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一例猫肠系膜鳞状细胞癌的病理诊断

Pathological diagnosis of mesenteric squamous cell carcinoma in cats

  • 摘要: 1只2.5岁雄性英短猫,就诊前10天出现呕吐、排便困难、粪便稀薄症状,经检查,患猫消瘦,体温38.5℃,呼吸频率、脉搏均正常,腹部可触及1个游离硬物,按压腹部无痛感。B型超声检查显示,腹中部有1个大小为4.41 cm×3.08 cm的肿物。为明确肿物性质、确定治疗方案,对患猫进行开腹探查,可见肠系膜有多个大小不等的球形肿物,手术切除肿物,分别进行细胞学、组织病理学及免疫组织化学检查。其中细胞学检查可见多种形状细胞,有分散排列的梭形细胞,有多角形体积较大的细胞,据此怀疑为间质来源的神经纤维瘤、胃肠道间质瘤或上皮来源的鳞状上皮癌。组织病理学检查可见肿瘤细胞排列呈巢状,肿瘤细胞为多边形或梭形,细胞大小不一,细胞核深染,可见多量病理性核分裂相,异型性较明显,肿瘤组织中心伴有坏死灶,具有低分化鳞状细胞癌特征。免疫组织化学染色显示,肿瘤细胞细胞角蛋白(CK)5/6阳性、DOG1阴性、S-100阴性、SMA阴性、波形蛋白(Vimentin)阴性,支持低分化鳞状细胞癌。根据病理结果建议术后化疗,但主人未配合,术后出院时各项指标均恢复正常,但应密切随访。

     

    Abstract: A 2.5-year-old male British Shorthair cat had been vomiting with difficult defecation and thin stools for 10 days before treatment,. The affected cat was emaciated; its body temperature was 38.5 ℃, and the respiratory rate and pulse were normal. A free hard object could be palpated in the abdomen, and there was no pain when pressing on the abdomen. B-mode ultrasonography revealed a mass 4.41 cm × 3.08 cm in the mid-abdomen. In order to clarify the nature of the tumor and determine the treatment plan, laparotomy was performed on the cat; multiple spherical tumors of different sizes were seen in the mesentery and the tumors were surgically removed; cytology, histopathology and immunohistochemistry were performed respectively. Among them, cytological examination showed cells of various shapes, including scattered spindle cells, and large polygonal cells. Based on this, it was suspected to be neurofibroma and gastrointestinal stromal tumor of stromal origin, or squamous cell carcinoma of epithelial origin. Histopathological examination showed that the tumor cells were arranged in nests; the tumor cells were polygonal or spindle-shaped; the cells were different in size; the nuclei were deeply stained, and a number of pathological nuclei mitotic phases were seen, with obvious atypia; the center of the tumor tissue was accompanied by necrotic foci, with features of low poorly differentiated squamous cell carcinoma. Immunohistochemical staining showed tumor cells cytokeratin(CK) 5/6(+), DOG1(-), S-100(-), SMA(-), Vimentin(-), which supported poorly differentiated squamous cell carcinoma. According to the pathological results, postoperative chemotherapy was recommended, but the owner did not cooperate. All indicators returned to normal when discharged after surgery, but close follow-up should be performed.

     

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