Doenças de felinos domésticos diagnosticadas no sul do Rio Grande do Sul: estudo de 40 anos / Domestic feline diseases diagnosed in southern Rio Grande do Sul: a 40-year study

O objetivo deste estudo foi identificar as principais doenças de felinos na região sul do Rio Grande do Sul. Foram revisados os protocolos de necropsia e das amostras biológicas de felinos encaminhados ao Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD/UFPel), no período de 1978 a 2018. Nesse período foram recebidas 1633 amostras de felinos, sendo 363 (22%) entre os anos de 1978 e 1999 e 1270 (78%) entre os anos de 2000 e 2018. Com relação aos diagnósticos, 457 felinos (28%) apresentaram tumores benignos ou malignos, sendo os tegumentares e os mamários os mais frequentes. As doenças bacterianas, fúngicas, virais, parasitárias, sem agente definido e as intoxicações totalizaram 554 casos (33,9%), destacando-se a esporotricose, com 12,8% dos diagnósticos. Concluiu-se que, na região sul do RS, o encaminhamento de felinos para diagnóstico aumentou significativamente após o ano 2000, comprovando que a espécie passou a ter maior importância como animal de companhia. Concluiu-se, também, que as neoplasias têm papel relevante entre as doenças de felinos e que a esporotricose é uma das mais importantes zoonoses na região.(AU)

The goal of this paper was to identify the main disease affecting felines in the southern region of Rio Grande do Sul. The necropsy protocols and feline biological materials submitted to the Regional Diagnostic Laboratory of the Veterinary College of the Federal University of Pelotas (LRD / UFPel) were reviewed, from 1978 to 2018. During this period 1633 feline samples were received, 363 (22%) between 1978 and 1999 and 1270 (78%) between 2000 and 2018. 59% of felines did not present a defined breed. As for diagnoses, 457 felines (28%) presented benign or malignant tumors, the most common being the integumentary and mammary tumors. Bacterial, fungal, viral, parasitic or undefined agent infections and intoxications were observed in 554 cases (33.9%), especially sporotrichosis with 12.8 % of the diagnoses. It was concluded that in southern RS the referral of cats for diagnosis increased significantly after the year 2000, proving that they became more significant as companion animals. It was also concluded that neoplasia play a relevant role among feline diseases, and that sporotrichosis is one of the most important zoonoses in the region.(AU)

Influência do tramadol associado à levobupicavaína epidural sobre a taxa de propofol e variáveis fisiológicas, em cadelas submetidas à mastectomia e à ovário-histerectomia / [Influence of tramadol combined with epidural levobupicavaine, on the propofol infusion rate and physiological variables, in female dogs undergoing mastectomy and ovariohysterectomy]

Objetivou-se avaliar os efeitos fisiológicos e sobre o consumo do propofol, relativos à anestesia epidural com levobupivacaína isolada ou associada a diferentes doses de tramadol. Para tal, 18 cadelas foram pré-tratadas com acepromazina, utilizando-se propofol para indução e manutenção anestésicas. Conforme o protocolo epidural instituído, formaram-se três grupos (n=6) tratados com levobupivacaína isolada (1,5mg/kg) (GL) ou acrescida de 2mg/kg (GLT2) ou 4mg/kg (GLT4) de tramadol, respectivamente. As fêmeas foram submetidas à mastectomia e à ovário-histerectomia (OH), registrando-se as variáveis fisiológicas nos períodos pré (TB e T0) e transanestésicos (T10 a T70), bem como a taxa mínima de propofol necessária. Houve redução da FC para o GL e o GLT4 em relação ao GLT2 (T30 a T70), detectando-se, no GL, redução da PAS e da PAD em relação ao TB. Maiores taxas de infusão do propofol foram necessárias para o GL (0,70±0,12mg/kg/min) em relação ao GLT2 (0,50±0,19mg/kg/min) e ao GLT4 (0,50±0,19mg/kg/min). Conclui-se que o tramadol potencializou o propofol, ao ofertar analgesia, independentemente da dose administrada. Todos os protocolos testados foram seguros e eficazes em cadelas submetidas à mastectomia e à OH.(AU)

