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INTRODUCERE
Un atlas despre citopatologia oncologica la caine 9i pisica este rar Intalnit In
literatura de specialitate, Insa acest volum speram sa fie un ghid extrem de util
speciali9tilor
unui diagnostic
pozitiv 9i
diferentialln oncopatiile maligne, la cele doua specii de animale. Pentru colectivul nostru
acest lucru se Inscrie ca 0 veritabila provocare, din care se spera sa ie9im In cele mai
bune conditii, cu sufragiile unei activitati bine facute, Implinite, deoarece, pentru ambii
autori exista 0 imensa motivatie.
Motivatiile noastre sunt legate de necesitatea ca medicii veterinari speciali9ti In
anatomie patologica 9i/sau oncologie, care sunt dedicati citodiagnosticului oncologic, sa
posede un material mai mult sau mai putin complet, care sa-i poata ajuta la elaborarea
diagnosticului de oncologie maligna la animalele de companie.
Lucrari expasate,
cu subiecte
punctiforme,
care trateaza aspecte ale
citodiagnosticului folosit atat In medicina veterinara cat 9i In cea umana au fost publicate
In ultimii 50 de ani 9i Inca se mai publica. Primul tratat care a abordat problematica
citodiagnosticului In oncologia umana a fost publicat In Romania, In 1968, In Editura
Medicala sub semnatura unui eminent colectiv de speciali9ti, In frunte cu marele citologoncolog Dr. V. lonescu.
Un astfel de elaborat In tara noastra, pentru oncologia veterinara nu a fost publicat
pana In momentul de fata. Avand 0 experienta care Insumeaza peste jumatate de secol,
fiind In acela9i timp experimentator, anatomo-patolog, oncolog, clinician 9i terapeut, am
putut observa dezvoltarea unor procese canceroase de la 0 unica celula pana la
constituirea unei tumori. Acestea ne permit astazi sa ne exprimam pareri decisive In
aprecierea 9i situarea citodiagnosticului In practica medical-veterinara, ca 0 valoare
intrinseca, cat 9i situarea corecta a acesteia In competitie cu alte mijloace de diagnostic,
de care profesia noastra dispune.
Prin colaborarea mea cu d-na Dr. Emilia Balint, eleva prestigioasa, medic oncolog
specialist, care de peste 15 ani practica zilnic, atat diagnosticul, cat 9i toate elementele
specifice Invatamantului 9i cercetarii 9tiintifice In domeniul oncologiei comparate, am
reu9it printr-o activitate continua 9i asidua sa strangem materialul propriu, din cadrul cazuisticii noastre, pe care II prezentam sub forma de atlas.
In cele ce urmeaza dorim sa prezentam avantajele, dar 9i Iimitele practicarii
citodiagnosticului In general 9i al animalelor de companie In special.
In cadrul avantajelor putem enumera:
1) Punctia aspirativa (biopunctia) este cea mai facila abordare a unei formatiuni
tumorale sau a unui tesut, fara nici un fel de risco
NiCOLAE
MANOLESCU,
EMILIA BALINT
2) Frotiurile obtinute din punctii sau amprentele obtinute din tumori excizate, se
coloreaza simplu ~i rapid (MGG sau alte metode) (Intre 5-30 minute).
3) Citologul poate stabili un diagnostic diferentiallntre un proces inflamator acut
sau cronic; un proces discrazic; un proces tumoral benign fata de unul malign
astfel identificand ~i precizand baza celulara a proliferarii tumorale.
4) Citologic se poate stabili G-ul celular al unei proliferari maligne.
5) Citologul poate dimensiona raportul dintre celulele In diviziune fata de totalul
celulelor tumorale, stabilind astfel gradul de malignitate.
6) Se poate alcatui mitograma, fazele mitozei cat ~i frecventa In populatia celulara
a celulelor In amitoza.
7) Citologul stabile~te gradul ~i tipologia celulelor implicate activ In raspunsul
imun al macroorganismului.
8) In cazul limfomului malign, citologul
fenomenului de descarcare citemica.
stabile~te
existenta
sau absenta
sunt:
1) Examenul citologic trebuie completat cu examenul histopatologic, deoarece
acesta din urma precizeaza gradul de infiltrare a procesului tumoral, relatia cu
pachetul vascular existent In parenchimul tumorii (vase limfatice, capilare,
vene, artere) ~i eventuala lor trombozare partiala cu embolusuri tumorale.
2) Examenul citologic nu este suficient pentru 0 apreciere a TNM-ului, comparativ
cu examenul anatomo-histologic.
