犬膀胱移行细胞癌的病理分析

对门诊接诊的1条10岁雌性金毛猎犬进行了一般检查和B超检查,保守治疗无效,手术切除肿物。用10％福尔马林固定病变组织,制作石蜡切片,进行病理分析,确诊为犬膀胱移行细胞癌,并对此病的病因、发病机理等进行了探讨。     

TRANSITIONAL CELL CARCINOMA OF THE URETHRA IN FOUR FEMALE DOGS: ITS URETHROGRAPHIC APPEARANCE

ansitional cell urethral carcinoma in four female dogs is reported. Lesion distribution in the proximal two thirds of the urethra and the radiographic appearance with retrograde positive contrast urethrography were similar in each dog. The normally smooth longitudinal urethral striations were replaced by multiple small, poorly marginated intraluminal masses that resulted in a generalized moth-eaten appearance. Extension of contrast medium into the periurethral tissues also occurred. Retrograde urethrography, a simple diagnostic technic, aided in establishing a differential diagnosis in dogs that had urine retention and stranguria.     

Transurethral resection in the management of urethral and prostatic neoplasia in 6 dogs

OBJECTIVE: To assess cystoscopic transurethral resection (TUR) for the palliative management of dogs with neoplastic infiltration of the urethra. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs. METHODS: Cystoscopic examination and electrosurgical TUR were performed in dogs with urination difficulties caused by prostatic or urethral neoplasia. TUR was performed in a retrograde manner in female dogs and antegrade in male dogs via exploratory celiotomy and ventral cystotomy. Cystoscopic examination was used to determine the extent of neoplastic involvement of the urethra. TUR involved piecemeal removal of neoplastic tissue from the urethral lumen using an electrocautery cutting loop. Hemorrhage was controlled with a cystoscopic cauterized roller-ball. In 2 male dogs, intraoperative radiation therapy (IORT) was used to treat both prostatic neoplasia and the sublumbar lymph node bed. Surgical technique, complications, adjuvant treatment, and outcome were recorded. RESULTS: TUR was performed in 3 male dogs with prostatic carcinoma and 2 female dogs with urethral transitional cell carcinoma (TCC). In 1 female dog, TUR was attempted but not successful because of cystoscope diameter. Iatrogenic urethral perforation occurred during TUR in 3 dogs. In 2 dogs, prolonged exposure to lavage fluid resulted in clinical and biochemical abnormalities consistent with TUR syndrome. Dysuria resolved in 5 dogs within 10 days of TUR. Treatment-related complications included urinary tract infection and tumor seeding. Local tumor progression and metastasis occurred in all dogs. CONCLUSIONS: TUR (in combination with chemotherapy+/-IORT) resulted in rapid palliation of urination difficulties in male dogs with prostatic carcinoma. In female dogs with urethral TCC, however, electrosurgical TUR cannot be recommended because of a high intra- and postoperative complication rate with no improvement in postoperative management compared with historical reports of tube cystostomy. CLINICAL RELEVANCE: TUR is a novel alternative for the palliation of male dogs with prostatic carcinoma. In female dogs with urethral TCC, electrosurgical TUR does not provide any advantages compared with tube cystostomy.     

LATE COMPLICATIONS OF PELVIC IRRADIATION IN 16 DOGS

When external beam radiation therapy is administered to the pelvis, normal tissues irradiated may include the colon, small intestine, urethra, bladder, bone, and spinal cord. The objectives of this retrospective study were to determine the incidence and severity of late radiation effects following pelvic irradiation in dogs and to identify factors that increase the risk of these effects. Medical records of all dogs treated with curative intent external beam radiation therapy to the pelvic region between 1993 and 1999 were reviewed. Patients with follow-up longer than 9 months or any patient that developed late complications earlier than 9 months were evaluated. Sixteen dogs met criteria for inclusion in this study. All dogs were treated with a 6-MV linear accelerator with bilaterally opposed beams. Diseases treated included transitional cell carcinoma of the bladder, transitional cell carcinoma of the prostate, and anal sac apocrine gland adenocarcinoma. Four dose/fractionation schemes were used: 49.5 Gy in 3.3 Gy fractions, 54 Gy in 3.0 Gy fractions, 54 Gy in 2.7 Gy fractions, and 18 Gy intraoperative radiation therapy followed by 43 Gy external beam radiation therapy in 2.9 Gy fractions. Implantable chemotherapy in the form of an OPLA-Pt sponge was used in six dogs as a radiation potentiator. Colitis was the major late effect following pelvic irradiation, occurring in nine dogs (56%). Colitis was characterized as mild in three dogs, moderate in one dog, and severe in five dogs. Three of the dogs with severe effects suffered gastrointestinal perforation. All dogs with severe late effects received 3 or 3.3 Gy per fraction, and 80% received radiation potentiators. In the seven dogs that received 2.7 Gy or 2.9 Gy per fraction, late effects were classified as none (n = 5), mild colitis (n = 1), and moderate colitis (n = 1). Radiation therapy can be administered to the pelvic region with a minimal risk of late effects to the colon by giving smaller doses per fraction and avoiding systemic radiation potentiators.     