The aim of this study was to evaluate the physiological and on propofol-sparing effects related to epidural anesthesia with levobupivacaine alone or combined with different doses of tramadol. For this purpose, 18 female dogs were pretreated with acepromazine, using propofol for induction and maintenance of anesthesia. Based on a previously established epidural (L7-S1) protocol, three groups (n=6) were treated with either levobupivacaine alone (1.5mg.k-1) (GL) or in association with to 2mg.kg-1 (GLT2) or 4mg.kg-1 (GLT4) of tramadol, respectively. These dogs were all undergoing mastectomy and ovariohysterectomy (OH). The physiological data were registered in the pre (TB and T0) and trans-anesthetic periods (T10 - T70), as well as the consumption of propofol. There was a reduction in the HR for GL and GLT4 in relation to GLT2 (T30 - T70) and reductions in SAP and DAP in relation to TB in the GL group. Higher continuous infusion rate of propofol were required for GL (0.70±0.12mg.kg-1.min-1) relative to GLT2 (0.50±0.19mg.kg-1.min-1) and GLT4 (0.50±0.19mg.kg-1.min-1). It was concluded that tramadol potentiated propofol, offering analgesia independently of its administered dose. All protocols tested were safe and effective in female dogs undergoing mastectomy and OH.(AU)

Relationship of obesity with clinical and laboratory changes in female dogs with mammary neoplasia / Relação da obesidade com alterações clínicas e laboratoriais em cadelas com neoplasia mamária

Obesity may be associated with the onset of mammary tumors in women. In companion animals, these data are still scarce, mainly associating the clinic of the patient with laboratory and histological findings. This study aimed to evaluate the clinical and laboratory aspects of female dogs with mammary neoplasia, investigating whether they are related to obesity. Four groups of spayed or non-spayed female dogs were studied, divided into (G1) female dogs without mammary tumor and normal body condition score (BCS), (G2) female dogs without mammary tumor and obese, (G3) female dogs with mammary tumor and normal BCS and (G4) female dogs with mammary tumor and obese. BCS, canine body mass index (CBMI), blood count, glucose, total cholesterol, triglycerides and cytopathological and histopathological examinations were evaluated. Mixed-breed animals were the most prevalent in this study (67.5%). There was a limitation regarding the use of CBMI related to body proportionality. Considering the 28 tumors evaluated, carcinoma in mixed tumor was the most prevalent malignant histological type, while adenomyoepithelioma was the most prevalent benign histological type. It was possible to conclude that obesity was not related to clinical and laboratory changes in the female dogs affected with mammary neoplasias. In addition, no relationship was noted between BCS and CBMI with the histological type or malignancy of mammary neoplasia, since the malignant histological types were the most prevalent tumors in both the ideal score group and the overweight to obese group.(AU)

A obesidade pode estar associada ao aparecimento de tumores mamários em mulheres. Em animais de companhia, esse dado ainda é escasso, principalmente associando a clínica da paciente aos achados laboratoriais e histológicos. Este estudo objetivou avaliar os aspectos clínicos e laboratoriais de cadelas com neoplasia mamária, investigando se estão relacionadas à obesidade. Foram estudados quatro grupos de cadelas castradas ou não castradas, divididas em (G1) cadelas sem tumor de mama e Escore de Condição Corporal normal (BCS), (G2) cadelas sem tumor de mama e obesa, (G3) cadelas com tumor de mama e ECC normal e (G4) cadelas com tumor de mama e obesa. Foram avaliados o Escore de Condição Corporal (ECC), Índice de Massa Corporal Canina (IMC), hemograma, glicose, colesterol total, triglicerídeos e exames citopatológicos e histopatológicos. Os animais de raça mista foram os mais prevalentes neste estudo (67,5%). Houve uma limitação quanto ao uso do IMC relacionado à proporcionalidade corporal. Considerando os 28 tumores avaliados, o carcinoma em tumor misto foi o tipo histológico maligno mais prevalente, enquanto o adenomioepitelioma foi o tipo histológico benigno mais prevalente. Foi possível concluir que a obesidade não esteve relacionada a alterações clínicas e laboratoriais nas cadelas acometidas por neoplasias mamárias. Além disso, não foi observada relação entre BCS e CBMI com o tipo histológico ou malignidade das neoplasias mamárias, uma vez que os tipos histológicos malignos foram os tumores mais prevalentes no grupo escore ideal e no grupo com sobrepeso e obesidade.(AU)

Risk factors associated with mammary tumors in female dogs / Fatores de risco para tumores mamários em cadelas de Uberlândia e Patos de Minas, Minas Gerais