3) Examenul histopatologic ofera relatii concludente, cu privire la gradul de
evolutie al unei leziuni displazice simple, displazice agravate, carcinom
intraepitelial, carcinom microinvaziv, carcinom invaziv, etc.
Desigur ca examenul histopatologic ramane pe soclu, ca metoda de baza la care
se apeleaza constant ~i perfect conclusiv, dar pentru ca examenul citomorfologic ne
ofera un diagnostic rapid, trebuie impus ca metoda de baza, permitand clinicianului
instituirea celei mai adecvate terapii anticanceroase.
Trebuie sa ne obi~nuim ~i deci sa introducem In practica dezideratul major pentru
animalele de companie (caine ~i pisica) a termenului de "urgenta. terapeutica.
Atlas de oncocitomorfologie
oncologica". Acest termen se justifica perfect 1inand cont ca 6-7 ani de via1a la om
reprezinta numai un an de via1a pentru animalele de companie. Daca facem un calcul
simplu, 0 zi de via1a la caine ~i pisica reprezinta 0 saptamana din via1a omului. Deci 10
zlle in medie, intarziere cauzata de durata examenului histopatologic, reprezinta de fapt,
pentru aceste specii 0 intarziere de circa 2 luni, pana la instituirea terapiei adecvate.
Poate fi prea tarziu, in acest rastimp putand sa apara fie recidive locoregionale, cat ~i
metastaze la distan1a. Acestea sunt argumentele ~i motiva1ii1e care ne-au asigurat
"combustibilul cel mai nobil", absolut indispensabil propulsiei pentru realizarea
prezentului elaborat. Pentru introducerea in practica larga a dezideratelor de mai sus,
este imperios necesar a organiza un judicios inva1amant post universitar de oncologie
comparata, care sa pregateasca adevara1i oncologi medici veterinari, condu~i de
cadrele didactice care fac parte din ~coala noastra.
Autorii
INTRODUCTION
The subject "Cytomorphological aspects in canine and feline oncology" is rarely
encountered in literature; nevertheless we hope that this guide will be extremely useful to
all veterinarians who are specialize in oncology and who are supposed to make a positive
and differential diagnosis of the malignant oncopathy to the two species. For our team
this atlas is entered as a true challenge, which is hoped to get out the best conditions, the
satisfaction of a well made, fulfilled, because, for both authors there is a huge motivation.
Our motivations are related to the fact that veterinarians specialize in pathological
anatomy and/or oncology and who are committed to the oncological cytodiagnosis
. should have at their disposal a material that is more or less complete and that can help
them to elaborate the diagnosis of malignant oncology in pets.
Over the last 50 years, several papers and books, with punctual topics, dealing with
aspects of the cytodiagnosis used both in human and veterinary medicine have been
published. The firs book that approached the problematics of the cytodiagnosis in the
human oncology was published in Romania in 1968 by the Medical Publishing House,
under the signature of a preeminent team of specialists led by the great Romanian
oncologist Dr.V.lonescu.
Such a treaty drafted in our country, for veterinary oncology has not been published
until now. With an experience which amount to over half a century, being an
experimenter, a clinician, a therapist and anatomo-pathologist, , we could see the
development of cancerous processes from a single cell up to the formation of tumors.
This allows me now to express my opinion in critical appreciation and location
cytodiagnosis in medical and veterinary practice as an intrinsic value and the correct
location in competition with other means of diagnosis that our profession has.
The same is valid for my collaborator, Dr. Emilia Balint, who was a brilliant student,
and who is at present a veterinarian specialized in oncology. For more than thirteen
years, she has been making diagnoses daily; she has also been making use of all the
elements specific to the scientific research in the domain of comparative oncology.
What follows is a list of the advantages and disadvantages of the practice of
cytodiagnosis, in general, with special reference to pets.
The advantages of cytodiagnosis
1) The aspiration punction (biopunction) is the easiest approach to a tumor or to a
tissue, with no risk whatsoever.
2) The smears obtained from punctions or the tissue prints obtained from the
excised tumors are fast and easy to colorate (MGG or other techniques)
(maxim 30', in case of emergency in 5").
Atlas de oncocitomorfologie
NiCOLAE
MANOLESCU,
EMILIA BALINT
introduce in practice the major imperative for pets ( cats, dogs) of the term oncological
therapeutic emergency. This term has perfect justification if one takes into consideration
the fact that 6-7 man-years are only one dog or cat-year. That is to say, one day in a life
of a pet amounts to a week in the life of a human. Therefore, an average of 10 days of
delay caused by the duration of the histopathologic test represents a delay of 2 months
for a pet. During this time, both loco-regional relapses and metastasis can occur.
