三匹马多发性小肠假性憩室伴淋巴瘤。

T S Mair, G R Pearson, T J Scase
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引用次数: 20

摘要

3匹成熟马表现出进行性体重减轻、食欲不振、腹侧水肿和嗜睡。其中两只动物有间歇性低度腹痛症状。3例患者均为低白蛋白血症;2例有高纤维蛋白原血症,1例有嗜中性粒细胞增多。2例患者均行口服葡萄糖耐量试验,均表现为葡萄糖吸收受损。一匹小马接受皮质类固醇治疗后,病情没有好转,出现腹膜炎,两周后被安乐死。一匹小马的小肠活检是通过站立剖腹手术获得的,结果显示粘膜主要是单核细胞浸润。抗生素和皮质类固醇治疗无效,2个月后,除腹侧水肿和腹膜炎外,还出现胸骨水肿,并被安乐死。尽管对症治疗,剩下的小马病情恶化,一周后被安乐死。尸检时,3只动物均出现小肠壁增厚、黏膜溃疡、假性憩室及肠系膜淋巴结肿大等多灶性病变。一匹小马在肠系膜根部也有一个多结节性肿块,一个纵隔肿块和一个肺肿块。组织学检查证实每例死后肠壁存在淋巴瘤,免疫组织化学(包括对接受腹部剖腹手术的小马肠道活检的回顾性评估)表明淋巴瘤是T细胞起源。
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Multiple small intestinal pseudodiverticula associated with lymphoma in three horses.

Three mature horses presented with progressive weight loss, inappetence, ventral abdominal oedema and lethargy. Two of the animals had intermittent signs of low grade abdominal pain. At presentation, all 3 had hypoalbuminaemia; 2 had hyperfibrinogenaemia and the other had neutrophilia. An oral glucose tolerance test was performed in 2 cases, both of which demonstrated impaired glucose absorption. One pony treated with corticosteroids failed to improve and developed peritonitis and was subjected to euthanasia after 2 weeks. One pony had small intestinal biopsies obtained via a standing flank laparotomy, which revealed a mainly mononuclear cell infiltrate of the mucosa. It failed to respond to treatment with antibiotics and corticosteroids and, after 2 months, developed sternal oedema in addition to the ventral abdominal oedema and peritonitis and was subjected to euthanasia. The remaining pony deteriorated despite symptomatic therapy and was subjected to euthanasia after one week. At post mortem examination, all 3 animals had multifocal lesions of small intestinal wall thickening, mucosal ulceration, pseudodiverticula and enlarged mesenteric lymph nodes. One pony also had a multinodular mass at the root of the mesentery, a mediastinal mass and a lung mass. Histological examination confirmed the presence of lymphoma of the intestinal wall at post mortem examination in each case and immunohistochemistry (including retrospective evaluation of the intestinal biopsies obtained from the pony that underwent a flank laparotomy) indicated that the lymphomas were of T cell origin.

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