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Background: Due to their abundant vascular supply, the lungs are a usual metastatic site, with primary lung cancer presenting a low prevalence in dogs and cats. Among the primary pulmonary tumors afflicting dogs, lepidic carcinoma is the most common and can be classified by site of onset. Lepidic predominant adenocarcinoma is characterized by the proliferation of neoplastic cells along the pulmonary alveoli and pre-existing alveolar structures. Few reports of this specific tumor were found in the literature, so the objective of this study is to describe the clinical, pathological, and immunohistochemical findings of a dog with predominantly diffuse lepidic adenocarcinoma. Case: A 14-year-old, female, spayed, mixed-breed canine with a history of progressive weight loss, cough, respiratory distress, and pain while eating was brought in for a consultation. A presumptive diagnosis of pneumonia was suggested. However, in spite of treatment, the dog died, and a necropsy was performed. Upon gross examination, the lungs were diffusely enlarged, whitish, and stiffened with large and highly vascular nodules. Histopathological findings showed proliferation of neoplastic cells along the vascular walls and within the bronchioalveolar structures, with moderate fibrovascular stroma. The growth patterns resembled the pre-existing alveolar structures, with papillary protrusions into the alveolar lumen. After immunohistochemical evaluation, the definitive diagnosis was diffuse lepidic predominant adenocarcinoma. This tumor is uncommon and difficult to diagnose in the clinical veterinary routine, so it should be considered in the differential diagnosis of respiratory conditions in canines, especially in elderly animals with chronic clinical signs not responsive to antibiotic therapy. Complementary diagnostic examinations such as imaging, laboratory tests, and biopsy are indispensable to the early diagnosis of this lung neoplasm. Discussion: Due to its insidious character, primary lung cancer is underdiagnosed in veterinary medicine and is regularly an incidental x-ray finding. Affected dogs have no clinical signs, and this poses a diagnostic challenge. Primary lung cancer tends to be more prevalent in older and purebred animals. The most frequent clinical sign in dogs is a chronic nonresponsive cough, which can be misdiagnosed as another respiratory disease. Hematological findings, such as anemia, neutrophilia, and lymphopenia, can be related to tumor progression. Most reported cases of lepidic adenocarcinoma in dogs have a single pulmonary nodule, and the diffuse form is less common. In this case report, besides the presence of a single pulmonary nodule, there was also widespread involvement of the parenchyma. Histopathology was compatible with lepidic predominant adenocarcinoma, and immunohistochemistry was positive for pan-cytokeratin, confirming the epithelial origin of the tumor, and negative for TFF-1. Despite being a highly specific marker for lung cancer in dogs, TFF-1 has variable sensitivity among the different types of l...
Background: Due to their abundant vascular supply, the lungs are a usual metastatic site, with primary lung cancer presenting a low prevalence in dogs and cats. Among the primary pulmonary tumors afflicting dogs, lepidic carcinoma is the most common and can be classified by site of onset. Lepidic predominant adenocarcinoma is characterized by the proliferation of neoplastic cells along the pulmonary alveoli and pre-existing alveolar structures. Few reports of this specific tumor were found in the literature, so the objective of this study is to describe the clinical, pathological, and immunohistochemical findings of a dog with predominantly diffuse lepidic adenocarcinoma. Case: A 14-year-old, female, spayed, mixed-breed canine with a history of progressive weight loss, cough, respiratory distress, and pain while eating was brought in for a consultation. A presumptive diagnosis of pneumonia was suggested. However, in spite of treatment, the dog died, and a necropsy was performed. Upon gross examination, the lungs were diffusely enlarged, whitish, and stiffened with large and highly vascular nodules. Histopathological findings showed proliferation of neoplastic cells along the vascular walls and within the bronchioalveolar structures, with moderate fibrovascular stroma. The growth patterns resembled the pre-existing alveolar structures, with papillary protrusions into the alveolar lumen. After immunohistochemical evaluation, the definitive diagnosis was diffuse lepidic predominant adenocarcinoma. This tumor is uncommon and difficult to diagnose in the clinical veterinary routine, so it should be considered in the differential diagnosis of respiratory conditions in canines, especially in elderly animals with chronic clinical signs not responsive to antibiotic therapy. Complementary diagnostic examinations such as imaging, laboratory tests, and biopsy are indispensable to the early diagnosis of this lung neoplasm. Discussion: Due to its insidious character, primary lung cancer is underdiagnosed in veterinary medicine and is regularly an incidental x-ray finding. Affected dogs have no clinical signs, and this poses a diagnostic challenge. Primary lung cancer tends to be more prevalent in older and purebred animals. The most frequent clinical sign in dogs is a chronic nonresponsive cough, which can be misdiagnosed as another respiratory disease. Hematological findings, such as anemia, neutrophilia, and lymphopenia, can be related to tumor progression. Most reported cases of lepidic adenocarcinoma in dogs have a single pulmonary nodule, and the diffuse form is less common. In this case report, besides the presence of a single pulmonary nodule, there was also widespread involvement of the parenchyma. Histopathology was compatible with lepidic predominant adenocarcinoma, and immunohistochemistry was positive for pan-cytokeratin, confirming the epithelial origin of the tumor, and negative for TFF-1. Despite being a highly specific marker for lung cancer in dogs, TFF-1 has variable sensitivity among the different types of l...