The only way out is the cytological test, in spite of the disadvantages it has in
comparison with the histopahological one. These are the arguments and the motivation
that ensured us "the noblest fuel", which is absolutely indispensable for the propulsion
to write the present book.
In order to put into practice the ideas mentioned above, it is crucial for us to have
a good post-graduate educational system of comparative oncology that should prepare
genuine veterinarians specialized in oncology, led by the scholars who belong to our
school.
The authors
CAPITOLUL 2/ CHAPTER 2
embrio-
A. Hemopatii maligne
1.
1.1
Leucemiile
Acute:
- leucemia promielocitara
Cronice:
Limfoame maligne
Limfom malign Hodgkinian
NiCOLAE
2.2
MANOLESCU,
EMILIA BALINT
Carcinomul pulmonar
cu celule mari
2.
3.
4.
4.bis
5.
6.
7.
Sertoliomul testicular
Luteomul ovarian
8.
9.
10.
11.
Carcinomul
mamare
12.
13.
14.
15.
16.
17.
intraepitelial
(displazia
agravata-intraductala)
al glandei
Atlas de oncocitomorfologie
- osteoblastic
-' osteocitic
- osteoclastic
4. Condrosarcom
5. Sinoviomul malign
6. Tumora Abricosov
7. Kupffer-cell-sarcoma
8. Sarcomul histiocitar tegumentar
9. Mastocitomul mucoaselor
D. Tumori nervoase si
, ale sistemului APUD:
D.1. Melanomul malign
D.2. Ganglioneuromul
E.
11
NiCOLAE
MANOLESCU,
EMILIA BALINT
1.2.
1.2.1
- monocitary leukemia
- histiomonocitary leukemia
- myeloblastic leukemia:
- micromyeloblastic
- macromyleoblastic
- megakaryocitic
- promyelocytary leukemia
Chronic:
Lymfocytary (LLC):
- "T" cellular
- "8" cellular
- Hairy cell-Leukemia
- N.K. cellular
1.2.2
Myeloid:
- neutrophilic
- eozinophilic
- basophilic
- mastocytary
12
Atlas de oncocitomorfologie
2. Malignant lymphomas
2.1 Malignant Hodgkin's lymphoma
2.2 Malignant non- Hodgkin's lymphoma
a) ,,8" cellular malignant lymphoma:
- Centrocytic
- Centroblastic
- Imunoblastic
- Plasmoblastic - plasmocytary
- Type Waldenstrbm
b)"T" cellular malignant lymphoma
- Sezary lymphoma
- Mycosis Fongoides lymphoma
c) Histiocitary malignant lymphoma
3. Thesaurismosis
B. Epithelial malignant tumors
1.
Pulmonary
2.
3.
4.
Squamos (epidermoidal )carcinoma
4. bis Adamantinoma
5.
Testicular seminoma
6.
Testicular sertolioma
7.
Ovarian luteoma
8.
9.
10.
11.
dysplasia) of the
mammary gland
12.
13.
14.
15.
16.
17.
NiCOLAE
c. Mesenchymal
MANOLESCU,
EMILIA BALINT
1. Fibrosarcoma
2. Rabdomiosarcoma
3. Osteosarcoma
- Osteoblastic -osteosarcoma
- Osteocytic osteosarcom of the bone
- Osteoclastic osteosarcoma of the bone
4. Chondrosarcoma of the bone
5.
6.
7.
8.
9.
Malignant sinovioma
Abricosov tongue tumor
Kupffer-cell-sarcoma
Tegumentary histiocitary sarcoma
Mastocytoma of the mucous membranes
14
REACTIILE
LEUCEMOIDE
,
Reactiile
leucemoide
sunt
stari
pasagere
(efemeroide)
care au 0
etiologie extrem de diversificata 9i de
multe ori neprecizata, care se traduce
printr-o proliferare a unei linii celulare
leucocitare la nivelul sangelui periferic. In
fata acestor cazuri medicul specialist
citomorfolog Intampina mari dificultati de
stabilire
a diagnosticului
pozitiv 9i
diferential Intre 0 reactie leucemoida, un
debut al unei leucemii vera sau 0
LEUKEMOID REACTIONS
Leukemoid
(ephemeral)
reactions
states
that
are
passing
have a very
to establish
differential
diagnosis
the positive
and
leucemie
vera. In cazul
reactiilor
leucemoide este necesara repetarea
examenului hematologic dupa 14-21 zile
clinice, specifice
unor boli, reactia
leucemoida este surprinsa In urma unui
examen hematologic de rutina.
Examenul citomorfologic (fig. 1-8).
