Umfangsvermehrungen der Milz beim Hund^[*]

Zusammenfassung

Gegenstand: Umfangsvermehrungen der Milz haben beim Hund eine hohe Prävalenz und kommen häufiger vor als diffuse Milzvergrößerungen. Ziel der Studie war die retrospektive Beschreibung der klinischen Aspekte und histopathologischen Charakteristika von Umfangsvermehrungen der Milz beim Hund.

Material und Methoden: Die Auswertung erfasste die Daten von Hunden mit der histopathologischen Diagnose einer Umfangsvermehrung der Milz zwischen Januar 2000 und März 2011.

Ergebnisse: 249 Hunde erfüllten die Einschlusskriterien und gingen in die Studie ein. Die Umfangsvermehrungen wurden histologisch als nichtmaligne Erkrankung (n = 117; 47%) und maligne Milzerkrankung (n = 132; 53%) klassifiziert. Das Hämangiosarkom war der häufigste maligne Tumor (n = 97; 73,5%). Als weitere maligne Tumoren wurden Sarkome (n = 14), fibrohistiozytäre Umfangsvermehrungen (n = 9), Lymphome, Blastome und Adenokarzinome diagnostiziert. Die nichtmalignen Umfangsvermehrungen umfassten noduläre Hyperplasien (n = 60), Milzhämatome (n = 41) und Splenitiden (n = 6). Bei Hunden mit Hämoperitoneum bestand eine höhere Wahrscheinlichkeit für eine Milzneoplasie.

Schlussfolgerung: Die Ergebnisse der Studie bestätigen bisherige Resultate, dass das Hämangiosarkom beim Hund den häufigsten Milztumor darstellt.Allerdings wurden bei annähernd der Hälfte der histologisch untersuchen Milzen nichtmaligne Veränderungen diagnostiziert.

Klinische Relevanz: Eine ausführliche Information der Besitzer hinsichtlich der Prognose und Therapie von Hunden mit einer Umfangsvermehrung der Milz in Verbindung mit einem Hämoperitoneum ist bedeutsam.

Summary

Objective: Splenic masses have a high prevalence and are more common than diffuse splenic enlargement in dogs. It was the aim of the present study to retrospectively describe clinical aspects and histopathologic characteristics of dogs with splenic masses.

Material and methods: Records of patients with a histologically diagnosed splenic mass between January 2000 and March 2011 were reviewed.

Results: 249 dogs met the inclusion criteria and could be included in the study. Splenic masses were diagnosed histologically as non-malignant disease (n = 117; 47%) and malignant splenic disease (n = 132; 53%). Hemangiosarcoma was the most common histological diagnosis (n = 97; 73.5%). Other malignant tumors included sarcoma (n = 14), fibrohistiocytic nodules (n = 9) as well as lymphoma, blastoma and adenocarcinoma. The non-malignant masses consisted of nodular hyperplasia (n = 60), splenic hematoma (n = 41), and splenitis (n = 6). Dogs with hemoperitoneum had a higher frequency of splenic neoplasia.

Conclusion: The results corroborate previous findings that hemangiosarcoma is the most frequent neoplasm of the canine spleen. However, in approximately half of the cases benign lesions were histologically diagnosed.

Clinical relevance: It is essential that a frank discussion is held with owners regarding the prognosis associated with the treatment of dogs with a splenic mass associated with hemoperitoneum.

