Oura Trisha J, Hamel Philip E, Jennings Samuel H, Bain Perry J, Jennings Dennis E, Berg John
From the Department of Clinical Sciences (T.J.O., P.E.H., J.B.), and Department of Biomedical Sciences (S.H.J., P.J.B.), Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts; and Independent Consultant, Libertyville, Illinois (D.E.J.).
J Am Anim Hosp Assoc. 2019 Jul/Aug;55(4):187-193. doi: 10.5326/JAAHA-MS-6907. Epub 2019 May 17.
In both dogs and cats, the most common cranial mediastinal masses (CMMs) are lymphoma and thymic epithelial tumors (TETs). Pretreatment differentiation of these tumors using fine needle aspiration or biopsy is essential because lymphomas are treated medically, whereas TETs are treated surgically. The purpose of this retrospective study was to determine whether thoracic radiographic findings can be used to aid clinicians in preliminarily differentiating the two tumor types before cytology or histopathology results become available. Medical records, available cytologic or histologic samples, and thoracic radiographs were evaluated for 62 dogs and 28 cats. Seventeen radiographic criteria were assessed by two examiners, and regression modeling was performed to test for significant predictors of tumor type. In dogs, CMMs with at least two well-defined radiographic margins on a lateral view and CMMs causing a rightward shift of the cardiac silhouette on a ventrodorsal or dorsoventral view were significantly more likely to be TETs than lymphomas (P < .001 and P < .01, respectively). No significant predictive variables were identified in cats. Radiographic findings do not eliminate the need for invasive sampling, but in dogs, they may guide the clinician in providing preliminary information to owners regarding the staging and therapeutic measures that may eventually be recommended.
在犬猫中，最常见的纵隔前部肿块（CMM）是淋巴瘤和胸腺上皮肿瘤（TET）。使用细针穿刺或活检对这些肿瘤进行治疗前的鉴别至关重要，因为淋巴瘤采用药物治疗，而TET采用手术治疗。这项回顾性研究的目的是确定在细胞学或组织病理学结果出来之前，胸部X线检查结果是否可用于帮助临床医生初步鉴别这两种肿瘤类型。对62只犬和28只猫的病历、可用的细胞学或组织学样本以及胸部X线片进行了评估。两名检查人员评估了17项X线标准，并进行回归建模以测试肿瘤类型的显著预测因素。在犬中，侧位片上至少有两个边界清晰的X线边缘的CMM以及腹背位或背腹位片上导致心脏轮廓向右移位的CMM比淋巴瘤更有可能是TET（分别为P < 0.001和P < 0.01）。在猫中未发现显著的预测变量。X线检查结果并不能消除进行侵入性采样的必要性，但在犬中，它们可以指导临床医生向主人提供有关最终可能推荐的分期和治疗措施的初步信息。
