肿瘤学课件 犬淋巴瘤.pptVIP

Babushka Signalment 特征 Female, 8 year old, poodle 雌性，8岁，贵宾犬 History 病史 PU/PD for the last few weeks 前几周多饮多尿 Acute collapse- immediately presented to the emergency service 严重虚脱－立刻送至急救 Physical Exam 体检 Weakness 虚弱 5% dehydration 5％脱水 No other abnormalities 无其他异常 Diagnostic Plan 诊断计划 CBC 血常规 Biochemistry 生化 Urinalysis 尿检 Results- CBC 全血细胞计数结果 WBC- 10.09白细胞计数 RBC- 6.26 红细胞 PCV-42 红细胞压积容量 Plts-159 血小板 Ts- 6.8 Results- Biochemistry生化结果 Glu- 101谷氨酸 Creat- 2.19 Na+- 151钠离子 K+-3.9钾离子 Ca++- 1.91 钙离子 Results- UA 尿检结果 SG-1.018 Ph- 6.0 No sediment or other findings 无沉淀，无其他异常 Problem List 问题列表 Acute collapse- weakness 急性虚脱－虚弱 Hypercalcemia-PU/PD 高钙血症－多饮多尿 Dehydration 脱水 DDs for Hypercalcemia 高钙血症鉴别诊断 1 Lab error - always make sure it is repeatable 实验错误－需要重复确认 2 Physiologic growth of young animals年轻动物生长 3 Dehydration (hyperproteinemia) 脱水（高蛋白血症） 4 Malignancy tumors恶性肿瘤 Lymphoma淋巴瘤, apocrine gland anal sac adenocarcinoma顶浆分泌腺和肛门腺癌, adenocarcinoma腺癌 (thyroid甲状腺, mammary gland乳腺, nasal鼻, pulmonary肺), thymoma胸腺癌, squamous cell carcinoma鳞状细胞癌, and primary hyperparathyroidism原发性甲状旁腺机能亢进. (Mets to bone- rare 成骨素－少见) 5 Hypoadrenocortcism (Addison‘s) 肾上腺皮质功能不全（阿迪森） Conditions Associated With Hypercalcemia (Cont.) 高钙血症相关的情况 6. Renal failure 肾衰 7. Hypervitaminosis D (cholecalciferol VD3) 高VD症 d/t increased intestinal absorption of calcium 帮助钙在肠内吸收 8. Primary hyperparathyroidism-. 原发性甲状旁腺机能亢进 older dogs and cats, Keeshond and Siamese predisposed. 老龄犬猫，基丝犬，仙罗猫易得 hypercalcemia, hypophosphatemia, ca-/p ratio 33. 高钙血症，低磷血症 （钙/鳞大于33） PTH level - usually elevated. 甲状旁腺素水平－通常升高 Conditions Associated With Hypercalcemia (Cont.) 9. Skeletal lesions (non-neoplastic) – 骨骼损伤（无增生物） osteomyelitis – inflammation 骨髓炎－炎症 Bone resorbing factors produced by monocytes and activated lymphocytes 单核细胞和核激活淋巴细胞产生各种骨吸收因子 hypertrophic osteodystrophy 肥大性骨营养不良 disuse osteoporosis (immobilization) - 萎缩性骨质疏松 Increased resorption, decreased bone formation吸收增加，生成减少 10. Blastomycosi