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区分猫低级别肠 T 细胞淋巴瘤与淋巴浆细胞性肠炎的临床、实验室和超声检查结果。

Clinical, laboratory and ultrasonographic findings differentiating low-grade intestinal T-cell lymphoma from lymphoplasmacytic enteritis in cats.

机构信息

Ecole Nationale Vétérinaire d'Alfort, CHUVA, Unité de Médecine Interne, Maisons-Alfort, France.

Centre DMV, Lachine, Quebec, Canada.

出版信息

J Vet Intern Med. 2021 Nov;35(6):2685-2696. doi: 10.1111/jvim.16272. Epub 2021 Oct 23.

Abstract

BACKGROUND

Low-grade intestinal T-cell lymphoma (LGITL) is the most common intestinal neoplasm in cats. Differentiating LGITL from lymphoplasmacytic enteritis (LPE) is challenging because clinical signs, laboratory results, diagnostic imaging findings, histology, immunohistochemistry, and clonality features may overlap.

OBJECTIVES

To evaluate possible discriminatory clinical, laboratory and ultrasonographic features to differentiate LGITL from LPE.

ANIMALS

Twenty-two cats diagnosed with LGITL and 22 cats with LPE based upon histology, immunohistochemistry, and lymphoid clonality.

METHODS

Prospective, cohort study. Cats presented with clinical signs consistent with LGITL or LPE were enrolled prospectively. All data contributing to the diagnostic evaluation was recorded.

RESULTS

A 3-variable model (P < .001) consisting of male sex (P = .01), duration of clinical signs (P = .01), and polyphagia (P = .03) and a 2-variable model (P < .001) including a rounded jejunal lymph node (P < .001) and ultrasonographic abdominal effusion (P = .04) were both helpful to differentiate LGITL from LPE.

CONCLUSIONS AND CLINICAL IMPORTANCE

Most clinical signs and laboratory results are similar between cats diagnosed with LGITL and LPE. However, male sex, a longer duration of clinical signs and polyphagia might help clinicians distinguish LGITL from LPE. On ultrasonography, a rounded jejunal lymph node, and the presence of (albeit small volume) abdominal effusion tended to be more prevalent in cats with LGITL. However, a definitive diagnosis requires comprehensive histopathologic and phenotypic assessment.

摘要

背景

低级别肠道 T 细胞淋巴瘤(LGITL)是猫最常见的肠道肿瘤。由于临床症状、实验室结果、诊断性影像学发现、组织学、免疫组织化学和克隆性特征可能重叠,因此将 LGITL 与淋巴浆细胞性肠炎(LPE)区分开来具有挑战性。

目的

评估可能具有鉴别意义的临床、实验室和超声特征,以区分 LGITL 与 LPE。

动物

根据组织学、免疫组织化学和淋巴细胞克隆性,诊断为 LGITL 的 22 只猫和 LPE 的 22 只猫。

方法

前瞻性队列研究。有 LGITL 或 LPE 临床症状的猫被前瞻性纳入。记录了所有有助于诊断评估的数据。

结果

由雄性(P = .01)、临床症状持续时间(P = .01)和多食(P = .03)三个变量组成的 3 变量模型(P < .001)和包括圆形空肠淋巴结(P < .001)和超声腹部积液(P = .04)的 2 变量模型,都有助于将 LGITL 与 LPE 区分开来。

结论和临床意义

LGITL 和 LPE 诊断猫的大多数临床症状和实验室结果相似。然而,雄性、较长的临床症状持续时间和多食可能有助于临床医生区分 LGITL 与 LPE。在超声检查中,LGITL 猫更常出现圆形空肠淋巴结和(尽管体积较小)腹部积液。然而,明确的诊断需要全面的组织病理学和表型评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89b/8692195/64fb22c95a0e/JVIM-35-2685-g001.jpg

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