Hughes Jonathan R, Szladovits Balazs, Drees Randi
Department of Clinical Sciences and Services, The Royal Veterinary College, North Mymms, Hatfield, AL9 7TA, UK.
Department of Pathobiology and Population Sciences, Hawkshead Lane, North Mymms, Hatfield, AL9 7TA, UK.
Vet Radiol Ultrasound. 2019 May;60(3):306-315. doi: 10.1111/vru.12717. Epub 2019 Feb 20.
Canine mast cell tumor staging is commonly performed using abdominal ultrasonography and fine-needle aspiration cytology of masses, lymph nodes, and hepatic and splenic parenchyma. Computed tomography is used for abdominal, thoracic, or whole body imaging in staging mast cell tumors in the authors' institution enabling evaluation of multiple body areas in one examination. The aim of this study was to compare the CT examinations acquired for staging of mast cell disease to their subsequent liver and spleen cytology findings. Medical records of dogs with primary mast cell tumors that underwent abdominal CT and concurrent liver and spleen aspirates were reviewed. The CT examinations were evaluated for attenuation, size, and margination of the liver and spleen. The relationship between CT findings and cytology results was analyzed. Forty-nine dogs matched the inclusion criteria: five of forty-nine dogs with cutaneous mast cell tumors were positive for metastasis from liver and/or spleen aspirates. Of the five dogs with cytological evidence of liver or spleen metastasis, four had normal CT liver attenuation and size, one dog had concurrent primary hepatocellular neoplasia, four dogs had abnormal splenic parenchyma (two nodular and two diffuse heterogeneity), and one dog had a normal attenuation of the spleen. In four dogs, the spleen was subjectively enlarged. Computed tomographic evaluation of the liver showed no consistent pattern associated with mast cell metastasis and did not predict cytology results. Multifocal splenic hypoattenuating lesions more commonly coincided with mast cell metastasis. Sampling of the liver and spleen remains to be considered in the absence of abnormal CT findings for full staging.
犬肥大细胞瘤分期通常采用腹部超声检查以及对肿块、淋巴结、肝实质和脾实质进行细针穿刺细胞学检查。在作者所在机构,计算机断层扫描用于肥大细胞瘤分期的腹部、胸部或全身成像,可在一次检查中评估多个身体部位。本研究的目的是比较用于肥大细胞病分期的CT检查结果与其后续肝脏和脾脏细胞学检查结果。回顾了患有原发性肥大细胞瘤并接受腹部CT检查以及同时进行肝脏和脾脏穿刺抽吸的犬只的病历。对CT检查评估肝脏和脾脏的密度、大小和边缘情况。分析CT检查结果与细胞学结果之间的关系。49只犬符合纳入标准:49只患有皮肤肥大细胞瘤的犬中有5只肝脏和/或脾脏穿刺抽吸显示转移阳性。在5只具有肝脏或脾脏转移细胞学证据的犬中,4只犬的肝脏CT密度和大小正常,1只犬同时患有原发性肝细胞肿瘤,4只犬的脾实质异常(2只呈结节状,2只呈弥漫性异质性),1只犬的脾脏密度正常。4只犬的脾脏主观上增大。肝脏的计算机断层扫描评估未显示与肥大细胞转移相关的一致模式,也无法预测细胞学结果。多灶性脾脏低密度病变更常与肥大细胞转移同时出现。在CT检查无异常发现的情况下,为进行全面分期仍需考虑对肝脏和脾脏进行采样。