Din punct de vedere citomorfologic
reactiile leucemoide se prezinta In 3
forme:
hematological
and
differential
diagnosis
the
leukemoid
reaction
is
NiCOLAE
MANOLESCU,
se remarca,
indiferent
de
EMILIA BALINT
16
Atlas de oncocitomorfologie
Fig. 1
r
Fig.
2
17
Dc
3V70:J/N
LlMFORETICULOZELE
REACTIVE
REACTIVE
LYMPHORETICULOSES
putand
reactions.
The
person
who
must
which,
from
an anatomo-
to the tegu21
NICOLAE
MANOLESCU,
EMILIA BALINT
celule fibrocitare
~i mastocitare
cu
absenta elementelor blastice.
c)
Statusul de Iimforeticulita
cronica specifica. In aceasta categorie
vom descrie numai granulomul TBC.
Clinic: aspectul
este de limfonod
boselat, nedureros ~i aderent de planul
profund, rar se poate observa 0 aderenta
la planul superficial tegumentar.
Citologic: apare exprimarea clasica a
granulomului TBC - cu prezenta de
celule epitelioide (ovoidale sub aspect de
nuclei
liberi,
fara
citoplasma
identificabila). Nucleii sunt oligocromi cu
cromatina
laxa, fara exprimare
a
nucleoli lor. Din loc Tnloc se gasesc celule
gigante de tip Langhans - adica celule de
50-6011 cu citoplasma larga, acidofila ~i
cu 0 coroana periferica de nuclei.
Numarul acestora variaza de la 3-4 la 10-
22
Atlas de oncocitomorfologie
cronica
nespecifica,
anterior
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
Fig.
27
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~~
CMLTJlLllL5L~HA~IEB~5
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~~~
"
THE EOSINOPHILIC
GRANULOMA
GRANULOMUL EOZINOFILIC
In aceasta forma tumorala
nu este
~i
sangvina.
Forma
tegumentara
sau mucotegumentara este u~or de diagnosticat
macroscopic deoarece leziunea prezinta
un aspect ulcerativ caracteristic. Citomorfologic granulomul
eozinofilic
se
exprima prin prezenta
unui infiltrat
unicelular
compus
din granulocite
eozinofile at at adulte cat ~i tinere.
Diagnosticul
diferential
prin examen
citomorfologic
trebuie sa se faca cu
carcinomul bazocelular, care evolueaza
anatomoclinic
sub forma ulcerativa.
Forma sangvina care apare ca 0 reactie
of medium
malignity
belongs to the class of
malignant disorders of the hematopoietic
cellular system.
We can identify three topog(aphical
forms:
- mucotegumentary
or tegumen-
and
sanguine
The tegumentary or mucotegumentary form is easily to diagnose from
macroscopic perspective because of the
lesion has a characteristic appearance
ulcerative. From the cytomorphological
point of view granuloma eosinophilia is
expressed by the presence of unicellular
infiltrate
composed
of granulocytes
eosinophilic
both adult and young.
Differential diagnosis by cytomorphological examination must be made with
bazocelular carcinoma, which develops
29
NiCOLAE
MANOLESCU,
30
EMILIA BALINT
as
ulcerative
anatomoclinic.
The
Atlas de oncocitomorfologie
Fig. 1
Fig.
2
31
iN/WB
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CA~IIOLUL.6J CHA~IER 6
LEUCEMIILE
LEUKEMIAS
malignantly
peripheral
maduvei
territory
hematopoetice.
hematologic
cantitativ
Examenul
~i calitativ
este
citomorfologic
investigatie
Prin
se stabile~te
atat
The
proliferated
blood
cells
in the
is coming
from the
of the hematopoietic
marrow.
quantitative
and
qualitative
examination
into
privind
clasificarea,
deoarece
vom
prezenta In acest atlas cazuistica proprie
pentru
interpretarea imagisticii.
Astfel prezentam:
1) Leucemia
limfocitara
the images.
Thus we present the following:
acuta
"T"
1) T-cell
acute
lymphocytic
leukemia
2) 8-cell
acute
lymphocytic
leukemia
33
-"
NiCOLAE
3) Leucemia
limfocitara
cronica
MANOLESCU,
"B"
7 -12.
5) Leucemia mieloida cronica (LMC) fig. 13 - 18.
6) Leucemia monocitara acuta (LMoA) fig. 19 - 20.
7) Leucemia histio-monocitara
acuta
cu
celule
NK
Legenda figurilor
Fig. 1: LLA "T"
leucocitoconcentrat,
segmentate
sau
EMILIA BALINT
leukemia
Atlas de oncocitomorfologie
masiva
proliferare
de
monobla9ti,
promonobla9ti ( In diviziune mitotica 9i
promonocite reduse numeric.
