Moore A Russell, Coffey Emily, Leavell Sarah E, Krafsur Greta, Duncan Colleen, Dowers Kristy, Santangelo Kelly S
Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Vet Clin Pathol. 2016 Sep;45(3):495-500. doi: 10.1111/vcp.12394. Epub 2016 Aug 29.
A 6-year-old, male castrated, mixed-breed dog was referred to the James L. Voss Veterinary Teaching Hospital at Colorado State University for bicavitary effusion. On examination, the dog was tachycardic and tachypneic with bilaterally decreased lung sounds. Thoracic and abdominal ultrasonic examination revealed pleural and peritoneal effusions, which were aspirated and submitted for fluid analysis and cytology. Both cavity fluids were classified as exudates with a large population of vacuolated mononuclear cells. Multiplex immunocytochemistry (ICC) for cytokeratin and vimentin demonstrated exclusively cytokeratin expression, indicating these cells were of epithelial origin. A full diagnostic evaluation was performed, including CBC, clinical chemistry, a pet-side test for heartworm disease, ehrlichiosis, Lyme disease, and anaplasmosis, imaging modalities of thorax, abdomen, and heart, urinalysis, and fine-needle aspirations of spleen, liver, and popliteal lymph nodes. The dog was diagnosed with pleural and peritoneal carcinoma with presumed carcinomatosis. A single dose of intracavitary carboplatin was administered before discharge, and over a period of 2 weeks, 5 thoracocenteses were performed. A subcutaneous mass was noted at a thoracocentesis site one week after initial presentation. Cytology of the mass was consistent with carcinoma, and neoplastic seeding of the tumor cells from the thoracocentesis was suspected. The dog was euthanized 15 days after the first visit, and a necropsy was performed. Findings were consistent with carcinomatosis secondary to anaplastic pulmonary carcinoma with transient subcutaneous seeding of neoplastic cells during routine thoracocentesis. This case demonstrates the utility of multiplex ICC in the clinical setting.
一只6岁已去势的雄性混血犬因双腔积液被转诊至科罗拉多州立大学詹姆斯·L·沃斯兽医教学医院。检查时,该犬心动过速、呼吸急促,双侧肺部呼吸音减弱。胸部和腹部超声检查发现胸腔和腹腔积液,对积液进行了抽吸并送检进行液体分析和细胞学检查。两个腔隙的液体均被分类为渗出液,有大量空泡化单核细胞。细胞角蛋白和波形蛋白的多重免疫细胞化学(ICC)显示仅细胞角蛋白表达,表明这些细胞起源于上皮。进行了全面的诊断评估,包括血常规、临床化学、犬心丝虫病、埃立克体病、莱姆病和无形体病的床边检测、胸部、腹部和心脏的影像学检查、尿液分析以及脾脏、肝脏和腘窝淋巴结的细针穿刺抽吸。该犬被诊断为胸膜和腹膜癌伴癌转移。出院前给予单剂量腔内卡铂,在2周内进行了5次胸腔穿刺术。初次就诊一周后,在一次胸腔穿刺部位发现一个皮下肿块。肿块的细胞学检查与癌一致,怀疑肿瘤细胞通过胸腔穿刺发生肿瘤种植。首次就诊15天后该犬实施安乐死并进行了尸检。结果与间变性肺癌继发的癌转移一致,在常规胸腔穿刺期间肿瘤细胞短暂皮下种植。本病例证明了多重ICC在临床环境中的实用性。