Mammary tumors in female dogs are the most frequent and corresponds to half of the canine tumors. The objectives of this study were to determine the risk factors associated with the occurrence of mammary tumors in female dogs and to evaluate the macroscopic characteristics of these neoformations, using 386 dogs from the "Outubro Rosa Pets" events done within the cities of Uberlândia and Patos de Minas, Minas Gerais State, Brazil, in 2015 (n=194), 2016 (n=105) and 2017 (n=87). For the determination of risk factors, the binary logistic regression test (P<0.05) was performed. The occurrence of mammary tumors was 23.6% (91/386). The significant risk factors identified were increased age (P<0.001), overweight (P=0.048) and non-castration (P<0.001) with a chance of, respectively, 1.6, 2.3 and 9.3 times for the development of mammary tumors. In dogs with mammary tumors (n=91), 153 lesions were present, of which 39 female dogs had two or more lesions (42.8%). Most of the lesions were at the caudal abdominal (M4) and inguinal (M5) mammary glands (60.13%, 92/153). Relative to the size of the lesions, it was observed that in 78% of the female dogs the lesions were determined asT1 (<3cm), 16.5% were T2 (3-5cm) and 5.5% T3 (>5cm). At least 15.4% (14/91) of the dogs had one of the regional lymph nodes increased. In conclusion, the occurrence of mammary tumors in the evaluated population was 23.6% and that age, overweight and non-realization of ovariohysterectomy are risk factors associated with the development of mammary tumors.(AU)

Em cadelas os tumores mamários são os mais frequentes e correspondem a aproximadamente metade dos tumores em cães. Este estudo teve os objetivos de determinar os fatores de risco envolvidos na ocorrência de tumores mamários em cadelas e avaliar as características macroscópicas destas neoformações, utilizando 386 cadelas do evento "Outubro Rosa Pets" nos municípios de Uberlândia e Patos de Minas, Minas Gerais, Brasil, em 2015 (n=194), 2016 (n=105) e 2017 (n=87). Para a determinação dos fatores de risco utilizou-se o teste de Regressão logística binária (P<0,05). A ocorrência de tumores mamários foi de 23,6% (91/386). Os fatores de risco significativos identificados foram aumento da idade (P<0,001), sobrepeso (P=0,048) e não-castração (P<0,001) com a chance de, respectivamente, 1,6, 2,3 e 9,3 vezes de desenvolvimento de tumores mamários. Nas cadelas com tumores mamários (n=91), constatou-se a presença de 153 lesões, sendo que 39 cadelas apresentaram duas ou mais lesões (42,8%). A maioria das lesões localizaram-se nas mamas abdominais caudais (M4) e inguinais (M5) (60,13%; 92/153). Em relação ao tamanho das lesões, observou-se que 78% das cadelas eram T1 (<3cm), 16,5% T2 (3-5cm) e 5,5% T3 (>5cm). Pelo menos 15,4% (14/91) das cadelas apresentaram um dos linfonodos regionais aumentados. Conclui-se que a ocorrência dos tumores mamários na população avaliada foi de 23,6% e que a idade, sobrepeso e não ovariohisterectomia são fatores de risco para o desenvolvimento de tumores mamários.(AU)

BI-RADS classification and gray level histogram of malignant mammary tumors in bitches / Classificação BI-RADS e histograma dos níveis de cinza de tumores mamários malignos em cadelas

Mammary tumor is the most frequent among the tumors that affect canine females, with relevant importance in veterinary medicine. The objective of this study was to determine the image characteristics of mammary tumors in female dogs, and compare different ultrasonographic techniques for neoplastic evaluation. During the experiment, 30 bitches with presence of nodular lesion in the mammary gland were used. Initially females were submitted to clinical and laboratory evaluations, and subsequent to the ultrasound examination of the tumor mass, as well as abdominal ultrasound and thoracic x-ray for the metastasis investigation. Quantitative analysis by histogram of the gray levels and categorization of the tumor masses by the BI-RADS system were performed. Later, the bitches were submitted to surgical resection of the tumors, where samples of the neoplastic tissue were collected for histopathological analysis. Carcinoma in mixed tumor showed a higher rate (33.3%), and the malignancy degree of epidermal tumors were classified in grade 1 (n=9), grade 2 (n=12) and grade 3 (n=3). Malignancy degree showed positive correlation with BI-RADS (r=0.55; P<0.05) and with the parameter echotexture - histogram base width (r=0.42, P<0.05). BI-RADS graduation also showed a positive correlation with the echotexture parameters (standard deviation of average echogenicity r=0.66, P<0.05 and base width r=0.55, P<0.05). It was concluded that the BI-RADS method in combination with the echotexture of tumors, can be used to evaluate mammary tumors in dogs and establish the planning of treatment.(AU)

