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Citologia de derrames pleurais em gatos
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Abstract(s)
O derrame pleural é a acumulação anormal de fluido na cavidade torácica, uma afeção que pode ser fatal para o animal, através de sinais clínicos inespecíficos, sendo frequentemente a dispneia o sinal que alerta os tutores. Em gatos, o derrame pleural pode ter diversas etiologias, incluindo neoplasia, insuficiência cardíaca congestiva (ICC), piotórax, quilotórax idiopático e peritonite infeciosa felina (PIF). O diagnóstico etiológico exige uma avaliação integrada com utilização de várias ferramentas de diagnóstico, sendo a análise citológica do fluido, obtido através de toracocentese, fundamental neste processo. A análise citológica permite classificar o tipo de derrame, auxiliando o médico veterinário na seleção de exames complementares, na redução de diagnósticos diferenciais e na escolha da terapêutica a instituir. O presente estudo pretende caracterizar uma amostra de gatos com derrame pleural, classificando os diferentes tipos de derrame com base nas observações citológicas, e destacando a relevância da citologia no diagnóstico etiológico. Foram analisados 41 casos de gatos com derrame pleural, nos quais foi realizada toracocentese e análise citológica do fluido. A classificação do derrame foi feita com base na concentração de proteínas totais, contagem de células nucleadas totais e critérios citológicos, e os derrames classificaram-se em transudado, transudado modificado, exsudado séptico, exsudado asséptico, quiloso, neoplásico e hemorrágico. Este estudo evidenciou a importância, já referida na literatura, da citologia como ferramenta de diagnóstico, destacando parâmetros como presença de células neoplásicas, tipo e proporção de células inflamatórias, presença de microrganismos, fundamentais para a classificação dos diferentes tipos de derrame pleural, para a determinação da etiologia e para a instituição da terapêutica. Constatou-se que os tipos de derrame mais frequentes foram quiloso (27%), neoplásico (22%) e transudado modificado (22%), que o derrame transudado (2%) foi raro, e não se identificaram casos de derrame hemorrágico. As etiologias mais comuns foram a neoplasia (35%) e a ICC (17%), em contraste com a PIF (2%), que foi uma etiologia muito pouco frequente. Observou-se ainda que os grupos de derrame transudado modificado, exsudado asséptico, quiloso e neoplásico podem ter como etiologia a neoplasia, e que a ICC pode originar derrame transudado, transudado modificado ou quiloso
ABSTRACT - Cytology of pleural effusion in cats - Pleural effusion is the abnormal accumulation of fluid in the thoracic cavity, a condition that can be life-threatening for the animal, through nonspecific clinical signs, with dyspnoea frequently being the symptom that alerts the owners. In cats, pleural effusion can have various aetiologies, including neoplasia, congestive heart failure (CHF), pyothorax, idiopathic chylothorax, and feline infectious peritonitis (FIP). Etiological diagnosis requires an integrated assessment using multiple tools, with cytological analysis of the fluid, obtained via thoracocentesis, being a key component of this process. Cytological analysis allows for the classification of the type of effusion, assisting the veterinarian in selecting complementary diagnostic tests, reducing differential diagnoses, and determining the appropriate therapy. The present study aims to characterize a sample of cats with pleural effusion, classifying the different types of effusion based on cytological observations, and highlighting the importance of cytology in the etiological diagnosis. A total of 41 cases of cats with pleural effusion were analysed, in which thoracocentesis and cytological analysis of the fluid were performed. Effusions were classified based on total protein concentration, total nucleated cell count, and cytological criteria, and were categorized as transudate, modified transudate, septic exudate, aseptic exudate, chylous, neoplastic and haemorrhagic. This study emphasized the importance of cytology, as already noted in the literature, as a diagnostic tool, highlighting parameters such as the presence of neoplastic cells, the type and proportion of inflammatory cells, and the presence of microorganisms, which are essential for classifying different types of pleural effusion and determining the underlying aetiology. It was found that the most frequent types of effusion were chylous (27%), neoplastic (22%), and modified transudate (22%), with transudative effusion (2%) being rare, and no cases of haemorrhagic effusion were identified. The most common aetiologies were neoplasia (35%) and CHF (17%), with FIP (2%) being a very rare aetiology. It was also observed that modified transudate, aseptic exudate, chylous, and neoplastic effusion types can have neoplasia as their underlying cause, and CHF can cause transudate, modified transudate, or chylous effusion
ABSTRACT - Cytology of pleural effusion in cats - Pleural effusion is the abnormal accumulation of fluid in the thoracic cavity, a condition that can be life-threatening for the animal, through nonspecific clinical signs, with dyspnoea frequently being the symptom that alerts the owners. In cats, pleural effusion can have various aetiologies, including neoplasia, congestive heart failure (CHF), pyothorax, idiopathic chylothorax, and feline infectious peritonitis (FIP). Etiological diagnosis requires an integrated assessment using multiple tools, with cytological analysis of the fluid, obtained via thoracocentesis, being a key component of this process. Cytological analysis allows for the classification of the type of effusion, assisting the veterinarian in selecting complementary diagnostic tests, reducing differential diagnoses, and determining the appropriate therapy. The present study aims to characterize a sample of cats with pleural effusion, classifying the different types of effusion based on cytological observations, and highlighting the importance of cytology in the etiological diagnosis. A total of 41 cases of cats with pleural effusion were analysed, in which thoracocentesis and cytological analysis of the fluid were performed. Effusions were classified based on total protein concentration, total nucleated cell count, and cytological criteria, and were categorized as transudate, modified transudate, septic exudate, aseptic exudate, chylous, neoplastic and haemorrhagic. This study emphasized the importance of cytology, as already noted in the literature, as a diagnostic tool, highlighting parameters such as the presence of neoplastic cells, the type and proportion of inflammatory cells, and the presence of microorganisms, which are essential for classifying different types of pleural effusion and determining the underlying aetiology. It was found that the most frequent types of effusion were chylous (27%), neoplastic (22%), and modified transudate (22%), with transudative effusion (2%) being rare, and no cases of haemorrhagic effusion were identified. The most common aetiologies were neoplasia (35%) and CHF (17%), with FIP (2%) being a very rare aetiology. It was also observed that modified transudate, aseptic exudate, chylous, and neoplastic effusion types can have neoplasia as their underlying cause, and CHF can cause transudate, modified transudate, or chylous effusion
Description
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Keywords
Derrame pleural Citologia Gato Toracocentese Diagnóstico etiológico Pleural effusion Cytology Cat Thoracocentesis Etiological diagnosis
Pedagogical Context
Citation
Costa CMP. 2025. Citologia de derrames pleurais em gatos [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária