Bir köpekte malignant perikardiyal mezotelyoma ve perikardiyal efüzyon
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Date
2010-01-06
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Uludağ Üniversitesi
Abstract
Kliniğimize kilo kaybı, abdominal dilatasyon, kollaps ve egzersiz intoleransı şikâyetiyle getirilen 15 yaşlı, erkek, Terrier ırkı bir köpeğe malignant perikardiyal mezotelyomaya bağlı perikardiyal efüzyon (PE) tanısı konuldu. Klinik muayenesinde aritmi, zayıf femoral nabız, kardiyak seslerde boğukluk ve juguler dolgunluk belirlendi. EKG’de QRS ile ilgili küçük kompleks oluşumu ve elektrik alternans, toraks radyografisinde; kalbin siluetinde opasite artışı ve pulmoner ödem, ekokardiyografide; PE ve kardiyak tamponat, abdominal ultrasonografide de asites saptandı. Hematolojik ve serum biyokimyasal bulgular ile perikardiyosentez sıvısının sitolojik muayenesi nonspesifikti. İdiopatik PE tedavisine (ampisilin + prednizolon) yanıt alınamayan hastaya bir ay sonra parsiyel perikardiyektomi yapılmasına karar verildi. Postoperatif kardiyopulmoner arrest nedeni ile hastada eksitus letalis şekillendi. Nekropsi muayenesi sonrası doku örnekleri alındı. Perikardiyumdaki neoplastik kitle, makroskobik, mikroskobik ve immunohistokimyasal özellikleri ile perikardiyal epitelyal mezotelyoma olarak tanımlandı. Sonuç olarak EKG ve ekokardiyografinin PE tanımlamasında yüksek doğruluk derecesinde kullanılabilecekleri, mezotelyoma gibi perikardiyal kitlelerin tanısında yetersiz kalınılabileceği gözlendi. İleri yaşlı PE’li köpeklerin tanısal sürecinde mezotelyomanın da düşünülmesi gerektiği kanısına varıldı.
Pericardial effusion (PE) due to malignant pericardial mesothelioma was diagnosed in a terrier-breed dog, of 15 year old, presented to our clinics with the clinical problems of weight loss, abdominal dilatation, collaps and exercise intolerance. In the clinical examination, arrhythmia, weak femoral pulse, cardiac stiffness, and jugular distension were determined. In ECG examination, small complex of QRS and electric alternans, in thoracic x-ray; increased opacity of the cardiac silhouette and pulmonic oedema, in echocardiographic examination; PE and cardiac tamponate, and ascites by abdominal ultrasonography were determined. The results of haematology and serum biochemistry analysis as well as cytological examination of pericardial fluid were non-specific. Based on these results, idiopathic PE was diagnosed and a treatment plan (ampicilin + prednisolone) was suggested. One month later, partial pericardiectomy was performed in the patient because of which treatment was unresponsive. Patient was died due to postoperative cardiopulmonary arrest. At necropsy, tissue specimen was collected. Neoplastic mass within pericardium was described the gross, microscopic, and immunohistochemical features of a pericardial epithelial mesothelioma. As a result, in PE diagnosis, ECG and echocardiography are highly reliable, however, they may be inadequate in the diagnosis of mass such as mesothelioma into pericardial cavity. Mesothelioma should be kept in mind, during the diagnostic work-up in geriatric dogs with PE, as well.
Pericardial effusion (PE) due to malignant pericardial mesothelioma was diagnosed in a terrier-breed dog, of 15 year old, presented to our clinics with the clinical problems of weight loss, abdominal dilatation, collaps and exercise intolerance. In the clinical examination, arrhythmia, weak femoral pulse, cardiac stiffness, and jugular distension were determined. In ECG examination, small complex of QRS and electric alternans, in thoracic x-ray; increased opacity of the cardiac silhouette and pulmonic oedema, in echocardiographic examination; PE and cardiac tamponate, and ascites by abdominal ultrasonography were determined. The results of haematology and serum biochemistry analysis as well as cytological examination of pericardial fluid were non-specific. Based on these results, idiopathic PE was diagnosed and a treatment plan (ampicilin + prednisolone) was suggested. One month later, partial pericardiectomy was performed in the patient because of which treatment was unresponsive. Patient was died due to postoperative cardiopulmonary arrest. At necropsy, tissue specimen was collected. Neoplastic mass within pericardium was described the gross, microscopic, and immunohistochemical features of a pericardial epithelial mesothelioma. As a result, in PE diagnosis, ECG and echocardiography are highly reliable, however, they may be inadequate in the diagnosis of mass such as mesothelioma into pericardial cavity. Mesothelioma should be kept in mind, during the diagnostic work-up in geriatric dogs with PE, as well.
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Keywords
Perikardiyal efüzyon, Pericardial effusion, Mezotelyoma, Köpek, Mesothelioma, Dog
Citation
Kocatürk, M. (2009). "Bir köpekte malignant perikardiyal mezotelyoma ve perikardiyal efüzyon". Uludağ Üniversitesi Veteriner Fakültesi Dergisi, 28 (2), 73-82.