Entre os tumores que acometem cadelas a neoplasia mamária é a de maior incidência, apresentando relevante importância na medicina veterinária. Este trabalho teve o objetivo de determinar as características ultrassonográficas de neoplasias mamárias em cadelas, e comparar diferentes técnicas ultrassonográficas de avaliação tumoral. Durante a realização deste experimento, foram utilizadas 30 cadelas com presença de lesão nodular em glândula mamária. Inicialmente as fêmeas foram submetidas a avaliações clínicas e laboratoriais, e subsequentemente à realização de exame ultrassonográfico da massa tumoral, assim como ultrassom abdominal e raio x torácico para a pesquisa de metástase. Foram realizadas a análise quantitativa por histograma dos níveis de cinza e categorização das massas tumorais pelo sistema BI-RADS. Posteriormente as cadelas foram submetidas à ressecção cirúrgica dos tumores, onde foram coletadas amostras do tecido neoplásico para análise histopatológica. O carcinoma em tumor misto foi o tipo tumoral de maior incidência (33.3%), e a graduação de malignidade dos tumores epiteliais foram classificadas em grau 1 (n=9), grau 2 (n=12) e grau 3 (n=3). A graduação demonstrou correlação positiva com a categorização BI-RADS (r=0,55; P<0,05) e com o parâmetro de ecotextura - largura de base do histograma (r=0,42; P<0,05). A graduação BI-RADS também demonstrou uma correlação positiva com os parâmetros de ecotextura (desvio padrão da média da ecogenicidade r=0,66; P<0,05 e largura de base r=0,55; P<0,05). Conclui-se que o método de categorização BI-RADS, assim como os parâmetros de ecotextura dos tumores, podem ser usados para avaliação de neoplasia mamária em cadelas e assim auxiliar no planejamento de tratamento de cada caso.(AU)

Linfoma no Hodgkin estadio IV con metástasis mamaria y vaginal / Non Hodgkin lymphoma stage IV with breast and vaginal metastasis

Resumen ANTECEDENTES: La afectación mamaria por un linfoma es poco frecuente; casi siempre se trata de linfomas tipo B que se caracterizan por falta de especificidad clínica y radiológica, lo que dificulta el diagnóstico diferencial con tumoraciones mamarias de otro origen. CASO CLÍNICO: Paciente de 72 años de edad, con antecedentes de hipercolesterolemia, hipertensión arterial, artrosis y depresión, con dos partos y menopausia a los 55 años. Madre con antecedente de cáncer de mama posmenopáusico. En la mamografía de la mama derecha se encontró una masa retroareolar de 8 cm, de contornos mal definidos y una adenopatía axilar con engrosamiento cortical. La biopsia reportó un linfoma no Hodgkin B de alto grado. Se administraron 8 ciclos de quimioterapia con el esquema R-CHOP. Luego de este esquema el PET-TC mostró una lesión mamaria derecha residual, metabólicamente inactiva, sin enfermedad nodal ni extramamaria supra ni infradiafragmática. CONCLUSIONES: Una neoplasia maligna mamaria no siempre se trata de un carcinoma ductal o lobulillar. Es necesario valorar la posibilidad de otras estirpes histológicas o, incluso, de una afectación metastásica. La entrevista y exploración adecuadas son fundamentales para una buena orientación diagnóstica.

Abstract BACKGROUND: The mammary affectation by a lymphoma is not frequent; it almost always involves type B lymphomas. It is characterized by a lack of clinical and radiological specificity, which makes differential diagnosis difficult with mammary tumors of another origin. CLINICAL CASE: A 72-year-old patient with a history of hypercholesterolemia, hypertension, osteoarthritis and depression, with two deliveries and menopause at 55 years of age. Mother with a history of postmenopausal breast cancer. The mammography of the right breast reported the existence of a retroareolar mass of 8 cm, of ill-defined contours and an axillary adenopathy with cortical thickening. The biopsy reported a high-grade non-Hodgkin B lymphoma. 8 cycles of chemotherapy were administered with the R-CHOP scheme. After this procedure, the PET-CT showed a residual, metabolically inactive right mammary lesion, with nodal or extramammary supra or infradiaphragmatic disease. CONCLUSIONS: A malignant mammary neoplasm is not always a ductal or lobular carcinoma. It is necessary to evaluate the possibility of other histological strains or, even, of a metastatic affectation. The adequate interview and exploration are fundamental for a good diagnostic orientation.

Imunomarcação da transição epitélio-mesenquima na neoplasia mamária primária de cadelas e sua metástase em linfonodo / Epithelial to mesenchymal transition immunostaining in canine primary mammary tumor and lymph node

