Ichikawa Yoshiki, Heishima Mizuki, Vyhnal Kristin, Aoshima Keisuke, Sasaoka Kazuyoshi, Kinoshita Ryohei, Kobayashi Atsushi, Takiguchi Mitsuyoshi, Kimura Takashi
Laboratories of Comparative Pathology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan.
Idexx Laboratories, Tokyo, Japan.
J Vet Diagn Invest. 2022 Jan;34(1):94-97. doi: 10.1177/10406387211042587. Epub 2021 Sep 4.
A 27-mo-old, spayed female mixed-breed dog was presented with left forelimb pain, which progressed to full thickness necrosis of the soft tissues of multiple limbs. Clinical imaging and postmortem examination suggested multiple large arterial thromboemboli. Histologic examination of vascular lesions revealed markedly thickened tunica intima with polypoid intraluminal projections, which partially to entirely occluded the arterial lumen. The expanded tunica intima was comprised of intimal accumulation of Alcian blue-positive matrix with scattered spindle-to-satellite cells. These cells were positive for von Willebrand factor and vimentin but negative for α-smooth muscle actin, suggesting endothelial origin. Deposition of the intimal mucoid matrix was observed in the elastic and muscular arteries associated with regional ischemic changes. Mucoid emboli, likely from fragmentation of proliferative intimal tissue, were identified in smaller vessels supplied by affected arteries. Based on these findings, we diagnosed systemic mucoid degeneration of the arterial tunica intima. Such systemic arterial degeneration characterized by deposition of mucoid matrix in the tunica intima has not been reported previously in dogs, to our knowledge, and should be distinguished from thromboembolism and other degenerative vascular diseases.
一只27月龄、已绝育的雌性混种犬因左前肢疼痛就诊,随后发展为多肢软组织全层坏死。临床影像学和尸检提示多发性大动脉血栓栓塞。血管病变的组织学检查显示内膜显著增厚,有息肉样腔内突起,部分或完全阻塞动脉腔。扩张的内膜由阿尔辛蓝阳性基质的内膜积聚以及散在的梭形至卫星状细胞组成。这些细胞血管性血友病因子和波形蛋白呈阳性,但α平滑肌肌动蛋白呈阴性,提示为内皮起源。在与局部缺血改变相关的弹性动脉和肌性动脉中观察到内膜黏液样基质的沉积。在受影响动脉供血的较小血管中发现了可能来自增生性内膜组织碎片的黏液样栓子。基于这些发现,我们诊断为动脉内膜系统性黏液样变性。据我们所知,这种以内膜黏液样基质沉积为特征的系统性动脉变性在犬类中此前未见报道,应与血栓栓塞和其他退行性血管疾病相鉴别。