猫脾脏的超声蜂窝状模式：33 例与病理诊断的相关性。
Ultrasonographic honeycomb pattern of the spleen in cats: correlation with pathological diagnosis in 33 cases.
机构信息
Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
出版信息
J Feline Med Surg. 2020 Aug;22(8):800-804. doi: 10.1177/1098612X19873197. Epub 2019 Sep 20.
OBJECTIVES
The aim of this study was to evaluate the relationship between the ultrasonographic (US) diffuse honeycomb pattern (HCP) of the spleen and a pathological diagnosis in cats, and to assess the influence of transducer type on HCP visualisation.
METHODS
Abdominal ultrasounds of cats with an HCP were reviewed and splenic size, shape, margination, other parenchymal alterations and splenic hilar lymphadenopathy were recorded. When applicable, images acquired with high-frequency linear and curvilinear transducers were compared to determine if an HCP was more frequently demonstrated on high-resolution images. A retrospective review of the corresponding splenic cytohistopathological samples was also performed.
RESULTS
Thirty-three cats met the inclusion criteria. Five cases were diagnosed by histology and 28 by cytology, confirmed by PCR for antigen receptor rearrangements (PARR) in uncertain cases. There were 15 cases of lymphoid hyperplasia, eight cases of lymphoma (four B cell, three T cell and one large granular lymphocytes), six cats with splenitis, three with extramedullary haematopoiesis and one with histiocytic sarcoma. The prevalence of lymphoma in cats with an HCP of the spleen was 24%. Splenomegaly was the most frequent US feature associated with an HCP and was observed in all lymphoma cases. In the images obtained from both high-frequency linear and micro-convex transducers the visualisation of an HCP was enabled in all cases (24/24) and in 62.5% (15/24), respectively.
CONCLUSIONS AND RELEVANCE
Based on our findings, a US HCP of the spleen in cats can be associated with benign and malignant disorders and is infrequently associated with lymphoma in comparison with dogs. Cytological or histological examination, possibly supplemented by PARR, should always be performed for diagnostic support. Use of high-frequency linear transducers is recommended to properly recognise an HCP or subtle changes in splenic parenchyma.
目的
本研究旨在评估猫脾脏超声弥漫性蜂巢样图案（HCP）与病理诊断之间的关系，并评估换能器类型对 HCP 可视化的影响。
方法
回顾性分析 HCP 猫的腹部超声，记录脾脏大小、形状、边缘、其他实质改变和脾门淋巴结肿大。在适用的情况下，比较高频线性和曲线换能器获得的图像，以确定 HCP 是否更常出现在高分辨率图像上。还对相应的脾细胞组织病理学样本进行了回顾性分析。
结果
33 只猫符合纳入标准。5 例经组织学诊断，28 例经细胞学诊断，不确定病例通过抗原受体重排聚合酶链反应（PARR）证实。有 15 例淋巴组织增生，8 例淋巴瘤（4 例 B 细胞，3 例 T 细胞，1 例大颗粒淋巴细胞），6 例脾炎，3 例髓外造血，1 例组织细胞肉瘤。HCP 猫的淋巴瘤患病率为 24%。脾肿大是与 HCP 最相关的最常见的 US 特征，在所有淋巴瘤病例中均可见。在高频线性和微凸换能器获得的图像中，HCP 的可视化在所有病例（24/24）和 62.5%（15/24）中均可见。
结论
根据我们的发现，猫的脾脏超声 HCP 可与良性和恶性疾病相关，与犬相比，HCP 与淋巴瘤的相关性较低。应始终进行细胞学或组织学检查，可能补充 PARR，以提供诊断支持。建议使用高频线性换能器以正确识别 HCP 或脾实质的细微变化。
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