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猫B细胞中枢神经系统淋巴瘤的表观扩散系数值

Apparent diffusion coefficient value for a B-cell central nervous system lymphoma in a cat.

作者信息

Tanaka Toshiyuki, Akiyoshi Hideo, Shimazaki Hitoshi, Kawakami Ryo, Mie Keiichiro, Yamada Yuki, Ohashi Fumihito

机构信息

Kinki Animal Medical Training Institute, Osaka, Japan.

Department of Advanced Clinical Medicine, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan.

出版信息

JFMS Open Rep. 2018 Jan 23;4(1):2055116917750762. doi: 10.1177/2055116917750762. eCollection 2018 Jan-Jun.

Abstract

CASE SUMMARY

This report involves a 10-year-old male mixed-breed cat with a B-cell central nervous system (CNS) lymphoma. The cat presented with ataxia progressing to left hemiparesis. While haematological findings were normal, serum biochemistry showed a high creatine phosphokinase concentration. MRI revealed a homogeneously enhancing well-demarcated extra-axial lesion involving the region of the left lateral aperture with oedema in left flocculus and left medulla oblongata. On diffusion-weighted imaging, the lesion margins showed marked hyperintensity relative to the right cerebellar hemisphere. On an apparent diffusion coefficient map, the lesion appeared hypointense, with an apparent diffusion coefficient value of 0.57 ± 0.01 × 10 mm/s. Cerebrospinal fluid (CSF) analysis and cytology, and genetic analysis of CSF lymphoblasts confirmed a diagnosis of B-cell lymphoma. The owner opted for palliative treatment with prednisolone (1 mg/kg q12h); however, the cat died of dyspnoea 10 days after presentation.

RELEVANCE AND NOVEL INFORMATION

CNS lymphomas, which are the second most common intracranial tumours in cats, are highly infiltrative lesions and radical surgical excision is not recommended. Therefore, accurate diagnosis is crucial. However, contrast-enhanced MRI cannot always differentiate these lesions from other conditions, including other CNS tumours and strokes. To the best of our knowledge, this is the first report to document the diffusion-weighted imaging features and apparent diffusion coefficient value for a feline CNS lymphoma. These findings are expected to improve the diagnostic accuracy of these lesions in cats.

摘要

病例摘要

本报告涉及一只10岁的雄性混血猫,患有B细胞中枢神经系统(CNS)淋巴瘤。该猫最初表现为共济失调,随后发展为左侧偏瘫。血液学检查结果正常,但血清生化显示肌酸磷酸激酶浓度升高。磁共振成像(MRI)显示一个边界清晰、均匀强化的轴外病变,累及左侧侧孔区域,左侧小脑绒球和左延髓出现水肿。在扩散加权成像上,病变边缘相对于右侧小脑半球呈明显高信号。在表观扩散系数图上,病变呈低信号,表观扩散系数值为0.57±0.01×10⁻³mm²/s。脑脊液(CSF)分析、细胞学检查以及CSF淋巴母细胞的基因分析确诊为B细胞淋巴瘤。主人选择用泼尼松龙(1mg/kg,每12小时一次)进行姑息治疗;然而,该猫在出现症状10天后死于呼吸困难。

相关性和新信息

CNS淋巴瘤是猫第二常见的颅内肿瘤,是高度浸润性病变,不建议进行根治性手术切除。因此,准确诊断至关重要。然而,增强MRI并不总能将这些病变与其他情况区分开来,包括其他CNS肿瘤和中风。据我们所知,这是第一份记录猫CNS淋巴瘤扩散加权成像特征和表观扩散系数值的报告。这些发现有望提高猫这些病变的诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1251/5784466/154f1cda2df9/10.1177_2055116917750762-fig1.jpg

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