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患犬系统性肥大细胞增多症伴皮下出血和水肿:病例报告及诊断标准回顾。

Systemic mastocytosis with subcutaneous hemorrhage and edema in a Greyhound dog: case report and review of diagnostic criteria.

机构信息

Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences.

Texas A&M Veterinary Medical Diagnostic Laboratory.

出版信息

J Vet Diagn Invest. 2021 Jan;33(1):95-100. doi: 10.1177/1040638720972500. Epub 2020 Nov 9.

Abstract

Systemic mastocytosis, characterized by infiltration of multiple organs by neoplastic mast cells, is a well-described entity in human medicine with specific criteria for diagnosis, but is ill defined in veterinary literature. Hemostatic disorders are reported in humans affected by systemic mastocytosis but have not been well described in veterinary literature. A 5-y-old, spayed female Greyhound dog had a 1-mo history of progressive ventral cutaneous edema, hemorrhage, and pain. Cytology of an antemortem aspirate from the subcutis of the ventral abdomen was suggestive of mast cell neoplasia, but no discrete mass was present. The dog was euthanized and submitted for autopsy; marked subcutaneous edema and hemorrhage were confirmed. The ventral abdominal panniculus and dermis superficial to the panniculus carnosus were infiltrated by a dense sheet of neoplastic mast cells. The neoplastic cells contained toluidine blue-positive granules and formed aggregates within the bone marrow and several visceral organs, including the liver, spleen, heart, and kidney. Diffuse edema and hemorrhage is an unusual presentation of mast cell tumors in dogs. Antemortem tests, including complete blood count, coagulation profile, and viscoelastic coagulation testing, were suggestive of a primary hemostatic defect. We discuss here the diagnostic criteria used in humans, how these can be applied to veterinary patients, and the limitations of the current diagnostic framework.

摘要

系统性肥大细胞增多症的特征是多器官浸润肿瘤性肥大细胞,在人类医学中是一种已有明确描述的实体,具有特定的诊断标准,但在兽医文献中定义不明确。人类系统性肥大细胞增多症患者会出现止血障碍,但在兽医文献中尚未得到充分描述。一只 5 岁、已绝育的雌性格雷伊猎犬患有 1 个月的进行性腹部腹侧皮肤水肿、出血和疼痛病史。腹壁皮下的生前抽吸物的细胞学检查提示肥大细胞瘤,但未发现明显肿块。该犬被实施安乐死并进行尸检;证实存在明显的皮下水肿和出血。腹部腹侧的腹侧浅筋膜和腹侧真皮下被致密的肿瘤性肥大细胞层浸润。肿瘤细胞含有甲苯胺蓝阳性颗粒,并在骨髓和包括肝脏、脾脏、心脏和肾脏在内的几个内脏器官中形成聚集物。弥漫性水肿和出血是犬肥大细胞瘤不常见的表现。生前检测,包括全血细胞计数、凝血谱和黏弹性凝血检测,提示存在原发性止血缺陷。我们在这里讨论了人类使用的诊断标准,如何将这些标准应用于兽医患者,以及当前诊断框架的局限性。

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