Schlüsselwörter

Hund - Umfangsvermehrung Milz - Staging - Hämaskos

Key words

Canine - splenic mass - staging - hemoperitoneum

^* English version available at www.tieraerztliche-praxis.de

• References

• 1 Aronsohn MG, Dubiel B, Roberts B, Powers BE. Prognosis for acute nontraumatic hemoperitoneum in the dogs: a retrospective analysis of 60 cases (2003–2006). J Am Anim Hosp Assoc 2009; 45: 72-77.
• 2 Brown NO, Patnaik AK, MacEwan EG. Canine hemangiosarcoma: retrospective analysis of 104 cases. J Am Vet Med Assoc 1985; 186: 56-58.
• 3 Cuccovillo A, Lamb CR. Cellular featues of sonographic target lesions of the liver and spleen in 21 dogs and cats. Vet Radiol Ultrasound 2002; 43: 275-278.
• 4 Day MJ, Lucke VM, Pearson H. A review of pathological diagnosis made from 87 canine splenic biopsies. J Small Anim Pract 1995; 36: 426-433.
• 5 De Morais HA, Argyle DJ, O’Brian RT. Disease of the spleen. In: Textbook of Veterinary Internal Medicine. 7th edn.. Ettinger SJ, Feldman EC. eds. St. Louis, Missouri: Saunders; 2010: 810-819.
• 6 Dietrich CF, Kratzer W, Stroberl D, Danse E, Fessl R, Bunk A, Vossas U, Hauenstein K, Koch W, Blank W, Oudkerk M, Hahn D, Greis C. Assessment of metastatic liver disease in patients with primary extrahepatic tumours by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 2006; 12: 1699-1705.
• 7 Eich CS, Whitehair JG, Moroff SD, Heeb LA. The accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis. J Am Anim Hosp Assoc 2000; 36: 16-18.
• 8 Feeney DA, Johnston GR, Hardy RM. Two-dimensional, gray-scale ultrasonography for assessment of hepatic and splenic neoplasia in the dog and cat. J Am Vet Med Assoc 1984; 184: 68-81.
• 9 Ferrozzi F, Bova D, Draghi F, Garlaschi G. CT findings in primary vascular tumors of the spleen. Am J Roentgenol 1996; 166: 1097-1101.
• 10 Fife WD, Samii VF, Drost WT, Mattoon JS, Hoshaw-Woodard S. Comparison between malignant and non-malignant splenic masses in dogs using contrast-enhanced computed tomography. Vet Radiol Ultrasound 2004; 45: 289-297.
• 11 Hammer A, Couto CG. Diagnosing and treating canine hemangiosarcoma. Vet Med 1992; 03: 188-201.
• 12 Hammond TN, Pesillo-Crosby SA. Prevalence of hemangiosarcoma in anemic dogs with splenic mass and hemoperitoneum requiring a transfusion: 71 cases (2003–2005) J Am Vet Med Assoc. 2008; 232: 553-558.
• 13 Hanson JA, Pennick DG. Ultrasonographic evaluation of traumatic splenic hematoma and literature review. Vet Radiol Ultrasound 1994; 35: 463-466.
• 14 Irausquin RA, Scavelli TD, Corti L, Stefanacci JD, DeMarco J, Flood S, Rohrbach BW. Comparative evaluation of the liver in dogs with a splenic mass by using ultrasonography and contrast-enhanced computed tomography. Can Vet J 2008; 49: 46-52.
• 15 Ivancic M, Long F, Seiler GS. Contrast harmonic ultrasonography of splenic masses and associated liver nodules in dogs. J Am Vet Med Assoc 2009; 234: 88-94.
• 16 Johnson KA, Powers BE, Withrow SJ, Sheetz MJ, Curtis CR, Wrigley RH. Splenomegaly in dogs: predictors of neoplasia and survival after splenectomy. J Vet Intern Med 1989; 03: 160-166.
• 17 Knapp DW, Aronsohn MG, Harpster NK. Cardiac arrhythmias associated with mass lesions of the canine spleen. J Am Anim Hosp Assoc 1993; 29: 122-128.
• 18 Marino DJ, Mathiessen DJ, Fox PR, Lesser MB, Stamoulis ME. Ventricular arrhythmias in dogs undergoing splenectomy: a prospective study. Vet Surg 1994; 23: 101-106.
• 19 Mongil CM, Drobatz KJ, Hendricks JC. Traumatic hemoperiteoneum in 28 cases: a retrospective review. J Am Anim Hosp Assoc 1995; 31: 217-222.
• 20 Pintar J, Breitschwerdt EB, Hardie EM, Spauding KA. Acute nontraumatic hemoabdomen in the dog: a retrospective analysis of 39 cases (1987–2001). J Am Anim Hosp Assoc 2003; 39: 518-522.
• 21 Pyrmak C, McKee LJ, Goldschmidt MH, Glickman LT. Epidemiologic, clinical, pathologic, and prognostic chararcteristics of splenic hemangiosarcoma and splenic hematoma in dogs: 217 cases (1985). J Am Vet Med Assoc 1988; 193: 706-712.
• 22 Quaia E, D’Onofrio M, Palumbo A. Comparison of contrast-enhanced ultrasonography verses baseline ultrasound and contrast-enhanced computed tomography in metastatic disease of the liver: Diagnostic performance and confidence. Eur Radiol 2006; 16: 1599-1609.
• 23 Srebrenik N, Appelby RC. Breed prevalence and sites of hemangioma and hemangiosarcoma in dogs. Vet Rec 1991; 129: 408-409.
• 24 Spangler WL, Culbertson MR. Prevalence, type, and importance of splenic disease in dogs: 1480 cases (1985–1989). J Am Vet Med Assoc 1992; 200: 829-834.
• 25 Spangler WL, Kass PH. Pathologic factors affecting postsplenectomy survival in dogs. J Vet Intern Med 1997; 11: 166-171.
• 26 Stark DD, Wittenberg J, Butch RJ, Ferrucci Jr JT. Hepatic metastases: Randomized controlled comparison of detection with MR imaging and CT. Radiology 1987; 165: 399-406.
• 27 Waters DJ, Caywood DD, Hayden DW, Klausner JS. Metastatic pattern in dogs with splenic hemangiosarcoma: clinical implications. J Small Anim Pract 1988; 29: 805-814.
• 28 Wernecke K, Vassalo P, Bick U, Diederich S, Peters PE. The distinction between benign and malignant liver tumors: an in vitro correlation study. Am J Roentgenol 1992; 159: 1005-1009.
• 29 Wood CA, Moore AS, Gliatto JM, Ablin LA, Berg RJ, Rand WM. Prognosis for dogs with stage I or II splenic hemangiosarcoma treated by splenectomy alone: 32 cases (1991–1993). J Am Anim Hosp Assoc 1998; 34: 417-421.
• 30 Wrigley RH, Konde LJ, Park RD, Lebel JL. Ultrasonographic features of splenic hemangiosarcoma in dogs: 18 cases (1980–1986). J Am Vet Med Assoc 1988; 192: 1113-1117.
• 31 Wrigley RH, Konde LJ, Park RD, Lebel JL. Clinical features and diagnosis of splenic hematomas in dogs: 10 cases (1980 to 1987). J Am Anim Hosp Assoc 1989; 25: 371-375.