Fig. 21 - 22: LHMoAc - sange periferic.
Bla9ti Inalti profund atipici 9i anaplazici In
melanj
cu
monobla9ti
9i
celule
primordiale histiocitare.
Fig. 23 - 31: LEAc. Sange periferic.
lntensa proliferare a liniei eritropoietice
Intre proeritroblast
9i diferite tipuri
celulare de eritrobla9ti. Un precursor al
liniei eritropoietice In diviziune mitotica
atipica.
Fig. 32 - 35: Lac NK. Sange periferic.
Masiva prezenta de bla9ti limfocitari cu
granulatii acidofile intracitoplasmatice
(largi granulatii oxifile intracitoplasmatice
= N.K. cells)
Fig. 36 - 40: LCr NK. Sange periferic. In
majoritatea
celulelor
limfocitare
se
remarca limfocite adulte 9i prolimfocite
care
intracitoplasmatic
contin
largi
granulatii oxifile = N.K. cells.
Fig. 41 - 50: SMP. Splina. In aceste
imagini se remarca Inlocuirea populatiei
celulare limfocitare dominante a splinei
cu 0 proliferare de ansamblu atipica, In
majoritate bla9ti din seria
mieloida
eritropoietica 9i monocitara.
proliferation
of
monoblasts,
promonoblasts ( in mitotic division and
few promonocytes.
Fig. 21 - 22:
LHMoAc - peripheral
blood. High very atypical and anaplastic
blasts mixed with monoblasts
and
primordial histiocytary cells.
Fig. 23 - 31: LEAc. peripheral blood.
Intense proliferation of the erythropoietic
line
between
proerythroblast
and
different cellular types of erythroblasts. A
forerunner of the erythropoietic line in
mitotic atypical division.
Fig. 32 - 35: Lac NK. peripheral blood.
massive presence of lymphosytic blasts
with
the
presence
of
acidophil
intracytoplasmatic
granulosities
(large
oxiphil intracytoplasmatic granulosities =
N.K. cells)
Fig. 36 - 40: LCr NK. peripheral blood. In
most
of the
lymphocytic
cellular
presence,
we
can
identify
adult
lymphocytes and prolymphocytes that
contain
oxiphil
intracytoplasmatic
granulosities = N.K. cells.
Fig. 41 - 50: SMP-spleen. In these
images, we can see the replacement of
spleen's dominantly cellular lymphocytic
population
with an atypical overall
proliferation, mostly with blast from the
myeloid erythropoietic and monocytary
series.
35
98
Atlas de oncocitomorfologie
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Fig. 4
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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Atlas de oncocitomorfologie
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3
CA~IIOLUL_llCHABIER]
LlMFOMUL HODGKIN
Aspectele
limfomul Hodgkin
noastre au fost:
In cadrul
cazuisticii
- Granulomul Hodgkinian;
~i
- Sarcomul Hodgkinian.
Caracteristicile esentiale ale acestor
doua forme sunt determinate de dominarea tabloului citomorfologic,
fie de
catre celula giganta Hodgkin, fie de catre
celula giganta Stenberg-Paltauf-Reed
(fig. 1 - 12).
Celula giganta Hodgkin este 0 celula
mononucleara
de talie mare, 30/-l.
Cromatina
nucleara este de regula
areolata, cu prezenta unui nucleol gigant.
Citoplasma este larga u~or bazofila ("fum
de tigara"). Raportul nucleo-citoplasmatic
este In favoarea nucleului. Dominanta
numerica a acestor celule este foarte
mare In cazul sarcomului Hodgkinian ~i
mai redus
In cazul
granulomului
Hodgkinian (fig. 1 - 7).
Celula giganta Sternberg-PaltanfReed este de asemenea de talie mare,
avand nuclei lobati, multipli.
Fiecare nucleu are cromatina densa ~i
lasa sa se observe prezenta unui nucleol
gigant. Citoplasma
larga, agranulata
30-40/-l,
of these
are determined
by the
of the cytomophological
giant cell
(fig. 1 - 12).
The Hodgkin giant cell is a mononuclear cell of large size, around 30/-l.
The nuclear chromatin is usually haloed,
with a giant nucleolus. The cytoplasm is
wide and slightly basophilic ("cigarette
smoke" form).
The nucleo-cytoplasmatic ratio favors
the nucleus. The number of these cells is
great in the case of Hodgkin's sarcoma
and smaller in the case of Hodgkin's
granuloma (fig. 1 - 7).
The giant Sternberg-Paltanf-Reed
cell is also of large size, around 30-40/-l,
with multiple
lobeate
nuclei.
