Bagwell Jonathan M, Herd Heather R, Breshears Melanie A, Hodges Steven, Rizzi Theresa E
Department of Pathobiology, Oklahoma State University, Stillwater, OK, USA.
Oklahoma Veterinary Specialists, Jenks, OK, USA.
Vet Clin Pathol. 2017 Mar;46(1):151-157. doi: 10.1111/vcp.12436. Epub 2017 Jan 9.
A 13-year-old, castrated male Maine Coon cat was presented to Oklahoma State University Boren Veterinary Medical Teaching Hospital for yearly echocardiographic examination monitoring hypertrophic cardiomyopathy (HCM) diagnosed in 2003. Physical examination revealed a heart murmur and premature beats, likely related to HCM, but was otherwise unremarkable. A biochemistry profile revealed a hyperglobulinemia (6.3 g/dL). Cytologic examination of fine-needle aspirates from liver and spleen revealed increased numbers of plasma cells and mast cells, confirmed with subsequent histologic examination. Immunohistochemistry (IHC) for c-kit in the spleen and liver showed mast cells predominantly exhibiting type I staining pattern, with moderate numbers exhibiting type II pattern in spleen, and scattered cells exhibiting type II and III patterns in liver. Bone marrow cytology and core biopsy documented approximately 22% plasma cells. Cutaneous masses on the cat's left shoulder and right carpus were cytologically confirmed mast cell tumors. Serum protein electrophoresis with immunofixation confirmed an IgG monoclonal gammopathy. This is an example of 2 hematologic neoplasms occurring simultaneously in a cat. Concurrent pathologies may be overlooked if a single disease is diagnosed and suspected of causing all clinical signs. Both neoplasms were well differentiated, and neoplastic cells could have easily been interpreted as a reactive population had a full workup not been performed. Missing either diagnosis could result in a potentially lethal outcome. Eleven months after diagnoses, the cat was clinically doing well following a splenectomy and oral prednisolone and chlorambucil chemotherapy. Globulins decreased to 4.9 g/dL.
一只13岁的去势缅因猫被送至俄克拉荷马州立大学博伦兽医医学教学医院，进行年度超声心动图检查，以监测2003年诊断出的肥厚型心肌病（HCM）。体格检查发现心脏杂音和早搏，可能与HCM有关，但其他方面无异常。生化检查显示球蛋白血症（6.3 g/dL）。对肝脏和脾脏的细针穿刺物进行细胞学检查，发现浆细胞和肥大细胞数量增加，随后的组织学检查证实了这一点。脾脏和肝脏中c-kit的免疫组织化学（IHC）显示，肥大细胞主要呈现I型染色模式，脾脏中有中等数量的肥大细胞呈现II型模式，肝脏中有散在细胞呈现II型和III型模式。骨髓细胞学和核心活检记录显示约22%为浆细胞。猫左肩部和右腕部的皮肤肿块经细胞学检查确诊为肥大细胞瘤。血清蛋白电泳及免疫固定证实为IgG单克隆丙种球蛋白病。这是一只猫同时发生两种血液系统肿瘤的例子。如果仅诊断出一种疾病并怀疑其导致所有临床症状，可能会忽略并发的病理情况。两种肿瘤均分化良好，如果未进行全面检查，肿瘤细胞很容易被解释为反应性细胞群。漏诊任何一种疾病都可能导致潜在的致命后果。诊断11个月后，这只猫在接受脾切除、口服泼尼松龙和苯丁酸氮芥化疗后，临床情况良好。球蛋白降至4.9 g/dL。
