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犬脊髓肥大细胞瘤:4例的影像学特征及临床结果

SPINAL MAST CELL TUMORS IN DOGS: IMAGING FEATURES AND CLINICAL OUTCOME OF FOUR CASES.

作者信息

Moore Trevor W, Bentley R Timothy, Moore Sarah A, Provencher Michele, Warry Emma E, Kohnken Rebecca, Heng Hock Gan

机构信息

Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN 47907.

Departments of Veterinary Clinical Sciences, Ohio State University, Columbus, OH 43210.

出版信息

Vet Radiol Ultrasound. 2017 Jan;58(1):44-52. doi: 10.1111/vru.12429. Epub 2016 Oct 9.

Abstract

Published information regarding canine vertebral column mast cell tumors (MCTs) is limited. The objectives of this study were to report clinical and advanced imaging findings for a group of dogs with confirmed spinal MCT. Inclusion criteria for this retrospective case series were dogs with spinal magnetic resonance imaging (MRI) or computed tomography (CT) scans and a histological diagnosis of spinal MCT. Clinical, imaging, treatment, and outcome data were recorded. Four dogs met inclusion criteria. One dog had primary spinal MCT and three dogs had metastatic spinal MCT. All four dogs presented for paraspinal hyperesthesia and subacute progressive or acute myelopathy. All CT and MRI lesions were extradural. Two cases exhibited distinct masses in the epidural space. In one case, an epidural tumor invaded from the paravertebral musculature. One case exhibited polyostotic lesions indistinguishable from multiple myeloma by MRI. One dog with a primary epidural low-grade MCT remains clinically normal 4 years postoperatively, following adjunctive lomustine. An epidural high-grade MCT, metastatic from a cutaneous tumor, recurred within 2 months of surgery despite adjunctive vinblastine. Two high-grade cases with concurrent visceral involvement were euthanized immediately after imaging. In dogs, MCT should be considered as a differential diagnosis for a progressive painful myelopathy and CT or MRI evidence of an extradural spinal lesion (epidural, paravertebral, or polyostotic). While more often associated with cutaneous or disseminated disease, MCT may also occur as a primary tumor of the epidural space in dogs.

摘要

关于犬脊柱肥大细胞瘤(MCT)的已发表信息有限。本研究的目的是报告一组确诊为脊柱MCT的犬的临床和高级影像学检查结果。该回顾性病例系列的纳入标准为进行过脊柱磁共振成像(MRI)或计算机断层扫描(CT)且组织学诊断为脊柱MCT的犬。记录临床、影像学、治疗及预后数据。四只犬符合纳入标准。一只犬患有原发性脊柱MCT,三只犬患有转移性脊柱MCT。所有四只犬均表现为椎旁感觉过敏及亚急性进行性或急性脊髓病。所有CT和MRI病变均位于硬膜外。两例在硬膜外间隙可见明显肿块。一例中,硬膜外肿瘤从椎旁肌肉组织侵犯而来。一例通过MRI表现出与多发性骨髓瘤难以区分的多骨病变。一只患有原发性硬膜外低度MCT的犬在辅助使用洛莫司汀后术后4年临床状态正常。一例从皮肤肿瘤转移而来的硬膜外高度MCT,尽管辅助使用了长春碱,仍在术后2个月内复发。两例伴有内脏受累的高度病例在影像学检查后立即实施安乐死。在犬中,MCT应被视为进行性疼痛性脊髓病以及硬膜外脊柱病变(硬膜外、椎旁或多骨)的CT或MRI证据的鉴别诊断。虽然MCT更常与皮肤或播散性疾病相关,但在犬中也可能作为硬膜外间隙的原发性肿瘤出现。

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