Each
nucleus has a thick chromatin and
reveals the presence of a giant nucleolus.
The
wide
non-grainy
cytoplasm
is
NiCOLAE
~i numeric
mai
redusa
MANOLESCU,
In Sarcomul
EMILIA BALINT
is
reduced
in
comparison
with
the
nivelul
celulei
gigante
Hodgkin
sunt
Hodgkin
prin prezenta
se
carac-
alaturi
de un
(neutrophilic
macrofage,
~i plasmocite),
fibrocite
Diagnosticul
basophilic,
phage,
granulocytes,
adult
eosinophilic,
lymphocyte,
fibrocytes
and
macro-
plasmocytes).
Hodgkin
and
cells can be
prezenta
diferential
Stenberg
Intre granulomul
celulelor
gigante
cu grad
Inalt
monstruozitate
celulara
Hodgkin
absenta
~i
Hodgkin ~i
Hodgkin
~i
de atipie
~i
In granulomul
acestora
In
abnormality
celule
strain"
gigante
gigante
inconfundabile
de
cu
"corp
celulele
and monstrousness.
In the
Stenberg-Paltauf-Reed (fig. 1)
Sarcomul Hodgkinian este u~or de
identificat
proliferari
tifiable
tinere
prolimfocite),
de
iar
din
Iimfobla~ti
loc
In
loc
existence
within
of
the
a
meaning
quasi
of
the
homogenous
~i
se
to place and more rarely giant SternbergPaltauf-Reed cells. 'This form of sarcoma
62
Atlas de oncocitomorfologie
Fig. 1
Fig.
63
v9
Atlas de oncocitomorfologie
Fig.
Fig.
6
65
lNlTtfg
99
Atlas de ancacitamarfalagie
Fig.
Fig. 10
67
89
3'r170:J1N
CAPITOLUL 8 '-CHAPTER 8
L1MFOAME MALIGNE
NONHODGKINIENE
Reprezinta cea mai frecventa forma
e exprimare
adrul
a bolii canceroase
hemopatiilor
maligne
oastra la animalele
in
din
tara
de companie,
iar
citomorfologice
ale
Iimfoame
nu sunt
specifice,
sus-
cand
la
palpatie
se constata
mono
sau a unei
poliadenopatii. Adenopatia este neduprezenta
unei
la planurile
nonhodgkiniene
acitemice(
fara
prezenta
in Iimfoame
bla~tilor
in
examinarii
Examenul
frotiului
in
de sange.
citomorfologic
se
of
less adherence
to the deep and
superficial layers of the lymph nodes. The
adenopathy may be accompanied or not
by hepato- and spleeno- megaly.
Clinical
the
animal
may
present
continuous weight loss, in contrast with
the appetite that remains within normal
parameters.
In the case of malignant
nonHodgkin's lymphomas, these may be
classified
in acythemic
lymphomas
(without the presence of blast cells,
especially periferical) or cythemic where
in addition we will identify the presence of
erythemia
within the
general investigation.
hematological
69
NiCOLAE
la elaborarea
diferential,
:;;i
prognosticului,
MANOLESCU,
care vor
unui diagnostic
necesar
evolutiei
stabilirii
:;;i terapiei
specifice.
Pe baza proliferarii celulare limfonodale
vom
prezenta
limfoame
urmatoarele
forme
de
maligne nonhodgkiniene.
Fig. 1 - 2: reprezinta
limfom malign
Limfonod:
monomorfe
prolimfocite
imaginea
"B" celular
Prezenta
alcatuita
:;;i foarte
de
centrocitic.
unei proliferari
din
Iimfocite,
rare limfoblaste.
polimorfa
blastice
atipici
cu
multe
(polimfobla:;;ti
-
Nucleii
elemente
:;;i limfobla:;;ti)
contin
nucleoli
bine
Limfocitele
"T"
nonhodgkinian
celular.
unde distingem
modificari
In
celulelor
,,8" deoarece,
Iimfocitul
multiplelor
scizuri
structurii nucleare.
70
"T"
este
specific
prezenta
:;;i e:;;ancruri
ale
EMILIA BALINT
The cytomorphological
examination - is carried out after the biopuncture of the tumor lymph. (It is
preferred to puncture the popliteal lymph
node with a thin needle.) The microscopic examination may reveal several
cytomorphological aspects which wililide
in developing a positive and differential
diagnosis because the non-Hodgkinis
lymphoma evolve differently, they have
different reactions to specific therapy,
and therefore the prognostication will
also be different.
Fig. 1 - 2: represents the image of a
centro- cytic malignant non-Hodgkin's
lymphoma of B-cell type.
