Gabor L J, Malik R, Canfield P J
Department of Veterinary Anatomy and Pathology, Faculty of Veterinary Science, University of Sydney, New South Wales.
Aust Vet J. 1998 Nov;76(11):725-32. doi: 10.1111/j.1751-0813.1998.tb12300.x.
To determine patients' characteristics and anatomical distribution of lesions in cats with lymphosarcoma.
Prospective multi-institutional study of naturally occurring feline lymphosarcoma.
Veterinarians in Sydney were provided with free diagnostic laboratory services for suspect cases of feline lymphosarcoma. Lymphosarcoma was diagnosed based on physical findings, radiographic and/or ultrasonographic images and results of cytological or histopathological examination. When owners were not interested in pursuing an antemortem diagnosis, suspect cases were collected for necropsy. Patients' characteristics and physical findings were recorded. A modified scheme for anatomical classification of lesions was devised including a 'mixed' category for cases which involved two or more anatomical forms.
One hundred and eighteen cases were accrued over an 18 month period. The median age was 120 months and range 5 to 212 months. Age distribution was bimodal, with a small peak for cats less than 24 months, and a normal distribution centred on 97 to 120 months. Eighty cats were domestic crossbreds, 22 were Siamese or Oriental cats (including crosses), 6 were Burmese, 5 were purebred longhairs and the remaining 5 were one of a number of purebred shorthaired breeds. In comparison to 1017 consecutive cases admitted to our hospital for conditions other than lymphosarcoma, Siamese/Oriental cats were over-represented amongst lymphosarcoma cases (P = 0.0006). Male cats were also over-represented, accounting for 72 of 118 cases (P = 0.05). Abdominal lymphosarcoma was the most common anatomical form (43 cats), followed by mixed (39), nodal (20), mediastinal (9) and atypical (involving non-lymphoid organs, 7) forms. When analysed for specific organ involvement, 29 (25%) had mediastinal involvement, 71 (60%) had abdominal involvement including 60 (51%) with involvement of the intestinal tract and/or mesenteric lymph nodes and 36 (31%) with bilateral renal involvement, and 47 (40%) had peripheral lymph node involvement. No case of primary lymphoid leukaemia was identified. A noticeable subgroup of cats younger than 24 months had involvement of the anterior mediastinum with or without concurrent enlargement of cervical or axillary lymph nodes; Siamese/Oriental cats were over-represented in this subgroup. Among cases with nodal involvement, lymph nodes of the head and neck were frequently involved, mandibular nodes most commonly, followed by superficial cervical nodes. In seven cases a solitary node was affected.
Compared with similar surveys overseas, our cats were older and male cats were over-represented. There was a notable subgroup of young cats with mediastinal involvement. Siamese/Oriental cats were over-represented in this subgroup as well as in the larger population of cats with lymphosarcoma. Compared with overseas surveys, renal involvement, mixed cases and atypical cases (including nasal lymphosarcoma) were more common. A new subcategory of nodal lymphosarcoma, with involvement restricted to node(s) of head and neck, was identified.
确定患有淋巴肉瘤的猫的患者特征及病变的解剖分布。
对自然发生的猫淋巴肉瘤进行前瞻性多机构研究。
为悉尼的兽医提供针对猫淋巴肉瘤疑似病例的免费诊断实验室服务。淋巴肉瘤根据体格检查结果、放射影像学和/或超声图像以及细胞学或组织病理学检查结果进行诊断。当猫主人对生前诊断不感兴趣时,收集疑似病例进行尸检。记录患者特征和体格检查结果。设计了一种改良方案用于病变的解剖学分类,包括为涉及两种或更多解剖形式的病例设立一个“混合”类别。
在18个月期间共收集了118例病例。中位年龄为120个月,范围为5至212个月。年龄分布呈双峰型,24个月以下的猫有一个小高峰,以97至120个月为中心呈正态分布。80只猫为家猫杂交品种,22只为暹罗猫或东方猫(包括杂交品种),6只为缅甸猫,5只为纯种长毛猫,其余5只为多个纯种短毛品种之一。与我院连续收治的1017例非淋巴肉瘤疾病病例相比,暹罗猫/东方猫在淋巴肉瘤病例中占比过高(P = 0.0006)。雄性猫也占比过高,118例中有72例(P = 0.05)。腹部淋巴肉瘤是最常见的解剖形式(43只猫),其次是混合形式(39只)、淋巴结型(20只)、纵隔型(9只)和非典型型(累及非淋巴器官,7只)。分析特定器官受累情况时,29只(25%)有纵隔受累,71只(60%)有腹部受累,其中60只(51%)累及肠道和/或肠系膜淋巴结,36只(31%)双侧肾脏受累,47只(40%)有外周淋巴结受累。未发现原发性淋巴细胞白血病病例。一个明显的亚组是年龄小于24个月的猫,有前纵隔受累,伴有或不伴有颈部或腋窝淋巴结同时肿大;暹罗猫/东方猫在该亚组中占比过高。在有淋巴结受累的病例中,头颈部淋巴结经常受累,最常见的是下颌淋巴结,其次是颈浅淋巴结。7例中单个淋巴结受累。
与海外类似调查相比,我们研究中的猫年龄更大,雄性猫占比过高。有一个明显的年轻猫亚组有纵隔受累。暹罗猫/东方猫在该亚组以及更大的淋巴肉瘤猫群体中占比过高。与海外调查相比,肾脏受累、混合病例和非典型病例(包括鼻淋巴肉瘤)更常见。确定了一种新的淋巴结型淋巴肉瘤亚类,其受累仅限于头颈部淋巴结。