Os carcinomas mamários em cães apresentam alta capacidade metastática o que confere menor sobrevida para os pacientes com este tipo de neoplasia. O fenótipo transição epitélio-mesênquima, caracterizado pela troca dos filamentos intermediários de citoqueratina por vimentina, além da perda da proteína de adesão entre células (E-caderina) está relacionado com a maior ocorrência de metástase. Diante disto, objetivou-se avaliar, por meio de imunomarcações, a expressão de vimentina, citoqueratina e E-caderina nos tumores mamários caninos e suas metástases em linfonodo, a fim de avaliar o comportamento celular frente a esta neoplasia. Foram analisados cinco casos de neoplasias mamárias primárias caninas e suas respectivas metástases em linfonodos. Foram comparadas as médias de imunomarcações do grupo de neoplasias primárias com as médias do grupo metástase. Não houve diferença estatística nas imunomarcações da citoqueratina (p=0,1407) e E-caderina (p= 0,312) entre os grupos, apesar da média de expressão da E-caderina ter sido maior no grupo de metástases. A expressão da vimentina foi maior nos sítios das metástases (p=0,0462). Conclui-se que a expressão de vimentina aumenta no foco da metástase em relação aos seus respectivos tumores primários mamários caninos, caracterizando alteração estrutural celular, conferindo um fenótipo transição epitélio-mesênquima. Além da E-caderina apresentar fortes indícios de aumento no foco da metástase caracterizando maior adesão.(AU)

Mammary carcinomas in dogs have a high metastatic capacity which gives a shorter survival rate for patients with this type of tumor. The epithelial-mesenchymal transition phenotype, characterized by the trade of intermediary filaments of cytokeratin by vimentin, also by the loss of the adhesion protein between cells (E-cadherin) is associated with metastasis. Due to this fact, it was aimed to evaluate, by immunostaining, the expression of vimentin, cytokeratin and E-cadherin in canine mammary tumors and the metastasis in lymph node, in order to assess the cell behavior when facing this cancer. Five cases of canine mammary tumors and metastasis in lymph node were evaluated. The averages of immunostainings of the group of primary neoplasms were compared with the averages of the lymph node group. The results showed that immunostaining for cytokeratins (p=0,1407) and E-caderina (p=0,312) were not significant between the groups, despite the expression mean of cadherin was higher in the metastase group. The expression of vimentin (p=0,04) was greater at sites of metastases. It is concluded that the expression of vimentin increases in the focus of the metastase in relation to their respective primary canine mammary tumors, characterizing cellular structural alteration, conferring a transient epithelial-mesenchymal phenotype. And cadherin present strong evidence of increased focus on metastasis characterizing increased adhesion.(AU)

Survival analysis of female dogs with mammary tumors after mastectomy: epidemiological, clinical and morphological aspects / Análise de sobrevivência de cadela com tumores mamários após mastectomia: aspectos epidemiológicos, clínicos e morfológicos

Mammary gland tumors are the most common type of tumors in bitches but research on survival time after diagnosis is scarce. The purpose of this study was to investigate the relationship between survival time after mastectomy and a number of clinical and morphological variables. Data was collected retrospectively on bitches with mammary tumors seen at the Small Animal Surgery Clinic Service at the University of Brasília. All subjects had undergone mastectomy. Survival analysis was conducted using Cox's proportional hazard method. Of the 139 subjects analyzed, 68 died and 71 survived until the end of the study (64 months). Mean age was 11.76 years (SD=2.71), 53.84% were small dogs. 76.92% of the tumors were malignant, and 65.73% had both thoracic and inguinal glands affected. Survival time in months was associated with age (hazard rate ratios [HRR] =1.23, p-value =1.4x10-4), animal size (HRR between giant and small animals =2.61, p-value =0.02), nodule size (HRR =1.09, p-value =0.03), histological type (HRR between solid carcinoma and carcinoma in a mixed tumor =2.40, p-value =0.02), time between diagnosis and surgery (TDS, with HRR =1.21, p-value =2.7x10-15), and the interaction TDS*follow-up time (HRR =0.98, p-value =1.6x10-11). The present study is one of the few on the subject matter. Several important covariates were evaluated and age, animal size, nodule size, histological type, TDS and TDS*follow up time were identified as significantly associated to survival time.

Os tumores da glândula mamária são o tipo mais comum de tumores em cadelas, porém, estudos sobre o tempo de sobrevida após o diagnóstico são escassos. Objetivou-se investigar a relação entre o tempo de sobrevida após a mastectomia, bem como variáveis clínicas e populacionais. Coletaram-se dados retrospectivos referentes a cadelas com tumores mamários atendidos no Serviço de Clínica Cirúrgica de Pequenos Animais da Universidade de Brasília e submetidas à mastectomia. A análise de sobrevida foi realizada mediante o método de Cox de risco proporcional. Dos 139 animais incluídos neste estudo, 68 morreram e 71 sobreviveram até ao final da conclusão deste traballho (64 meses). A média de idade foi de 11,76 anos (DP=2,71), 53,84% dos cães eram pequenos. Dentre os tumores, 76,92% eram malignos, e 65,73% tiveram as duas glândulas torácicas e a inguinal afetadas. O tempo de sobrevida em meses foi associado à idade (taxa de razão de risco [HRR] =1,23, p valor =1.4x10-4), o tamanho do animal (HRR entre animais gigantes e pequenos = 2,61, p=0,02), tamanho do nódulo (HRR=1,09, p valor =0,03), tipo histológico (HRR entre carcinoma sólido e carcinomas em tumor misto =2,40, p=0,02), tempo decorrido entre o diagnóstico e a cirurgia (TDC, com HRR =1,21, p valor =2,7 x10-15), e a interação TDC*tempo de seguimento (HRR = 0,98, p valor = 1.6x10-11). O presente estudo é um dos poucos sobre o assunto. Várias covariáveis importantes foram avaliadas e idade, tamanho do animal, o tamanho do nódulo, tipo histológico, TDC e TDC*tempo de seguimento foram identificados como significativamente associado ao tempo de sobrevida.

