Tsunenori Suganuma

Primary Lung Carcinoma with Paraneoplastic Leukocytosis in a Dog

In human lung cancers, marked leukocytosis, especially with neutrophilia and monocytosis, has been reported as a paraneoplastic syndrome. In dogs, several reports have been published on paraneoplastic leukocytosis. In this case, various examinations were conducted on a dog with extreme neutrophilic leukocytosis diagnosed via a blood test at first admission. A huge pulmonary mass was detected, which was surgically removed. The tumor was diagnosed as papillary adenocarcinoma of the lung by histopathology. The number of neutrophils recovered to normal after surgery, and the dog was diagnosed as paraneoplastic syndrome due to lung cancer. Key word:dog, leukocytosis, lung cancer, paraneoplastic syndrome 1)Sato Animal Hospital, 1-14 Miyashitachou, Ichinoseki, Iwate 021-0013, Japan 2)School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo, Sagamihara, Kanagawa 252-5201, Japan 3)Veterinary Teaching Hospital, Azabu University, 1-17-71 Fuchinobe, Chuo, Sagamihara, Kanagawa 252-5201, Japan 4)Yamada Animal Hospital, 2-1, Koorikitanomachi, Neyagawa, Osaka 572-0080, Japan Corresponding author:Takuo Shida Telephone:042-754-7111 Facsimile:042-769-2418 Email address:shida@azabu-u.ac.jp Received:May 27, 2012 / Accepted:September 12, 2012 Note J Jpn Vet Cancer Soc, 3(2) −21− were all within normal ranges. According to these results, we surmised that the elevated BUN level was prerenal secondary to cardiac insufficiency. Based on these clinical data, the cause of the cough and the neutrophilia were considered to possibly be related to the thoracic mass. In order to improve the cough, thoracotomy was performed. The patient underwent surgery through the intercostal approach on the 15th day after first admission. The 5th rib of the patient was removed due to the large size of the mass. The mass involved the left caudal lung lobe and adhered to the pleura of the mediastinum and diaphragm. The pericardium was not involved in the mass. Blunt dissection of the mass from the pleura of the mediastinum caused some bleeding. After blunt dissection from the adhered sites, the left lung lobe was totally removed with the mass. Swelling of the tracheobronchial lymph nodes was not observed. The patient recovered from surgery without any events and showed good healthy conditions. The WBC count decreased to the normal range 2 weeks after surgery(Table 3)and was normal for 21 weeks after surgery. The patient’s cough disappeared after surgery, and the respiratory function of the patient was recovered. Furthermore, cardiac function was maintained well with the simultaneous administration of digoxin and an angiotensin converting enzyme inhibitor for cardiac insufficiency. However, cardiac function worsened, and 4 months after surgery, the patient had an increased BUN level. The patient showed collapse/syncope due to cardiac failure and died 5 months after surgery. Autopsy was not permitted by the client. Histopathological examination of the pulmonary mass revealed that the tissue consisted of multiple neoplastic foci divided by various amounts of fibrous septa. The neoplastic foci were characterized by papillary or glandular structures that were lined by cuboid to cylindroid epithelial cells. Some tumor cells showed a goblet-cell appearance, while some had cilia on their cell surface. These proliferating neoplastic cells showed moderate cellular atypia, and the mitotic figure index was 2-3 per high-power magnification(×400)field. The tumor cells invaded the lymph vessels of the surrounding tissues. Multifocal necrotic areas were also observed within the neoplastic foci. In the interstitial areas, there were moderate infiltrations of lymphocytes and macrophages, deposition of calcium, and occasional ossification. The pleurae were Fig. 1.Thoracic radiography(ventrodorsal view)revealed a large mass in the left caudal lung area that compressed and shifted the enlarged heart to the right. Fig. 2.Numerous neutrophils were observed in the blood smear specimen (×100).

A REMOTE CONTROLLED AND PROLONGED GENERAL ANESTHESIA OF PIGS FOR THE IRRADIATION IN ATOMIC REACTOR

Saffan (アルファキサロン, アルファジオン: Glaxo) によるネコの全身麻酔を100例に対して行なったところ, 種々の合併症がみられた。すなわち, 麻酔したネコの69%に前肢や耳の充血, 浮腫が認められ, 気管内チューブ挿入時に咳嗽, 喉頭痙攣, チアノーゼ, 術後の嘔吐, 後弓反張が認められた。これらの反応は, ヒスタミン産生によるものと考えられるが, Saffanを使用する際には以下の注意が必要である。1) 術後の嘔吐の可能性を少なくしておくこと。2) 抗ヒスタミン剤の前投薬を行なう (アセプロマジンは有効であろう) 。3) 静脈内注射が良いが, 緩除に注入する。4) 気管内チューブを挿入する際には, 投薬量を増すか, マスクで吸入麻酔薬を吸入させてのち行なう。5) 頭・頸部の手術の際に本剤を使用すると喉頭を刺激し痙攣の原因となる。6) ネコを静かな環境に置くことにより, 術後の興奮と後弓反張を少なくすることができる。鎮静処置もまた有効である。7) ネコのSaffan麻酔の場合, とくに覚醒期に注意する。 (吉田慎三訳)