Hemoabdomen | Hemoperitoneum | The Splenectomy скачать в хорошем качестве

Hemoabdomen | Hemoperitoneum | The Splenectomy

#surgeryrecovery #spleen #cancer Splenic lesions make up 0.3 to 2% of all neoplasia in dogs over 8 years of age and 5% of all non-skin primary malignant neoplasms in large breed dogs. Splenic masses are neoplastic in 48.2 to 66% of cases, unclassified in 0.4%, and not neoplastic in 34% to 54.1%. Overall malignant incidence 76.1% and benign 23.9%. Canine splenic neoplasia has a 33 to 66% incidence overall. Of splenic lesions, 80% are malignant and 10% are benign (hematoma or hemangioma). Of the malignant splenic/hepatic neoplasms, 50 to 90% are hemangiosarcoma, making it the most prevalent. Overall, hemangiosarcoma is found in 65 to 88% of affected dogs. Splenic hemangiosarcoma cases in dogs present with hemoperitoneum in 76.1% of cases and hematoma in 29.6% of cases. Of dogs with hemangiosarcoma, in 75% of such cases the hemangiosarcoma lesion is the source of the hemorrhage with hemoabdomen cases. Other canine splenic neoplastic malignancies include chondrosarcoma, fibrosarcoma, leiomyosarcoma, leiomyoma, lipoma, liposarcoma, malignant fibrous histiocytoma, metastatic adenocarcinoma, mast cell tumor, myeloproliferative disease, myxosarcoma, osteosarcoma, rhabdomyosarcoma, poorly differentiated/undifferentiated sarcoma, sarcoma, malignant splenic carcinoma, mesothelioma, melanoma, lymphosarcoma, pheochromocytoma, and adrenocortical carcinoma. Overall these are seen in 22 to 43% of cases. Benign/non-neoplastic differential diagnoses of localized splenic disease include reactive hyperplasia of the splenic white pulp (seen mostly in medium and large breed dogs), coagulopathic disease, lymphoid follicular hyperplasia, other causes of hyperplastic nodules, and hematoma formation. Neoplasia may be generalized, as is seen with myeloproliferative diseases such as lymphosarcoma, histolytic sarcoma, mastocytosis. Metastatic splenic disease may be appear as multiple focal diseases, with lymphosarcoma being the most common. Histiocytic sarcoma can be focal and may be most often seen in the Flat Coated Retriever, Rottweiler, and Golden Retriever. Neoplasia may be of heme or non-heme sources, being generalized in cats and focal in dogs. Non-hemic diseases include include hemangiosarcoma, sarcoma, and benign disease. Hemic diseases includes lymphoid, mast cell, histiocytic, plasma cell, and myeloproliferative. Localized splenomegaly may be due to neoplastic or non-neoplastic disease. Differential diagnoses include nodular hyperplasia, hematoma and hemangiosarcoma most commonly. Etiopathogenesis Cellular infiltration within the spleen of any type may be due to neoplasia (primary or metastatic), splenic amyloidosis, and lysosomal storage disease, amongst other causes. Lysosomal storage disease is an inherited accumulation of lipids, carbohydrates, or both, seen in the less than one year old patient with a pale spleen. Nodular hyperplasia may be due to splenoma, neoplasia, trauma, or spontaneous occurrence. Splenoma is from older dogs and is incidental, composed of lymphoid, myeloid, erythroid, megakaryocytes, or fibrohistiocytic nodules, that can change into a hematoma with a decreased marginal zone circulation. Nodular hyperplasia is not common in cats because of their non-sinusoidal spleen. Nodular hyperplasia can become a fibrohistiocytic nodule, as may be seen in specific breeds. The Cocker Spaniel is most common. Others include the German Shepherd dog, Labrador Retriever, Standard Poodle, and Golden Retriever. Nodular hyperplasia lesions can undergo malignant transformation into malignant fibrous histiocytoma. Nodules may be single or multiple and 20 cm or less in size. They tend to be larger, firmer, and more organized than hemangiosarcoma. Death is seen 14 months post-operative splenectomy and due to other non-related disease processes. The 2-month survival post-operatively is 83% and 12-month survival is 65%. Hemangiosarcoma Hemangiosarcoma is a malignancy of vascular endothelial origin that results in widespread metastatic disease and poor survival in dogs. Common primary sites of hemangiosarcoma include the spleen, right atrium and skin. Other locations include the liver, pericardium, peritoneum, vertebrae, eyes, kidneys, oral cavity, mucous membranes, bones, urinary bladder, tongue, and prostate Cardiac hemangiosarcoma Right atrial hemangiosarcoma may be spontaneous rather than a metastatic lesion in affected dogs. The incidence of concurrent cardiac hemangiosarcoma with splenic hemangiosarcoma is 8.7 to 30% with the higher percentages being seen in German Shepherd dog (70% of cases). The Golden Retriever is at an 11-fold risk of being seen with splenic hemangiosarcoma with concurrent right atrial hemangiosarcoma. Cardiac hemangiosarcoma is seen with hemoabdomen in 5% of cases, with abdominal metastatic disease in 30% of cases, and along with other metastatic disease sites in 42 to 85% of cases. Of right atrial masses 50% are diagnosis by ultrasound.