Inmunohistoquímica y expresión de receptores de estrógenos y progesterona en neoplasias mamarias malignas caninas en distintos estadios clínicos / Immunohistochemistry and expression of estrogen and progesterone receptors in canine malignant mammary tumors in different clinical stages

La técnica de inmunohistoquímica descrita por Walker y col. (1998) y Mote y col. (2001) es de utilidad para la determinación de receptores de estrógenos y de progesterona en tumores mamarios de la hembra canina. Existe bastante controversia respecto al porcentaje de receptores de estrógenos y de progesterona, con valor pronóstico o predictivo en tumores malignos caninos debido, muy probablemente, a la falta de uniformidad en criterios de inclusión de los casos en los estudios realizados. El presente trabajo se realizó en una población de 51 perras. Los tumores fueron escindidos quirúrgicamente mediante mastectomía de las glándulas afectadas. Para la determinación de receptores hormonales, se analizó la muestra con mayores características histológicas de malignidad de cada animal. Se contabilizó el porcentaje de células tumorales positivas para cada uno de los receptores (receptor de estrógeno alfa, receptor de estrógeno beta y receptores de progesterona) en los distintos estadios clínicos (I, II, II, IV). Se consideró positivo todo corte ³ 20% de células tumorales positivas para cada uno de los receptores. Se realizó una estadística descriptiva (media y error estándar) con los animales positivos para cada uno de los receptores en los distintos estadios clínicos. En línea con reportes de otros autores, más de la mitad de caninos portadores de tumores mamarios malignos expresaron receptores de estrógenos y de progesterona. Conociendo que el comportamiento biológico de una neoplasia varía con el estadio clínico del paciente, resulta interesante estudiar la expresión de los receptores en cada uno de éstos, en animales con neoplasias mamarias malignas. Adicionalmente, a este objetivo incluye la puesta a punto la de técnica de inmunohistoquímica para la determinación de receptores hormonales en la especie.

receptors in canine mammary tumors. There is considerable controversy regarding the percentage of estrogen and progesterone receptors that having prognostic or predictive value in malignant tumors in dogs because, most likely, the lack of uniform criteria for inclusion of cases. This study was conducted in a population of 51 female dogs. The tumors were surgically treated by mastectomy of the affected glands. For the determination of hormone receptors, the sample analyzed was showed higher histological malignancy features of each animal. It was counted the percentage of tumor cells positive for each of the receptors (estrogen receptor alpha, estrogen receptor beta and progesterone receptor) in animals in various clinical stages (I, II, III, IV). It was considered positive cut-off ³ 20% tumor cells positive for each of the recipients. It was conducted a descriptive statistics (mean and standard error) which positive animals for each of the receptors in different clinical stages. In line with reports of other authors, more than half of canine carriers of malignant mammary tumors expressed estrogen and progesterone receptors. Knowing that the biological behavior of cancer varies with the clinical stage of the animal, objective was to study the expression of receptors in each of the clinical stages in animals with malignant mammary tumors. Additionally, this includes the preparation of the immunohistochemical technique for the determination of hormone receptors in this species.

Comparación de dos métodos diagnósticos en tumores mamarios en un Centro de Cancerología de Colima, México / Comparing two diagnostic methods used for breast neoplasm in a cancer centre in Colima, Mexico

