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犬脊髓室管膜瘤的临床、磁共振成像、组织病理学特征、治疗选择及预后:8例(2011 - 2022年)

Clinical, magnetic resonance imaging, histopathological features, treatment options and outcome of spinal ependymoma in dogs: 8 cases (2011-2022).

作者信息

Della Camera N, Cantile C, Falzone C

机构信息

Diagnostica Piccoli Animali s.r.l - Clinica Veterinaria Pedrani, Zugliano, Italy.

Dipartimento di Scienze Veterinarie, Università degli Studi di Pisa, Pisa, Italy.

出版信息

J Small Anim Pract. 2024 Dec;65(12):906-915. doi: 10.1111/jsap.13792. Epub 2024 Oct 24.

Abstract

OBJECTIVES

This study aims to report on the clinical magnetic resonance imaging, histological features, treatment options and outcomes of spinal ependymomas in dogs.

MATERIALS AND METHODS

Retrospective evaluation of medical records from dogs histologically confirmed spinal ependymomas with clinical presentations, magnetic resonance imaging findings, histological aspects, treatment options and outcomes.

RESULTS

Eight dogs presented with acute to subacute onset of para- or tetraparesis. Magnetic resonance imaging findings included intramedullary oval-shaped space-occupying lesions that appeared hyperintense on T2-weighted images isointense on T1-weighted images and exhibited marked homogeneous or ring contrast enhancement. A peculiar feature, previously described only in human ependymomas, was observed in three patients - a T2-weighted hypointense rim, termed hemosiderin cap sign. Haematomyelia with necrotic foci was observed in one dog. Surgery, when performed, enabling a definitive intra-vitam diagnosis. Histological examination revealed that rosettes and pseudo-rosettes as disposition of neoplastic cells were the most common features reported. Furthermore, cerebrospinal fluid metastases were identified in one case.

CLINICAL SIGNIFICANCE

Clinical and histopathological findings in our case series were consistent with those previously reported in the literature. Magnetic resonance imaging features were fairly typical and highly suggestive of spinal ependymomas. The hemosiderin cap sign may aid in the presumptive intra-vitam diagnosis of these rare spinal tumours. Additionally, we described cerebrospinal fluid spread of neoplastic cells and subsequent multifocal or metastasis presentations. Surgery offered a dual benefit by facilitating intra-vitam diagnosis and, in some cases, extending survival time.

摘要

目的

本研究旨在报告犬脊髓室管膜瘤的临床磁共振成像、组织学特征、治疗选择及预后情况。

材料与方法

对组织学确诊为脊髓室管膜瘤的犬的病历进行回顾性评估,内容包括临床表现、磁共振成像结果、组织学特征、治疗选择及预后情况。

结果

8只犬表现为急性至亚急性的截瘫或四肢瘫。磁共振成像结果显示,髓内椭圆形占位性病变在T2加权图像上呈高信号,在T1加权图像上呈等信号,并表现出明显的均匀或环形对比增强。在3只犬中观察到一种仅在人类室管膜瘤中描述过的特殊特征——T2加权低信号边缘,称为含铁血黄素帽征。在1只犬中观察到伴有坏死灶的脊髓出血性软化。手术在可行时能够实现确定性的生前诊断。组织学检查显示,肿瘤细胞呈菊形团和假菊形团排列是最常见的特征。此外,在1例中发现了脑脊液转移。

临床意义

我们病例系列中的临床和组织病理学发现与先前文献报道一致。磁共振成像特征相当典型,高度提示脊髓室管膜瘤。含铁血黄素帽征可能有助于这些罕见脊髓肿瘤的生前推测性诊断。此外,我们描述了肿瘤细胞的脑脊液播散及随后的多灶性或转移表现。手术通过促进生前诊断并在某些情况下延长生存时间带来了双重益处。

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