Marsh Oliver, Destri Alessandra, Di Palma Stefano, Mari Lorenzo, De Risio Luisa, Stabile Fabio
Southfields Veterinary Specialists, Laindon, UK.
Southern Counties Veterinary Specialists, Ringwood, UK.
JFMS Open Rep. 2021 Mar 31;7(1):20551169211003806. doi: 10.1177/20551169211003806. eCollection 2021 Jan-Jun.
An 8-year-old neutered female domestic longhair cat was presented for investigation of a 48 h history of lethargy and pelvic limb ataxia. MRI of the spinal cord and vertebral column (C1 to sacrum) and brain was unremarkable. Lumbar cerebrospinal fluid analysis revealed pleocytosis and increased protein concentration. Thoracic radiographs and abdominal ultrasound were unremarkable. Anti-inflammatory doses of prednisolone were administered. Clinical deterioration occurred over the following 2 days, with the development of lower motor neuron deficits in both thoracic limbs. On repetition of the MRI, bilateral enlargement, T2-weighted hyperintensity, and marked contrast enhancement of the C7, C8 and T1 nerve roots, spinal nerves and brachial plexuses were observed. Infectious disease testing was negative. An immune-mediated inflammatory process was suspected and immunosuppressive doses of prednisolone were commenced. The clinical signs improved transiently, but marked deterioration occurred after 2 weeks. The patient was euthanased and a post-mortem examination was performed. A lymphocytic inflammatory infiltrate was detected in the C7, C8 and T1 nerve roots and dorsal root ganglia, and neoplastic plasma cells were identified in multiple organs. A diagnosis of non-cutaneous extramedullary plasmacytoma with multiorgan involvement and paraneoplastic ganglioradiculoneuritis was reached.
Paraneoplastic ganglioradiculoneuritis in association with a plasma cell neoplasia has not been previously reported in the cat and should be considered as a differential diagnosis for cats with clinical or imaging evidence of an inflammatory process affecting the nerve roots, spinal nerves or brachial plexuses.
一只8岁已绝育的雌性家养长毛猫因嗜睡和盆腔肢体共济失调48小时病史前来接受检查。脊髓和脊柱(C1至骶骨)及脑部的MRI检查未见异常。腰椎脑脊液分析显示细胞增多和蛋白浓度升高。胸部X光片和腹部超声检查未见异常。给予了抗炎剂量的泼尼松龙。在接下来的2天里病情恶化,双前肢出现下运动神经元功能障碍。再次进行MRI检查时,观察到C7、C8和T1神经根、脊神经和臂丛神经双侧增粗、T2加权像高信号以及明显的对比增强。传染病检测呈阴性。怀疑是免疫介导的炎症过程,开始给予免疫抑制剂量的泼尼松龙。临床症状短暂改善,但2周后病情明显恶化。对该猫实施了安乐死并进行了尸检。在C7、C8和T1神经根及背根神经节中检测到淋巴细胞性炎症浸润,并在多个器官中发现了肿瘤性浆细胞。最终诊断为多器官受累的非皮肤性髓外浆细胞瘤伴副肿瘤性神经节神经根神经炎。
猫中此前尚未报道过与浆细胞瘤相关的副肿瘤性神经节神经根神经炎,对于有临床或影像学证据显示神经根、脊神经或臂丛神经存在炎症过程的猫,应将其视为鉴别诊断之一。