Objetivo Determinar la relación entre los hallazgos de tumores mediante mamografía y el diagnóstico histopatológico de los mismos. Métodos Se realizó un estudio transversal descriptivo. Participaron pacientes del Centro Estatal de Cancerología de la ciudad de Colima, México. Los criterios de inclusión fueron: mujeres con mamografía y calificación BIRADS; mujeres con biopsia y diagnóstico histopatológico; mujeres de todas las edades, todos los estadios clínicos y con expediente clínico completo. Para la estadística descriptiva se utilizaron las frecuencias, porcentajes, promedios y desviación estándar. Para la estadística inferencial se utilizaron las pruebas de t de Student, de chi cuadrada y el cálculo del OR e IC (95 por ciento). Las diferencias se consideran significativas cuando p<0,05. Resultados Al relacionar las categorías del BIRADS, dependiendo de la probabilidad de benignidad (BIRADS I-II-III) o malignidad (BIRADS IV-V) con los resultados histopatológicos (benigno o maligno), no se encontró relación (p=0,0666). En un análisis individual por categoría, las relaciones significativas fueron: categoría IV (OR=0,024, IC=0,005-0,11, p=0,0007) y categoría V (OR=40,5, IC=9,03-181,3, p=0,0002). Conclusiones La clasificación BIRADS I, III y V tuvo relación con el diagnóstico histopatológico, mientras que en el II y IV no hubo esta relación. Sin embargo, los únicos resultados estadísticamente significativos se obtuvieron en las categorías IV y V.

Objective Determining the relationship between mammography neoplasm reports and histopathological diagnosis of neoplasms. Methods A descriptive cross-sectional study was carried out. Patients were included who were attending the state cancerology centre (Centro Estatal de Cancerología) in Colima, Mexico. Inclusion parameters were: females having mammography and BIRADS score of 1 or over; females having biopsy and histopathology diagnosis; females of all ages, all clinic stages having a complete clinic record. Frequency, percentages, means and standard deviations were applied for descriptive statistics. Student's t-test, the Chi square test, OR and 95 percentCI were applied for inferential statistics. Differences were considered to be significant when p<0.05. Results No relationship between a BIRADS score classified as being benign (BIRADS I-II-III) or malign (BIRADS IV-V) was found with histopathological results (benign or malign) (p=0.0666). Significant relationships by category were found in a separate analysis: category IV (OR=0.024, 95 percentCI=0.005-0.11, p=0.0007) and category V (OR=40.5, 95 percentCI=9.03-181.3, p=0.0002). Conclusions I, III and V BIRADS scores had a relationship with histopathological diagnosis, while category II and IV BIRADS scores had no relationship. However, only categories 4 and5 were statistically significant.

Biopsia por aspiración con aguja fina en lesiones mamarias: experiencia institucional / Fine needle aspiration biopsy of breast lesions: institutional experience

Background. With the advent of new diagnostic technologies and the fear of low diagnostic accuracy, there has been a reduction in the use of fine needle aspiration (FNA) for diagnosis of breast lesions. The objectives of the present study were to establish the diagnostic accuracy and complications associated with FNA of breast lesions. Material and methods. We retrospectively reviewed FNA of breast lesions done in a tertiary referral center in Mexico City from 1999 through 2001. We analyzed demographic, radiologic and pathological variables in order to establish diagnostic accuracy of FNA. The gold standard was considered the histopathologic study of the specimen or the clinical follow-up of benign lesions. Categorical variables were analyzed with the method and statistical significance was considered at p < 0.05. Results. We identified 300 patients with a mean age of 50 years (range, 20-86). Fifty-three percent were postmenopausal. In ninety-three percent of patients, FNA was performed in the outpatient clinic. Nonpalpable lesions were aspirated under ultrasound guidance. Mean size of the lesion was 2.27 cm (range 0.7-10 cm). Thirty-one percent of patients had definite diagnosis of malignancy. The only variables associated with cancer diagnosis were the BTRADS category and the presence of palpable adenopathy. Cancer was diagnosed in 6.5% of lesions categorized as BTRADS 0-3 compared to 56.2% for lesions BTRADS 4-5 (p < 0.0001). Positive predictive value and specificity of FNA were 100%. Sensitivity, negative predictive value and accuracy were 82.6%, 92.8% and 94.7%, respectively. The most common diagnosis of false negative lesions were lobular and papillary carcinomas. There were no significant complications associated with FNA. Conclusions. Diagnostic accuracy of FNA for breast lesions is very high with minimal complications. Positive predictive value of 100% allows to establish therapy based on its results.

