Patologin tuloksia

Jekulta löytyneeseen kasvaimeen tehtiin kolme tutkimusta:


1. Ohutneulanäyte - tulos löytyy alinna - Hinta 50€

Ohutneulanäytteellä saa perustietoa, mikä patti on.  Sen tarkempaa ja varmempaa tietoa tutkimus ei anna.

2. Histokemiallinen tutkimus - tulos keskimmäisenä - Hinta 70€

Histokemiallinen puolestaan selvittää tarkemmin kasvaimen tyypin ja luokan. Koirilla on useita eri kasvaintyyppejä ja luokka puolestaan kertoo miten leviävästä tyypistä on kyse. Mastsolukasvaimet jaetaan kolmeen luokkaan ja Jekun kasvain oli luokkaa 1.Näillä ykköstyypin kasvaimilla on noin 10% mahdollisuus tehdä etäpesäkkeitä.

3. Immunohistokemiallinen värjäys - tulos ylimmäisenä.
- Hinta 93€

Värjäys on näistä tutkimuksista kallein ja eläinlääkärin mukaan näitä tutkimuksia tehdään harvoin koirien kasvaimille. Mastsolukasvainten osalta tyyppien 1 ja 2 sisällä on taas eroja ja jotkut niistä on aggressiivisempia kuin toiset.  Värjäys varmentaa huononeeko ennuste ja Jekun osalta näitä reagoituneita kasvainsoluja löytyi alle 23, mikä tarkoittaa sitä että ennuste ei huonone.

Periaatteessa histokemiallinen tutkimustulos ei kerro kaikkea ja olisi ollut yksistään turha, ja ehkä antanut myös vääränlaista turvallisuudentunnetta, kun kasvain oli vain ykköstyyppiä.


IMMUNOHISTOKEMIALLISEN VÄRJÄYKSEN RAPORTTI:
"Immunohistokemiallisen värjäyksen perusteella Jekulta poistetun mastsolukasvaimen ennuste on hyvä. Värjäyksessä havaittiin alle 23 C-kit reagoinutta kasvainsolua. Jos näitä soluja havaitaan yli 23, ennuste huononee. " kirjoitteli eläinlääkäri Jekun kasvaintutkimuksesta. 

Immunohistochemical investigations revealed the following c-kit
receptor expression pattern:

C-kit reaction pattern II: intensive and partially finely granulated
cytoplasmatic reaction.

According to the reaction pattern c-kit I-III (Kiupel et al.,
Vet.Path.41: 371-377, 2004 and Webster et al., Vet.Path.44: 298-308,
2007).

Assumed correlation:
Reaction pattern II: elevation in recurrence rate and reduction of
survival time remain possible; Furthermore the number of Ki-67 Antigen positive tumour cells was
counted:  Less than 23 Ki-67 positive cells in 1,0 cm2 were detected.

Ki-67 is a proliferation marker:
If more than 23 Ki-67 positive cells are found the prognosis is
declined. An overall survival time less than 24 month is likely (Webster et al. 2007).In this case, the number was less than 23. - Laboklin

HISTOKEMIALLINEN RAPORTTI:

Submitted was a haired skin sample of 3.1 x 3 x 1.3 cm with a mass of 0.5 cm. Three sections were embedded for histological examination.

Histological description:
The following staining was performed according to standard operation procedures: H&E. In the dermis, a tumor growth of well differentiated mast cells with a distinct to fine granulation of the cytoplasm occurred.

Cellular and nuclear atypia were only mild. No or very rare mitotic figures were observed. Tumor growth was dense and highly cellular. In addition, an infiltration of a moderate number of eosinophils was found.The margins of the tissue were clean.

Diagnosis:
Cutaneous mast cell tumor, grade I, low grade

Critical report:

A well differentiated grade I mast cell tumor was diagnosed,according to a grading form from I to III (Patnaik et al. 1984). According to recent studies (Matti Kiupel, Anual meeting European Society of Veterinary Pathology, 2007), it is difficult to give prognostic assumptions on histologic features alone.

Grade I and II tumors are classified as "low-grade", whereas grade III tumors are considered as "high-grade" (more malignant) variants.

The submitted tumor was a low grade mast cell tumor (Kiupel et al.2011).

Mast cell tumors grade II (Patnaik) seem to show a large variety in biologic behaviour. The prognosis of multiple tumors is yet controversial.

Futhermore, the intracellular distribution pattern of the c-kit receptor and the proliferation activity of the tumor cells (ki-67) are supposed to be prognostically relevant.
An immunohistologic examination is possible in formalin fixed, paraffin embedded tissue.  - Laboklin

OHUTNEULANÄYTTEEN RAPORTTI:

"Submitted were 5 unstained smears. A Pappenheim-staining was performedaccording to the standard operation procedure. High numbers of round cells were present. The cells were well-differentiated, with numerous distinct metachromatic stained granules and uniform small nuclei, which were obscured by granules. Anisocytosis and anisokaryosis were mild. Mitotic figures were absent. Multifocally, granules were released and scattered through the background. Low numbers of eosinophils and high numbers yof erythrocytes were found. Bacteria or fungal organisms could not be found within the examined smears.

Interpretation

Cytological examination was suspicious for a well differentiated mast cell tumor.

Histopathological examination is recommended in order to perform a grading of the mass (grade I to III (Patnaik, 1984), and high-grade and low-grade (Kiupel et. al, 2011)).

Additionally with paraffin embedded tissue an immunohistologic examination would be possible, too. The degree of proliferation (Ki-67) and the distribution pattern of the C-kit receptor seems to have an influence on the prognosis, especially in grade I and II tumors. Cytology is not suited to perform these gradings and further immunohistochemistry." - Laboklin