Schwartz Rebecca, Sugai Nicole J, Eden Kristin, Castaneda Caitlin, Jevit Matthew, Raudsepp Terje, Cecere Julie T
Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, United States.
Department of Veterinary Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, United States.
Front Vet Sci. 2022 Jul 8;9:937991. doi: 10.3389/fvets.2022.937991. eCollection 2022.
A 10-year-old intact female Chinese Crested dog was presented for evaluation and further diagnostics due to persistent symptoms of vulvar swelling, vaginal discharge, and an 8-year history of acyclicity. At presentation, generalized hyperpigmentation and truncal alopecia were identified, with no aberrations of the female phenotype. Vaginal cytology confirmed the influence of estrogen at multiple veterinary visits, and hormonal screening of progesterone and anti-Mullerian hormone indicated gonadal presence. Based on findings from abdominal laparotomy and gonadectomy, the tissue was submitted for histopathology. Histopathologic evaluation identified the gonads to be abnormal testes containing multiple Sertoli and interstitial (Leydig) cell tumors. The histopathologic diagnosis of testes and concurrent normal external female phenotype in the patient lead to a diagnosis of a disorder of sexual development (DSD). Karyotype evaluation by conventional and molecular analysis revealed a two cell line chimeric pattern of 78,XX (80%) and 78,XY (20%) among blood leukocytes, as well as a positive PCR test for the Y-linked gene. Cytogenetic analysis of skin fibroblasts revealed the presence of 78,XX cells exclusively, and PCR tests for the Y-linked gene were negative in the hair and skin samples. These results are consistent with an XX/XY blood chimerism. This is one of the few case reports of a canine with the diagnosis of leukocyte chimerism with normal female phenotypic external genitalia. This case illustrates a distinct presentation for hormonally active Sertoli cell tumorigenesis and demonstrates surgery as a curative treatment option for clinically affected patients.
一只10岁未绝育的雌性中国冠毛犬因持续出现外阴肿胀、阴道分泌物增多以及8年的无发情周期病史前来接受评估和进一步诊断。就诊时,发现全身色素沉着和躯干脱毛,女性表型无异常。阴道细胞学检查在多次兽医检查中均证实有雌激素影响,孕酮和抗苗勒管激素的激素筛查表明存在性腺。根据腹部剖腹术和性腺切除术的结果,将组织送去做组织病理学检查。组织病理学评估确定性腺为异常睾丸,含有多个支持细胞和间质(莱迪希)细胞瘤。患者睾丸的组织病理学诊断以及同时存在的正常女性外部表型导致诊断为性发育障碍(DSD)。通过传统和分子分析进行的核型评估显示,血液白细胞中存在78,XX(80%)和78,XY(20%)的双细胞系嵌合模式,并且Y连锁基因的PCR检测呈阳性。皮肤成纤维细胞的细胞遗传学分析仅显示存在78,XX细胞,毛发和皮肤样本中Y连锁基因的PCR检测均为阴性。这些结果与XX/XY血液嵌合一致。这是少数几例诊断为白细胞嵌合且具有正常女性表型外生殖器的犬类病例报告之一。该病例说明了激素活性支持细胞瘤发生的一种独特表现,并证明手术是临床受影响患者的一种治愈性治疗选择。