Antecedentes. El advenimiento de nuevas tecnologías diagnósticas, así como el temor a baja exactitud diagnóstica, han reducido el papel de la biopsia por aspiración con aguja fina (BAAF) en lesiones mamarias. El objetivo del presente estudio fue el establecer la exactitud diagnóstica y complicaciones de la BAAF en esta indicación. Material y métodos. Estudio retrospectivo de BAAF de lesiones mamarias realizadas en nuestra institución de 1999 a 2001. Se analizaron variables demográficas, radiológicas e histopatológicas para establecer la exactitud diagnóstica. Se definió como estándar diagnóstico al análisis histopatológico del tejido o bien al seguimiento clínico en caso de lesiones benignas dejadas para observación. Las variables categóricas se analizaron con la prueba de . Se estableció como significativa a una p < 0.05. Resultados. Fueron identificados 300 pacientes con una edad promedio de 50 años (20-86). Fueron posmenopáusicas 53.3%. En 93.3% de los casos se realizó BAAF de lesión clínicamente palpable y en el resto de una lesión visible por ultrasonido. El tamaño promedio de la lesión fue de 2.27 cm (0.7-10 cm). De las pacientes, 30.7% tuvieron diagnóstico definitivo de lesión maligna. Las únicas variables asociadas al diagnóstico de cáncer fueron la clasificación radiológica de BI-RADS y la presencia de adenomegalias palpables. La incidencia de cáncer en pacientes con BI-RADS de 0 a 3 fue de 6.5% vs. 56.2% en aquellas con BI-RADS 4 o 5 (p < 0.0001). Tanto el valor predictivo positivo como la especificidad de la BAAF fueron de 100%, con una sensibilidad de 82.6% y valor predictivo negativo de 92.8%, para una exactitud diagnóstica de 94.7%. Las causas más frecuentes de falsos negativos fueron el carcinoma lobulillar infiltrante y el carcinoma papilar. No se presentaron complicaciones significativas en ningún caso asociadas con la BAAF. Conclusiones. La exactitud diagnóstica de la BAAF en lesiones mamarias es muy elevada, con una incidencia mínima de complicaciones. Un valor predictivo positivo de 100% permite basar la terapéutica en sus resultados. El diagnóstico de benignidad por BAAF permite el seguimiento seguro de lesiones mamarias.

Linfoma no Hodgkin de células B con extensión secundaria a glándula mamaria: Evaluación por imagen / Secondary non-Hodgkin's B-cell lymphoma involving the breast: radiologic imaging

Los linfomas secundarios con afectación de la glándula mamaria, aunque raros, representan el grupo más grande de tumores metastásicos de la mama. El linfoma no Hodgkin primario de la mama es también raro, representando del 1.7%-2.2% de los casos de linfoma no Hodgkin extranodal y del 0.38-0.7% de todos los linfomas no Hodgkin. Aproximadamente 300 casos han sido reportados en la literatura. El aspecto mamográfico ha sido descrito como áreas redondeadas u ovales con densidad aumentada. Las masas mamarias pueden aparecer homogéneas o heterogéneas. Las lesiones pueden ser muy bien definidas y ser confundidas con procesos benignos, esto último más probable en pacientes menores de 35 años de edad. Los hallazgos ultrasonográficos son descritos como masas de márgenes bien definidos con ecos de intensidad baja a moderada. Las paredes posteriores de la masa suelen estar bien definidas, probablemente con ligero reforzamiento acústico pero sin sombra posterior asociada. En resumen, el aspecto mamográfico del linfoma mamario no es específico, pero el diagnóstico puede ser excluido si hay presencia de calcificaciones o reacción desmoplásica. El tejido linfoide prominente en un paciente con masas mamarias debería despertar la sospecha de linfoma mamario. El aspecto más crítico en el estudio de una masa de la mama es la biopsia del tejido, puesto que una lesión linfomatosa tiene radiográficamente patrones indeterminados. Presentamos el caso de una mujer de 79 años con dolor abdominal y una masa palpable en la mama derecha; realizamos un breve resumen de las características clínicas y principales hallazgos por imagen del linfoma no Hodgkin con afección a la glándula mamaria (radiografía de tórax, mastografía, ultrasonido mamario, y tomografía de tórax).

Secondary lymphomas involving the breast, although uncommon, represent the largest group of metastasic tumors to the breast. Primary non-Hodgkin lymphomas (NHLs) of the breast are also rare, accounting for 1.7% to 2.2% of extranodal NHL cases and 0.38 to 0.7% of all NHLs. Approximately 300 cases have been reported in the Medical literature. Mammographic appearances are described as round or oval areas of opacity. The breast mass may appear homogeneous or inhomogeneous. The lesion may be very well defined and may be mistaken for a benign process, most notable in patients younger than 35 years of age. Ultrasonographic appearance is described as a sharply defined mass with low or medium echoes. The posterior aspect of the mass is well defined (possibly with slight acoustic enhancement but with no associated posterior shadowing). In summary, the mammographic appearance of the breast lymphoma is nonspecific, but the diagnosis can possibly be excluded if calcifications or a desmoplastic reaction are present. Prominent lymph vessels in a patient with a breast mass should raise the suspicion of breast lymphoma. The most critical aspect in the workup of a breast mass is the tissue biopsy, since radiographically lymphomatous lesions are indeterminate. We present the case of a 79-year-old woman with abdominal pain and a palpable breast mass; we also make a brief summary of the clinical features and main imaging findings of NHL (plain radiograph, mammography, breast ultrasound and thorax tomography).