Udelsman R, Citino S B, Prasad M, Donovan P I, Fredholm D V
Endocrine Neoplasia Institute, Miami Cancer Institute, Baptist Health South Florida, 8900 North Kendall Drive, Miami, FL, 33176, USA.
Veterinary Medicine, White Oak Conservation, Yulee, FL, USA.
World J Surg. 2018 Feb;42(2):514-520. doi: 10.1007/s00268-017-4325-8.
The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified.
Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974. His early years were unremarkable. In 2006, he was donated to White Oak Conservation in Yulee, Florida, where he bred and sustained minor injuries. In his geriatric years, he developed a cataract and degenerative joint disease (DJD). At age 41, he developed progressive ataxia and lameness and was euthanized to minimize suffering when he was unable to stand. ROS, FH, SH and medication history were unremarkable. Physical exam was age and species appropriate. Pre-mortem serum demonstrated: creat 1.8 mg/dL (0.8-2.1), calcium 10.6 mg/dL (9.7-13.1), phos 3.8 mg/dL (2.5-6.7), alk phos 69 U/L (26-158) and intact PTH 44.1 pg/mL (rhinoceros reference range: unknown). Necropsy revealed intervertebral DJD with thoracic spondylosis, which combined with osteoporosis, resulted in thoracic myelopathy and ataxia. The neck block was sent in formalin to the Yale University School of Medicine.
Detailed dissection was performed under loupe magnification. Presumed structures were photographed in situ and biopsied. The thyroid was identified deep to the strap muscles, received its blood supply from the inferior and superior thyroid arteries and was blue in color. The right recurrent laryngeal nerve, identified and photographed in situ for the first time in the rhinoceros, was deep to the inferior thyroid artery and was traced throughout its cervical course. Single parathyroid glands identified on the lateral thyroid lobes received their blood supply from the inferior thyroid arteries and were confirmed histologically. They appear to be the largest parathyroids yet identified in the rhinoceros with estimated weights of 6,280 and 11,000 mg, respectively. Although the etiology of the parathyroid gland enlargement is unknown, the specimen has been preserved recapitulating the dissection performed by Sir Richard Owen.
The parathyroids, thyroid and recurrent laryngeal nerve were identified in an Indian rhinoceros. This appears to be the first display of the rhinoceros recurrent laryngeal nerve in situ, and the parathyroid glands are the largest yet identified in the rhinoceros.
1849年,理查德·欧文爵士首次在印度犀中发现了甲状旁腺。我们对一头印度犀进行了尸检,重现了欧文的解剖过程,并展示了首次在原位识别出的喉返神经以及迄今所识别出的最大犀牛甲状旁腺的解剖结构和组织学特征。
帕特里克·T·犀牛,一头41岁的印度犀,出生于1974年。它早年并无异常。2006年,它被捐赠给佛罗里达州尤利的白橡树保护中心,在那里它繁育后代并受过轻伤。在其老年时,它患上了白内障和退行性关节疾病(DJD)。41岁时,它出现进行性共济失调和跛行,在无法站立时为减轻痛苦而实施了安乐死。既往史、家族史、个人史和用药史均无异常。体格检查符合其年龄和物种特征。生前血清检测结果显示:肌酐1.8mg/dL(0.8 - 2.1),钙10.6mg/dL(9.7 - 13.1),磷3.8mg/dL(2.5 - 6.7),碱性磷酸酶69U/L(26 - 158),完整甲状旁腺激素44.1pg/mL(犀牛参考范围:未知)。尸检发现存在椎间盘退变伴胸椎关节强硬,这与骨质疏松症共同导致了胸段脊髓病和共济失调。颈部组织块用福尔马林固定后送往耶鲁大学医学院。
在放大镜放大下进行了详细解剖。对推测的结构进行了原位拍照并活检。甲状腺位于带状肌深层,由甲状腺上下动脉供血,呈蓝色。首次在犀牛中于原位识别并拍照的右侧喉返神经,位于甲状腺下动脉深层,并追踪了其在颈部的全程。在甲状腺侧叶上识别出的单个甲状旁腺由甲状腺下动脉供血,并经组织学证实。它们似乎是迄今在犀牛中所识别出的最大甲状旁腺,估计重量分别为6280毫克和11000毫克。尽管甲状旁腺肿大的病因不明,但该标本已被保存下来,重现了理查德·欧文爵士所进行的解剖。
在一头印度犀中识别出了甲状旁腺、甲状腺和喉返神经。这似乎是首次展示犀牛喉返神经的原位情况,且这些甲状旁腺是迄今在犀牛中所识别出的最大的。