病例報告：犬顱內惡性腦膜瘤一例

一雙13歲雌性已結紮之迷你貴賓犬因持續性癲癇（status epilepticus）就診。臨床症狀包括叢集性癲癇大發作、共濟失調（ataxia）及頭向左偏斜，神經學檢查結果顯示病畜呆滯、向左轉圈及左側本體知覺反應（proprioceptive reaction）喪失。顱內核磁共振影像（magnetic resonance imaging, MRI）檢查結果顯示，右側嗅球（olfactory bulb）有一腫塊，在T2影像下，腫塊量不均質的訊號強度，大部分界限明顯，但與後方腦實質部有部分界線不清楚，位於嗅溝部分外緣不規則且向外伸展狀，右側大腦則明顯可見受壓迫而水腫。病畜安樂死後進行解剖。外觀上，右側嗅球辰部可見一黃白色、與硬膜緊密黏遠之實質腫塊，大小約2.5 x 1.6 x 1 cm。顯微鏡下可見腫瘤呈巢狀、小葉狀或片狀，有少量至中度的纖維血管組織（fibrovas-cular tissue）散佈其中，並有多發局部性壞死及多量嗜中性球的浸潤。腫瘤細胞可分為融合（syncytial）、轉化（transitional）及乳突狀（papillary）三種型態。一些區域會出現不典型的退變（anaplasia）細胞，有絲分裂旺盛。而在腫瘤邊緣，部分區域可見腫瘤細胞侵入大腦皮質。免疫組織化學染色顯示腫瘤細胞呈vimentin陽性，而S-100、神經膠質纖維酸性蛋白（glial fibrillary acidic protein: GFAP）及上皮細胞膜抗原（epithelial membrane antigen: EMA）則呈陰性反應。基於臨床症狀、神經學檢查、顱內核磁共振影像檢查配合病理學檢查及免疫組織化學染色結果，證實此犬罹患惡性腦膜瘤。

關鍵字

犬；核磁共振影像；惡性腦膜瘤

並列摘要

An 13-year-old spayed female miniature poodle was admitted to Kuang-Tzu Animal Hospital because of status epilepticus. She showed cluster generalized seizures, ataxia, and a left tilt. Neurological examination revealed that the dog was lethargic, circling to left, hypermetria of the thoracic limbs, and left proproceptive deficits. Magnetic resonance imaging (MRI) revealed a mass on right olfactory bulb, and the mass compressed the right cerebrum and formed obvious edema in peripheral brain tissue. On T2-wieghted images, the mass showed inhomogeneous signal intensity, mostly demarcated but some of the margin was indistinct from cerebrum and irregular projections at the olfactory groove margin. The patient was euthanasized, and the necropsy examination showed a yellowish firm mass, 2.5 x 1.6 x 1 cm, located at the left olfactory bulb and tightly adhered to the corresponding dura mater. Microscopically, the tumor cells were subdivided into lobules, nests or sheets by a finely to moderately coarse fibrovascular stroma. Extensive areas of tumor necrosis with foci of neutrophils infiltration were evident. The lobules showed a syncytial, transitional or papillary pattern, and analplasia cells were present in some areas with had high mitotic index. Marked invasion of tumor cells into cerebrum was present. The immunocytochemistry showed that vimentin was strongly immunoreactive with the majority of the neoplastic cells, but which failed to stain with S-100, glial fibrillary acidic protein (GFAP) and epithelial membrane antigen (EMA) antibody. Based on the MRI, pathomorphological characteristics, immunocytochemistry results, and tumor invasiveness , intracranial malignant meningioma was diagnosed.

並列關鍵字

Dog ； Magnetic resonance imaging ； Malignant meningioma

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病例報告：犬顱內惡性腦膜瘤一例

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