ULTRASONOGRAPHIC APPEARANCE OF URETHRAL TRANSITIONAL CELL CARCINOMA IN TEN DOGS

The mucosal margin of the urethra is best assessed by positive contrast urethrography, but ultrasonography offers complementary information such as urethral wall thickness and size of medial iliac lymph nodes. Ultrasonography of the urethra is quick, noninvasive and does not require sedation or general anesthesia. In patients with complete urethral obstruction, ultrasonography may be the only way to image the urethra. Twelve dogs which were presented to Tufts University School of Veterinary Medicine with clinical signs referable to the urinary bladder, urethra or vagina were examined ultrasonographically. Seven were neutered females and five were neutered males. Each dog had a hyperechoic, nonshadowing line at the epithelial surface of the proximal urethra. In the seven female patients and one of the males, the urethral wall was also thick and hypoechoic to surrounding tissue. In the other males, the urethral epithelial changes were at the level of the prostate, and the limits of the urethra were not visible. In six dogs, the urethral change was the only abnormality seen, while in six, bladder wall, bladder luminal and/or prostatic parenchymal changes were also detected. Three patients had hydronephrosis, and one had enlarged medial iliac lyumph nodes. Biopsies were obtained via suction with urinary catheterization (n = 6), exploratory celiotomy (n = 3), urethroscopy (n = 2), or at post-mortem (n = 1). A histopathologic diagnosis of urethral transitional cell carcinoma was obtained in ten dogs. The ultrasonographic appearance was not pathognomonic for transitional cell carcinoma, as one dog with transitional cell dysplasia and one dog with severe ulcerative and necrosupperative cystitis and urethral stricture had similar findings.     

DEFINITIVE RADIATION THERAPY FOR INFILTRATIVE THYROID CARCINOMA IN DOGS

The medical records of eight dogs with histopathologically confirmed infiltrative thyroid carcinoma treated with external beam radiation were reviewed and a retrospective analysis of survival and local tumor control were performed. The dogs received a definitive radiotherapy protocol of 46.8-48 Gray. All dogs had a reduction in tumor size to a clinically undetectable level on follow up examinations. Kaplan-Meier analysis indicated a median survival time of 24.5 months. Pulmonary metastasis was detected in three dogs and one of these dogs had concurrent bone metastasis. One dog had bone metastasis alone. Two dogs were alive at the censor. This study suggests that fractionated, definitive radiation therapy using multiple, moderate doses of radiation is an effective treatment for local control of invasive thyroid carcinoma in dogs.     

Description and efficacy of a response-based “QUAD” cyclical hypofractionated palliative-intent radiation protocol in dogs with macroscopic solid tumours: 108 cases

Palliative-intent radiation therapy can alleviate pain and clinical signs in dogs with cancer, but optimal fractionation scheme is unknown. The objective of this retrospective case series is to evaluate clinical benefit, objective response, adverse effects, and outcomes in 108 dogs with macroscopic solid tumours treated with a cyclical “QUAD” hypofractionated palliative-intent radiation therapy protocol. Median QUAD dose was 14 Gy (14–16 Gy). Median total dose was 28 Gy (14–48 Gy). Clinical benefit rate was 93%, with median onset of subjective palliation 21 days after the first QUAD, lasting a median of 134 days. Tumour volumetric objective response was assessed with CT prior to the third QUAD in 36 dogs, with stable disease in 24 dogs (67%) and partial response in 9 dogs (25%). Sinonasal and oral were the most common tumour locations in 32 and 30 dogs, respectively. Median progression-free survival was 153 days (95% CI 114–200). Median overall survival was 212 days (95% CI 152–259). Number of QUAD cycles completed, clinical benefit achieved, anti-inflammatory received, total radiation dose, time to maximum clinical benefit, and response duration were positively associated with progression-free and overall survival. Acute toxicities were observed in 15 dogs (14%) with 3 high-grade (grade 3) toxicities (3%). Low-grade (grade 1 and 2) late skin and ocular toxicities were observed in 31 dogs (29%), predominantly leukotrichia, alopecia, keratoconjunctivitis sicca, and cataracts. This report demonstrates that QUAD radiation is an alternative protocol to be considered for palliation of dogs with inoperable or advanced stage solid tumours.