Department of Pathology, University of Veterinary Medicine Foundation Hannover, Hannover, Germany; Centre for Systems Neuroscience Hannover (ZSN), Hannover, Germany.
Small Animal Clinic, University of Veterinary Medicine Foundation Hannover, Hannover, Germany.
J Comp Pathol. 2022 Apr;192:33-40. doi: 10.1016/j.jcpa.2022.01.006. Epub 2022 Feb 23.
We report the clinical, pathological and immunohistochemical characteristics of a phaeochromocytoma (PCC) in a 9-year-old male neutered Golden Retriever dog. The dog presented with acute onset of deteriorating cervical pain but was otherwise normal on general physical and neurological examinations. Magnetic resonance imaging of the cervical spine revealed a focal, extramedullary, infiltrative, poorly demarcated, heterogeneous mass with moderate contrast enhancement at the left cranial articular process of C2, associated with osteolysis and pathological fractures of C2, and marked soft tissue trauma. Due to the severe lesions and grave prognosis, the dog was euthanized. Post-mortem examination revealed severe enlargement of the right adrenal gland due to a neoplasm of the adrenal medulla. C2 was lytic and there was a white, well-demarcated, firm neoplastic mass in the surrounding musculature. Neoplasms were also present in, and adjacent to, the prostate gland and in pulmonary lymph nodes. Histologically, the neoplasms were composed of dense sheets and nests of small, round to polyhedral cells with frequent palisading along fine connective tissue septa, karyomegaly, multinucleated cells and frequent mitotic figures. Immunohistochemically, neoplastic cells expressed chromogranin A and synaptophysin. Gross, microscopic and immunohistochemical findings support the diagnosis of PCC, originating from the right adrenal gland, with multiple metastases in the cervical spine, prostate gland and pulmonary lymph nodes. This case highlights the difficulty of intra-vitam diagnosis of PCC as its manifestation can be highly variable. PCC should be considered as a rare but possible differential diagnosis for painful vertebral masses in elderly dogs.
我们报告了一例 9 岁雄性已去势金毛寻回犬发生的嗜铬细胞瘤(pheochromocytoma,PCC)的临床、病理和免疫组织化学特征。该犬表现为突发性进行性颈痛,但全身体格检查和神经学检查均未见明显异常。颈椎磁共振成像显示,C2 左侧颅关节突有一个局灶性、髓外、浸润性、边界不清、异质性肿块,中等对比增强,伴有 C2 溶骨性和病理性骨折,以及明显的软组织损伤。由于病变严重且预后不良,该犬被安乐死。尸检发现,由于肾上腺髓质的肿瘤,右侧肾上腺明显肿大。C2 有溶骨性病变,周围肌肉中有一个白色、边界清楚、坚硬的肿瘤肿块。前列腺和肺淋巴结也有肿瘤。组织学上,肿瘤由密集的小圆形至多角形细胞片层和巢组成,常沿细结缔组织隔呈栅栏状排列,核肥大,多核细胞和频繁有丝分裂象。免疫组织化学染色显示,肿瘤细胞表达嗜铬粒蛋白 A 和突触素。大体、显微镜和免疫组织化学检查结果支持 PCC 的诊断,起源于右侧肾上腺,在颈椎、前列腺和肺淋巴结有多处转移。本病例强调了 PCC 的活体内诊断难度很大,因为其表现可能高度多变。PCC 应被视为老年犬发生疼痛性椎骨肿块的罕见但可能的鉴别诊断之一。