Stone Marisa D, Davies Rebecca K, Kridel Heather A
Ocean State Veterinary Specialists, East Greenwich, RI, USA.
Massachusetts Veterinary Referral Hospital, Woburn, MA, USA.
JFMS Open Rep. 2023 May 6;9(1):20551169231162484. doi: 10.1177/20551169231162484. eCollection 2023 Jan-Jun.
A 6.4 kg 3-year-old male neutered indoor-outdoor domestic shorthair cat was referred for further evaluation of non-resolving lethargy and hyporexia of 4 days' duration. Physical examination identified tachypnea with mild respiratory effort and muffled lung sounds bilaterally. Point-of-care ultrasound revealed a large volume of pleural and pericardial effusion (PCE), which was confirmed by thoracic radiography. Echocardiogram indicated normal cardiac function but revealed a mass-like structure along the left epicardium within the pericardial space. After 72 hours in hospital, re-evaluation via echocardiogram showed the epicardial mass lesion to have doubled in size and with apparent extension to involve the pericardium. The patient was hospitalized for 72 h of supportive care and intervention, including therapeutic pericardiocentesis, bilateral thoracocentesis, thoracic and cardiac imaging and infectious disease testing. On the third day of hospitalization, the patient developed cardiac tamponade. Further workup was discussed, including CT and subtotal pericardiectomy with biopsy, but the cat was euthanized due to clinical decline and rapid re-accumulation of effusion. Post-mortem histopathologic evaluation diagnosed an epicardial pleomorphic sarcoma, exclusive of mesothelioma or histiocytic sarcoma on immunohistochemistry (IHC).
This report describes a case of epicardial undifferentiated pleomorphic sarcoma (UPS) in a young cat presenting with pleural and PCE. Pleomorphic sarcoma is a rarely reported mesenchymal neoplasia in the feline patient and has thus far primarily been identified in peripheral soft tissue structures. IHC is key to the correct histopathologic diagnosis. To our knowledge, epicardial UPS has not been previously reported in a cat.
一只6.4千克的3岁已绝育室内外活动的家养短毛雄性猫因持续4天的无法缓解的嗜睡和食欲减退前来进一步评估。体格检查发现呼吸急促，有轻度呼吸用力，双侧肺部呼吸音减弱。床旁超声显示大量胸腔和心包积液（PCE），胸部X线摄影证实了这一点。超声心动图显示心脏功能正常，但在心包腔内左心外膜处发现一个肿块样结构。住院72小时后，通过超声心动图重新评估显示心外膜肿块病变大小增加了一倍，且明显扩展至心包。该患者接受了72小时的支持性护理和干预，包括治疗性心包穿刺术、双侧胸腔穿刺术、胸部和心脏成像以及传染病检测。住院第三天，患者出现心脏压塞。讨论了进一步的检查，包括CT和活检的次全心包切除术，但由于临床状况恶化和积液迅速重新积聚，该猫被实施安乐死。尸检组织病理学评估诊断为心外膜多形性肉瘤，免疫组织化学（IHC）排除了间皮瘤或组织细胞肉瘤。
本报告描述了一例年轻猫的心外膜未分化多形性肉瘤（UPS），伴有胸腔和PCE。多形性肉瘤是猫科动物患者中很少报道的间叶性肿瘤，迄今为止主要在周围软组织结构中发现。IHC是正确组织病理学诊断的关键。据我们所知，心外膜UPS此前尚未在猫中报道过。
