The purpose of this investigation was to study the lymph drainage of the neoplastic mammary glands in the bitch using indirect lymphography. The main conclusions drawn from the study of 41 natural cases were as follows: the first or cranial thoracic and second or caudal thoracic neoplastic mammary glands usually drain into the ipsilateral axillary lymph nodes and rarely into the ipsilateral axillary and sternal lymph nodes, simultaneously. The third or cranial abdominal neoplastic mammary gland usually drains into the ipsilateral axillary and superficial inguinal lymph nodes simultaneously, but sometimes only cranially into the ipsilateral axillary lymph nodes. Rarely, it drains only caudally into the ipsilateral superficial inguinal and medial iliac lymph nodes, simultaneously. The fourth or caudal abdominal neoplastic mammary gland usually drains only caudally into the ipsilateral superficial inguinal lymph nodes. Rarely, it drains into the ipsilateral axillary and superficial inguinal lymph nodes simultaneously. The fifth or inguinal neoplastic mammary gland usually drains into the ipsilateral superficial inguinal lymph nodes but rarely, does it also drain into the ipsilateral popliteal lymph node and into a lymphatic plexus at the medial aspect of the ipsilateral thigh. Lymphatic connections between the neoplastic and adjacent normal mammary glands were demonstrated in only one case. The lymph drainage pattern of the neoplastic mammary glands is slightly different to that described in normal glands using the same radiographic method.
In the staging process of the breast cancer, demonstrating metastasis of the sentinel lymph node (SLN) has an important prognostic value, in both humans and animals. The aim of this prospective case-control study was to determine the diagnostic value of computed tomographic indirect lymphography (CT-LG) for detecting SLN metastasis in dogs with mammary cancer. Thirty-three female dogs with tumors in the abdominal and inguinal mammary glands were prospectively selected and subjected to CT-LG, 1 and 5 min after injection of 1 ml of contrast agent (iopamidol) in the subareolar tissue of the neoplastic and the contralateral normal mammary glands. The pattern of postcontrast opacification, degree of postcontrast enhancement, and size and shape were assessed in 65 SLNs in total and were correlated with histopathological findings. The absence of opacification or heterogeneous opacification 1 min after contrast medium injection showed the highest sensitivity, specificity, and accuracy (93%, 100%, and 98.4%, respectively). In images taken 1 min after injection, an absolute density value lower than 444 Hounsfield units (HU) in the center of the SLN also provided significant sensitivity and specificity (93.8% and 75%, respectively). The size and shape of the SLN (maximum and minimum diameter, maximum/minimum diameter ratio, maximum diameter/height of fifth thoracic vertebral body ratio) showed the lowest sensitivity and specificity. Results of this study support the hypothesis that CT-LG could help in the assessment of SLN metastasis in cases of mammary gland tumors in dogs.
Isolated abdominal aortic dissection is a rare clinical entity. We report a single-center experience with six patients with acute isolated abdominal aortic dissection managed during a period of seven years. The patients' median age was 62 years and they were predominantly male. All patients presented acutely with abdominal pain, one with hypovolemic shock due to aortic rupture, two with acute lower limb ischemia and one with buttock necrosis. Interestingly, one major symptom was astasia observed in four patients that resolved postoperatively. Computed tomography scan of the thoracic and abdominal aorta was the main diagnostic tool in all patients. Treatment consisted of open repair in three cases and endovascular repair with stent-graft deployment in the remaining three patients. One patient died postoperatively from multiorgan failure. Although natural history and treatment strategies of isolated abdominal aortic dissection have not been well defined, accurate clinical diagnosis and prompt management are essential to prevent adverse complications. Moreover, sudden development of astasia should alert the physician about this pathologic entity.
Our midterm results demonstrated that the ProCol vascular bioprosthesis was a promising material for VA with good patency and low complication rates.
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