Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA.
Department of Clinical Sciences, Cornell University, Ithaca, New York, USA.
J Vet Emerg Crit Care (San Antonio). 2022 Mar;32(2):260-266. doi: 10.1111/vec.13157. Epub 2021 Nov 12.
(1) To report an unusual etiology for nontraumatic hemoabdomen in cats, and (2) to describe onset and recovery from severe, unexpected pancytopenia seen after surgical removal of a large intra-abdominal myelolipoma.
A 14-year-old neutered male domestic shorthair cat was presented for emergent treatment of suspected nontraumatic hemoabdomen. A hyperechoic mass, with ultrasonographic echogenicity similar to fat, was found in the right cranial abdomen and believed to be associated with the mesentery. Cytological examination of abdominal fluid identified marked extramedullary hematopoiesis within the hemorrhagic effusion. Exploratory laparotomy identified a hepatic mass, which was resected, and revealed to be a hepatic myelolipoma on histopathological examination. The patient's initial recovery was uneventful. However, continued hyporexia resulted in readmission 4 days postoperatively, at which time the patient was found to have a profound, tri-lineage pancytopenia, and cytological evidence indicative of bone marrow recovery. The pancytopenia resolved with continued medical management and supportive care.
Ruptured myelolipoma is not a commonly considered differential for nontraumatic hemoabdomen in cats. Furthermore, severe pancytopenia is unexpected following surgical resection of a myelolipoma. This case provides a unique clinical presentation of both nontraumatic hemoabdomen and bone marrow recovery.
(1) 报告猫非创伤性血性腹水的不常见病因，(2) 描述在手术切除巨大腹腔髓性脂肪瘤后出现严重、意外全血细胞减少症的发病和恢复情况。
一只 14 岁已绝育雄性短毛家猫因疑似非创伤性血性腹水而紧急就诊。在右颅腹部发现一个高回声肿块，超声回声与脂肪相似，被认为与肠系膜有关。腹腔液的细胞学检查发现血性渗出物中有明显的骨髓外造血。剖腹探查发现肝脏有一个肿块，切除后组织病理学检查显示为肝髓性脂肪瘤。患者最初的恢复情况平稳。然而，持续的食欲减退导致术后 4 天再次入院，此时发现患者患有严重的三系全血细胞减少症，细胞学证据表明骨髓正在恢复。全血细胞减少症通过持续的药物治疗和支持性护理得到解决。
髓性脂肪瘤破裂不是猫非创伤性血性腹水的常见鉴别诊断。此外，髓性脂肪瘤切除术后发生严重的全血细胞减少症是出乎意料的。该病例提供了非创伤性血性腹水和骨髓恢复的独特临床表现。
