPF）的可能诊断。与之前猫IPF的断层扫描和组织学描述相比，病变的弥漫分布并不典型。本病例报告提示猫肺纤维化疾病存在异质性，需要进一步研究以更好地进行特征描述和分类。
