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回顾性评估 2014-2018 年间 51 例猫腹部淋巴结手术活检的临床相关性。

Retrospective assessment of the clinical relevance of surgical biopsies of abdominal lymph nodes in cats: 51 cases (2014-2018).

机构信息

Dick White Referrals, Six Mile Bottom, UK.

出版信息

J Feline Med Surg. 2020 Dec;22(12):1168-1175. doi: 10.1177/1098612X20916387. Epub 2020 May 18.

DOI:10.1177/1098612X20916387
PMID:32419573
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10814371/
Abstract

OBJECTIVES

The aims of this study were to assess surgical biopsy of abdominal lymph nodes (LNs) in cats taken at the time of exploratory laparotomy and to evaluate any additional benefit of histopathology compared with LN cytology.

METHODS

We carried out a retrospective study from a single institution of cats that had abdominal ultrasound and LN biopsies as part of an exploratory laparotomy (2014-2018). Clinical records were reviewed for presenting signs, medical investigations, ultrasound, cytology, surgical findings and histopathology.

RESULTS

Fifty-one cats were included. In total, 60 LNs were biopsied. Forty-four cats had evident LN enlargement at the time of surgery. Nine of those cases were reported to have normal-sized LNs on ultrasound, including one cat that was subsequently diagnosed with lymphoma. Ultrasound-guided LN aspiration was performed in 19 cases. Five of these cats had a histological diagnosis of neoplasia following biopsy, but only one was correctly identified with cytology. Histopathology results were reactive hyperplasia (n = 41), tumour metastasis (n = 11), lymphadenitis (n = 6), inconclusive (n = 1) and normal (n = 1). The most common final diagnoses were inflammatory bowel disease (n = 17/51) and gastrointestinal lymphoma (n = 10/51). There were 15 cats with neoplastic disease; LN biopsies confirmed metastatic disease in 10 and ruled out nodal involvement in five.

CONCLUSIONS AND RELEVANCE

Surgical biopsy of grossly enlarged or normal abdominal LNs provides additional information to LN cytology in cats and in the majority of cases is associated with a positive histological diagnosis. There appears to be the potential to underdiagnose neoplasia with cytology alone.

摘要

目的

本研究旨在评估在剖腹探查时对猫进行的腹部淋巴结(LN)外科活检,并评估与 LN 细胞学相比组织病理学的额外益处。

方法

我们对一家机构的猫进行了一项回顾性研究,这些猫在剖腹探查时接受了腹部超声和 LN 活检(2014-2018 年)。回顾临床记录,以评估其表现症状、医学检查、超声、细胞学、外科发现和组织病理学。

结果

共纳入 51 只猫,总共对 60 个 LN 进行了活检。44 只猫在手术时存在明显的 LN 肿大。这些病例中有 9 例在超声检查中报告为正常大小的 LN,其中 1 只猫随后被诊断为淋巴瘤。在 19 例中进行了超声引导下的 LN 抽吸。其中 5 例在活检后诊断为肿瘤,但仅 1 例在细胞学检查中被正确识别。组织病理学结果为反应性增生(n=41)、肿瘤转移(n=11)、淋巴结炎(n=6)、不确定(n=1)和正常(n=1)。最常见的最终诊断为炎症性肠病(n=17/51)和胃肠道淋巴瘤(n=10/51)。有 15 只猫患有肿瘤性疾病;LN 活检在 10 只猫中证实了转移性疾病,在 5 只猫中排除了淋巴结受累。

结论和相关性

在大体增大或正常的腹部 LN 中进行外科活检可为猫提供比 LN 细胞学更多的信息,并且在大多数情况下与阳性组织学诊断相关。单独使用细胞学检查似乎有漏诊肿瘤的潜在风险。