Introdução : Uma neoplasia pulmonar é uma proliferação anormal de células no tecido pulmonar, podendo ser classificada como primária, secundária ou metastática e multissistêmica. No entanto, uma neoplasia primária é rara em canídeos. Além disso, as neoplasias podem ser classificadas de acordo com seu comportamento biológico como malignas ou benignas. Os tumores malignos são mais prevalentes. O diagnóstico pode ser difícil devido a sintomas inespecíficos, tendo em vista que alguns pacientes afetados não apresentam nenhum sintoma; assim, um real da doença pode permanecer sem diagnóstico em certas ocasiões.Portanto, objetivamos relatar um caso de sucesso inédito de cirurgia de lobectomia pulmonar em cães com auxílio de videotermometria infravermelha, que mostrada como imagens em tempo real durante o procedimento cirúrgico.Caso : Um cão macho de 10 anos, mestiço com Cocker Spaniel, foi atendido com história de letargia, embotamento, perda progressiva de peso, tosse e dificuldade respiratória. Avaliação à gravidade dos sinais clínicos e ao exame clínico fisiológico normal, foram solicitados exames complementares, como radiografia da região cervical e torácica, tomografia computadorizada de sangue e toracoabdominal (TCT). Os resultados dos exames obtiveram a presença de massa nodular no lobo pulmonar direito caudal que ocasionava desvio lateral para hemitórax esquerdo da silhueta cardíaca. A paciente foi submetida a um procedimento cirúrgico com abordagem pela região torácica, na altura do sétimo espaço intercostal, sendo realizada lobectomia total. Durante todo o procedimento cirúrgico,A videotermometria em tempo real por meio da estação MART (Atividade Metabólica em Tempo Real FLIR SC325®) foi utilizada para determinar a viabilidade dos tecidos adjacentes por meio de diferenças de temperatura medidas em graus Celsius. O fragmento cirúrgico contendo o lobo pulmonar caudal direto e a massa foi encaminhado ao setor de patologia para avaliação anatomopatológica. Abundante proliferação epitelial papilar foi visualizada ao microscópio, apresentando áreas de necrose e infiltrado polimorfonuclear inflamatório. O nódulo foi diagnosticado como adenocarcinoma papilar de pulmão. O fragmento cirúrgico contendo o lobo pulmonar caudal direto e a massa foi encaminhado ao setor de patologia para avaliação anatomopatológica. Abundante proliferação epitelial papilar foi visualizada ao microscópio, apresentando áreas de necrose e infiltrado polimorfonuclear inflamatório. O nódulo foi diagnosticado como adenocarcinoma papilar de pulmão. O fragmento cirúrgico contendo o lobo pulmonar caudal direto e a massa foi encaminhado ao setor de patologia para avaliação anatomopatológica. Abundante proliferação epitelial papilar foi visualizada ao microscópio, apresentando áreas de necrose e infiltrado polimorfonuclear inflamatório. O nódulo foi diagnosticado como adenocarcinoma papilar de pulmão.Discussão :Os adenocarcinomas consistem em estruturas glandulares papilares, acinares, sólidas ou mistas. Podem originar-se das vias aéreas, glândulas brônquicas ou região broncoalveolar e, freqüentemente, apresentam crescimento invasivo apresentando formato rudimentar e irregular. Os sinais clínicos são inespecíficos, incluindo intolerância a exercícios, tosse não produtiva, sinais respiratórios crônicos como taquipneia ou dispneia, apetite reduzido, perda de peso, letargia, dor à palpação torácica, hemotórax, pneumotórax e derrame pleural. O diagnóstico é concluído por meio de exames de diagnóstico por imagem, sendo a radiografia de tórax o mais importante, seguida da ressonância magnética e da tomografia computadorizada. Além disso, o exame histopatológico é essencial para determinar um diagnóstico definitivo. O tratamento de escolha para os nódulos de adenocarcinoma é a excisão cirúrgica da massa tumoral. Contudo, o tipo de abordagem cirúrgica é determinado por diferentes fatores, como tamanho, localização e envolvimento de estruturas adjacentes. A ablação de massas pulmonares pode ser realizada por meio de lobectomias parciais ou totais. No entanto, a lobectomia parcial é mais frequentemente realizada em massas não neoplásicas ou para obtenção de material para biópsia, enquanto a lobectomia total é recomendada para a remoção de uma neoplasia maligna.O prognóstico é sempre cauteloso, tendo um desfecho mais favorável nas massas de menor diâmetro sem o envolvimento de estruturas adjacentes.
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