Broadbridge Catherine, Taylor Samantha S, Renfrew Helen, Gemignani Francesco, Livet Veronique, Vicek Tom, Dobromylskyj Melanie
Lumbry Park Veterinary Specialists, Alton, UK.
Finn Pathologists, Harleston, UK.
JFMS Open Rep. 2021 Mar 14;7(1):2055116921997665. doi: 10.1177/2055116921997665. eCollection 2021 Jan-Jun.
A 13-year-old neutered female domestic shorthair rescue cat presented asymptomatically with raised hepatic enzymes following a routine pre-anaesthetic blood test. Cholangitis was suspected, and supportive treatment with 2 weeks of amoxicillin-clavulanic acid and 4 weeks of ursodeoxycholic acid and -adenosylmethionine was trialled, with no improvement in biochemistry parameters. Clinicopathological investigations also revealed a markedly raised total bilirubin and abnormal bile acid stimulation test. Abdominal ultrasonography revealed pathological changes in the gallbladder, hepatomegaly with increased echogenicity and markedly thickened common bile duct walls. An exploratory laparotomy was performed revealing a grossly abnormal gallbladder with a small rupture at the dorsal fundus, which was managed via cholecystectomy. Pancreatic and hepatic biopsies were collected concurrently. Histopathology from the submitted samples revealed a gallbladder adenoma, chronic neutrophilic cholangitis and nodular hyperplasia of the pancreas. Culture of the gallbladder bile was negative but may be attributable to the initial treatment with antibiosis. At the time of writing, 5 months postoperatively, the cat had recovered well and remained asymptomatic and clinically healthy, but hepatic enzymes and bilirubin were only mildly reduced from the preoperative levels, despite the cat remaining clinically normal.
To our knowledge, this is the first case of a gallbladder adenoma confirmed histopathologically in a feline patient. Our findings suggest that although gallbladder neoplasia is rare in cats, this benign tumour should be considered a differential diagnosis.
一只13岁已绝育的雌性家养短毛救助猫，在常规麻醉前血液检查后无症状性出现肝酶升高。怀疑有胆管炎，试用了2周的阿莫西林-克拉维酸以及4周的熊去氧胆酸和S-腺苷甲硫氨酸进行支持治疗，但生化指标无改善。临床病理检查还显示总胆红素显著升高以及胆汁酸刺激试验异常。腹部超声检查发现胆囊有病理改变，肝脏肿大、回声增强且胆总管壁明显增厚。进行了剖腹探查术，发现胆囊严重异常，在胆囊底背部有一个小破裂口，通过胆囊切除术进行处理。同时采集了胰腺和肝脏活检样本。送检样本的组织病理学检查显示为胆囊腺瘤、慢性中性粒细胞性胆管炎以及胰腺结节性增生。胆囊胆汁培养结果为阴性，但这可能归因于最初使用抗生素治疗。在撰写本文时，术后5个月，这只猫恢复良好，仍无症状且临床健康，但尽管猫临床正常，肝酶和胆红素仅比术前水平略有降低。
据我们所知，这是第一例经组织病理学确诊的猫胆囊腺瘤病例。我们的研究结果表明，尽管猫胆囊肿瘤罕见，但这种良性肿瘤应被视为鉴别诊断的对象。
