Caulfield Sarah, Priestnall Simon L, Kathrani Aarti
Small Animal Internal Medicine Service, Lumbry Park Veterinary Specialists, CVS Group Plc, Hampshire GU34 3HL, UK.
Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire AL9 7TA, UK.
Animals (Basel). 2021 Oct 11;11(10):2938. doi: 10.3390/ani11102938.
Histopathologic discordance between gastrointestinal (GI) locations in canine chronic inflammatory enteropathy (CIE) has prompted recommendations to biopsy both the duodenum and ileum, while further evaluation is required for non-CIE. We aimed to determine the concordance of histopathologic diagnosis between duodenal and ileal endoscopic or full-thickness biopsy specimens for all dogs with CIE and GI neoplasia and to assess the association between histopathologic discordance between GI locations with clinicopathologic variables. Seventy-nine dogs were eligible, with endoscopic (74) or full-thickness (5) biopsy specimens. Clinicopathological data were recorded for all dogs. Concordance of histopathologic diagnosis was retrospectively assessed for concurrent duodenal and ileal biopsy specimens by a single board-certified veterinary pathologist using the modified World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group guidelines. Sixty-seven dogs were diagnosed with CIE and 5 with enteric-associated T-cell lymphoma-2 (EATL-2). Concordance of histologic diagnosis between duodenal and ileal sites was similar between endoscopic (73.0%) and full-thickness (80.0%) biopsy groups. For the CIE cases, lymphoplasmacytic enteritis had the highest concordance (73.0%) and eosinophilic enteritis the least (16.7%). Of the 5 neoplastic cases, 5/5 (100%) were present at the duodenum but only 3/5 (60%) in the ileum. No clinicopathologic variables demonstrated a statistically significant association with discordance. We conclude that the level of discordance necessitates concurrent biopsy of both duodenum and ileum in all dogs with chronic GI signs. The rate of EATL-2 was lower than rates reported for cats.
犬慢性炎症性肠病(CIE)中胃肠道(GI)不同部位之间的组织病理学不一致,促使人们建议对十二指肠和回肠都进行活检,而非CIE则需要进一步评估。我们旨在确定所有患有CIE和GI肿瘤的犬只十二指肠和回肠内镜或全层活检标本之间组织病理学诊断的一致性,并评估GI不同部位之间组织病理学不一致与临床病理变量之间的关联。79只犬符合条件,有内镜活检标本(74只)或全层活检标本(5只)。记录了所有犬只的临床病理数据。由一名获得委员会认证的兽医病理学家,使用改良的世界小动物兽医协会(WSAVA)胃肠道标准化小组指南,对同时采集的十二指肠和回肠活检标本的组织病理学诊断一致性进行回顾性评估。67只犬被诊断为CIE,5只患有肠相关T细胞淋巴瘤-2(EATL-2)。内镜活检组(73.0%)和全层活检组(80.0%)中,十二指肠和回肠部位组织学诊断的一致性相似。对于CIE病例,淋巴细胞性浆细胞性肠炎的一致性最高(73.0%),嗜酸性肠炎的一致性最低(16.7%)。在5例肿瘤病例中,5/5(100%)出现在十二指肠,但只有3/5(60%)出现在回肠。没有临床病理变量显示与不一致有统计学上的显著关联。我们得出结论,对于所有有慢性GI症状的犬只,不一致的程度使得有必要同时对十二指肠和回肠进行活检。EATL-2的发生率低于猫的报道发生率。