肿瘤学课件 肥大细胞瘤.pptVIP

Canine Mast Cell Tumors犬肥大细胞瘤 ?Jouschka“ 10 year old FS Airdale Terrier 1 History 主诉 Masse hind leg 后腿肿块 Since several weeks 已发病几周 Changes size 大小发生改变 Otherwise no abnormalities 无其他异常现象 Physical Exam 体检 BAR No abnormalities except mass 除肿块外无异常 Soft 肿块柔软 Subcutaneous 位于皮下 Not well circumscribed 界限不明显 Differential Diagnosis鉴别诊断 Mast cell tumor 肥大细胞瘤 Lipoma 脂肪瘤 Sebaceous hyperplasia/adenoma 脂肪增生 / 腺瘤 Fibrosarcoma 纤维肉瘤 Melanoma 黑素瘤 Squamous cell carcinoma 鳞状细胞癌 Seroma, abscess… 肿, 脓肿… Fine Needle Aspiration细针抽吸术 Cytologic Diagnosis细胞学诊断 ?Mast cell tumor“ (MCT)肥大细胞瘤 Mast Cells 肥大细胞 Derived from hematopoietic precursors 来自造血细胞的前体 Found in liver, lung, skin, GI tract, bone marrow 可以在肝、 肺 、皮肤、胃肠道以及骨髓中发现 Integral in inflammatory and allergic responses 可在炎症及过敏反应中出现 General Most common skin tumor of dogs (16-21%) 狗常见的皮肤肿瘤 (16%-21%) ； Breed predisposition:具有品种遗传的特点 ... Mast cell tumors Clinical Presentation临床特征 Mast cell tumors Clinical Presentation临床特征 Location 发病部位 Head and neck 头颈部 (13%) Thorax and forelimb 胸部及前肢 (29%) Abdomen and hindlimb 腹部及后肢 (40%) Genital or perianal 生殖器或肛周 (18%) 10% of dogs have multiple cutaneous tumors 10% 的狗患有混合性的皮肤瘤 Behave similar to low or intermediate grade solitary MCT 行为与轻微或是中等程度的单个肥大细胞瘤相似 (Mullins M et al, JAVMA 2006 Systemic mastocytosis 全身性的肥大细胞增生病 Usually associated with cutaneous tumors 通常伴有皮肤肿瘤 First Step: Getting a Diagnosis第一步 : 进行诊断 Fine needle aspiration 细针抽吸术 - Usually easy diagnosis 常用的简单方法 - No grading on cytology!! 但不能在细胞学上分级 ： Biopsy 活组织检查： - Antihistamines 抗组织胺类 - Grading on histology - prognosis!! 组织学分类,以便判断预后 Grade 1: well differentiated 一级:分化良好 Grade 2: moderately differentiated 二级: 中等程度的分化 Grade 3: poorly differentiated；三级:分化不明显. Mast cell tumors Staging 诊断步骤 Bloodwork 验血 Thoracic radiographs 胸片 Abdominal ultrasound 腹