Lymph node: The presence
of
monomorphic proliferation consisting in
lymphocytes, pro- lymphocytes and very
rare Iymphoblasts.
Fig. 3 - 4 - 5 and 5 bis: represents the
image of a centro-blast malignant nonHodgkin's
lymphoma of B-cell type.
Lymph node: The cell image is
relatively polymorphic with many blast
atypical elements (poly-Iymphoblasts and
Iymphoblasts) - The nuclei contain wellrendered nucleoli and have frequent
atypical mitoses. The dominant cell is the
high lymphoid blast together with the
polylymphocytes. The adult lymphocytes
are often missing.
Fig. 6 - 14: there are images of the
malignant non-Hodgkin's
lymphoma
of T-cell type.
Fig. 6: there are images taken of a
lymph node where we can see changes
such the presence of Iymphoproliferated
Atlas de oncocitomorfologie
In fig.
7 -
10 imaginile
au fost
In
imaginile
11 -
14 este
prezentata In leucocitoconcentrat
celula
limfomul
malign
at at acitemic
cat
9i citemic.
24 - 25 au surprins
un
limfomul
terizeaza
histiocitar,
citomorfologic
se
printr-o
caracproli-
fenomene
de gigantism
are 0 forma
paralelogramica.
Cromatina
nucleara
are
Nucleolii sunt
and prolympho-
NICOLAE
MANOLESCU,
EMILIA BALINT
aspecte citomorfologice.
Fig. 26 - 29 prezinta celule de talie
prelungiri
limfonodale
citoplasmatice.
normale sunt
complet remaniate.
Fig. 30 - 31 prezinta nuclei liberi de
talie mica sau medie monomorfa, fara
diviziuni celulare ~i lipsiti de monstruozitati
care lasa Impresia ca sunt a~ezati pe 0
citoplasma vacuolara, u~or bazofila quasi
unitara datorita multiplelor prelungiri care
se anastomozeaza Intre ele.
Fig. 32 - 39 - reprezinta imagistica
citomorfologica remaniata din limfonoduli
de catre proliferarea celulara specifica
limfomul
malign
NK.
Majoritatea
celulelor proliferate indiferent de statutul
de "blaste" sau "cite"contin In citoplasma
u~or bazofila sau acidofila 0 cantitate
variabila de incluzii oxifile de talie diferita.
Nucleul
celular
este
specific
limfocitare.
Atipiile
celulare
mitozele atipice, sunt moderate.
liniei
cat
~i
quasi
celule
72
imunoblastice
In cultura
Atlas de oncocitomorfologie
semicentral,
cu cromatina densificata -
47
63
sunt
rezervate
NlCOLAE
MANOLESCU,
surprize
pentru
hemopatiile
excentrici,
larga acidofila
3D)..!
cu
avand 0 citoplasma
plina de vacuole
care
(limfobla9ti
9i prolimfocite
In
74
blastice (plasmob1a9ti 9i
alaturi
de plasmocite
EMILIA BALINT
Walden-
From a cytomorphological
point of
view, the aspect is very characteristic as
this malignant lymphoma, no matter if it
develops at lymph nodes' structures or by
metastases from thIs level towards other
tissues or viscera, manifests exclusively
through the proliferation of both lymphoid
Atlas de oncocitomorfologie
citomorfologic
minutios
al
75
9L
Atlas de oncocitomorfologie
Fig.
Fig. 4
77
BL
Atlas de ancacitamarfalagie
Fig.
Fig.
7
79
DB
..
iN/TriB tfl7/W3 'n;JS370NtfW 3tf70;J!N
Atlas de oncocitomorfologie
Fig. 10
Fig. 11
81
lNl7'r1B
G8
Atlas de oncocitomorfologie
Fig. 14
Fig. 15
83
iN/Tv'S
v8
9t "6!d
Atlas de oncocitomorfologie
Fig. 18
Fig. 19
85
iN/W8
98
Atlas de oncocitomorfologie
Fig.
22
Fig.
23
87
88
Atlas de oncocitomorfologie
Fig.
26
Fig.
27
89
.iN/We
06
'v'17/W3'n~S370N'v'W 3'v'70~1N
Atlas de oncocitomorfologie
Fig. 30
Fig. 31
91
iN/Tv'B
V17/W3 'n:JS370NVI/V
c6
3V70:J/N
Atlas de oncocitomorfologie
Fig. 34
Fig.
35
93
.iN/Tv'S
't/17/VV3 'n:JS370N't/VV
176
3't/70:J1N
Atlas de oncocitomorfologie
Fig.
