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患有急性髓性白血病或淋巴肿瘤(大细胞淋巴瘤或急性淋巴细胞白血病)的犬只在X光片上可能有难以区分的纵隔肿块。

Dogs with acute myeloid leukemia or lymphoid neoplasms (large cell lymphoma or acute lymphoblastic leukemia) may have indistinguishable mediastinal masses on radiographs.

作者信息

Epperly Erin, Hume Kelly R, Moirano Steven, Stokol Tracy, Intile Joanne, Erb Hollis N, Scrivani Peter V

机构信息

The Departments of Clinical Sciences and Population Medicine & Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853.

The Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.

出版信息

Vet Radiol Ultrasound. 2018 Sep;59(5):507-515. doi: 10.1111/vru.12622. Epub 2018 May 3.

Abstract

Acute myeloid leukemia is an uncommon hematopoietic neoplasm of dogs that should be differentiated from lymphoid neoplasms, such as lymphoma, because of different treatment protocols and a worse prognosis. Thoracic radiography is performed frequently in dogs with suspected hematopoietic neoplasia, and detecting a mediastinal mass often prioritizes lymphoma as the most likely diagnosis. However, we have observed a mediastinal mass in several dogs with acute myeloid leukemia and hypothesized that (1) the frequency of a mediastinal mass was higher and (2) the size of the mass was larger in dogs with acute myeloid leukemia compared to dogs with lymphoid neoplasms. In this analytical study (observational, retrospective, and cross-sectional), the sample population included 238 dogs with hematopoietic neoplasia. These dogs were divided into lymphoid (large cell lymphoma, acute lymphoblastic leukemia) and myeloid groups based on standard phenotyping tests. A mediastinal mass was detected during thoracic radiography in 73/218 (33%) and nine of 20 (45%) dogs in the lymphoid and myeloid groups (P = 0.21), respectively. The median size ratio of mediastinal mass to cardiac silhouette was 0.20 and 0.23 in the lymphoid and myeloid groups (P = 0.96), respectively. Additionally, we observed normal thoracic radiographs in 111/218 (51%) dogs in the lymphoid group and nine of 20 (45%) dogs in the myeloid group. In conclusion, acute myeloid leukemia should be considered when a mediastinal mass is detected during radiography in dogs with suspected hematopoietic neoplasia-but the presence or size of a mediastinal mass does not differentiate between myeloid and lymphoid neoplasms.

摘要

急性髓性白血病是犬类中一种不常见的造血肿瘤,由于治疗方案不同且预后较差,应与淋巴瘤等淋巴样肿瘤相鉴别。胸部X线摄影在疑似造血肿瘤的犬类中经常进行,检测到纵隔肿块时,淋巴瘤通常被优先作为最可能的诊断。然而,我们在几只患有急性髓性白血病的犬类中观察到纵隔肿块,并推测:(1)与淋巴样肿瘤的犬类相比,急性髓性白血病犬类纵隔肿块的发生率更高;(2)肿块尺寸更大。在这项分析性研究(观察性、回顾性和横断面研究)中,样本群体包括238只患有造血肿瘤 的犬类。根据标准表型测试,这些犬被分为淋巴样(大细胞淋巴瘤、急性淋巴细胞白血病)和髓样组。在胸部X线摄影中,淋巴样组218只犬中有73只(33%)、髓样组20只犬中有9只(45%)检测到纵隔肿块(P = 0.21)。淋巴样组和髓样组纵隔肿块与心脏轮廓的中位尺寸比分别为0.20和0.23(P = 0.96)。此外,我们观察到淋巴样组218只犬中有111只(51%)、髓样组20只犬中有9只(45%)的胸部X线片正常。总之,在疑似造血肿瘤的犬类进行X线摄影检测到纵隔肿块时,应考虑急性髓性白血病——但纵隔肿块的存在或大小并不能区分髓样和淋巴样肿瘤。

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