38
Fig. 39
95
iN/W8
96
'tf17/W3'nOS370N'tfW 3'tf7001N
Atlas de oncocitomorfologie
Fig.
42
Fig. 43
97
86
3\f70QIN
Atlas de oncocitomorfologie
Fig. 46
Fig. 47
99
--------------------------
iN/Tv'S
'tf17IW3 'nQS370N'tfW
oo~
3'tf70QIN
Atlas de oncocitomorfologie
Fig. 50
Fig. 51
101
Atlas de oncocitomorfologie
Fig. 54
Fig.
--------------------------
55
103
--------------------------
vO~
Atlas de oncocitomorfologie
Fig.
58
Fig. 59
105
--------------------------
90~
09 "6!d
31170;J1N
Atlas de oncocitomorfologie
Fig.
62
Fig. 63
--------------------------
107
--------------------------
BO~
Atlas de oncocitomorfologie
Fig.
66
Fig. 67
109
--------------------------
O~ ~
69 '6!d
Atlas de oncocitomorfologie
Fig. 70
Fig. 71
--------------------------
111
--------------------------
iN/Trl8
G~ ~
1117/w3'n~S370NIII/V 31170~1N
Atlas de oncocitomorfologie
Fig. 74
Fig.
--------------------------
75
113
--------------------------
t~~
LL -B!d
9L 'B!d
Atlas de oncocitomorfologie
Fig. 78
Fig. 79
115
--------------------------
9~ ~
08 'B!d
3\f70:J/N
C_A~ITOLUL9~1
CHA~TER9
'{
SARCOMUL HISTIOCITAR
HISTIOCYTAR SARCOMA
--------------------------
117
'O!d
Atlas de oncocitomorfologie
Fig.
Fig. 4
119
-~-
----.-
~---
--------------------------
iN/Wg
OG~
'tf17/W3'n:JS370N'tff/IJ 3'tf70:JIN
Atlas de oncocitomorfologie
Fig.
Fig.
--------------------------121
:CA~IJ_OLUL_tO_LCHA~TE
MASTOCYTOMA
MASTOCITOMUL
este 0 tumora mezen-
Mastocitomul
a mastocitului
9i/sau visceral),
fix (con-
mastocitomului
medular, cu
cu celule
pri-
Mastocytoma
is a mesenchymal
tumour of the hematopoietic territory with
a high frequency in canine species and it
can take very different aspects. We will
refer to the location of this tumoral type,
on one hand, and to the cytoproliferative
aspect on the other hand.
Regarding to location, 3 forms are
to be distinguished:
a subcutaneomucous, a visceral form, and a
visceral)
mastocyte
into
In proliferarea
--------------------------
mastocitara
se iden-
cat si
, rare
cells plus
123
NiCOLAE
MANOLESCU,
EMILIA BALINT
blastic mastocytary
cells plus rare
primordial cellular elements, which are
specific to the mastocytary class as well.
Celula
mastocitara
primordiala
(fig. 1 9i 12)
Este 0 celula rara avand 0 talie mare,
circa 28-30 11. Frecvent aceste celule se
afla Tn diviziune. Elementul caracteristic
este acela ca poseda un numar mult mai
mic de granule fine, negre situate atat Tn
citoplasma, cat 9i Tn nucleu.
Diagnosticul diferential trebuie sa se
faca Tntre:
de
melanina)
are
reactie
negativa
metacromatica (cu albastru de toluidina),
granulatiile
sunt grosiere,
dand un
124 --------------------------
diagnosis
must be
the
reaction
negative
Atlas de oncocitomorfologie
.
The basophilic granulocyte cellular
system
125
--------------------------
9G~
.. "
t -
..."-.- -...----..
-~"
" "7
..-....-
'.""""'"
"""t'
~'~~
I. .
"~~','fI..~
..
iN/Tv'S
V17/VV3 'nOS:370NVW
3V7001N
Atlas de oncocitomorfologie
Fig.
Fig. 4
127
--------------------------
8G~
3't/700iN
Atlas de oncocitomorfologie
Fig.
Fig.
--------------------------129
--------------------------
08~
Atlas de oncocitomorfologie
Fig. 11
Fig. 12
--------------------------131
G8~
3'tf7001N
Atlas de ancacitamarfafagie
Fig. 15
--------------------------
133
CA~ITOLULll1CHA~IER
11
MELANOMUL MALIGN
de cancer
can
indiferent
glanda
de
topografie,
mamara,
inclusiv
In
dar 9i In structurile
este
stabilirea
diagnosticului
be
located
on
the
tegument,
for
diagnosis
the
can
be done
granulations
homogenous
by analyzing
are
having
that is to
fine
a more
and
uniform
B,
C,D-melanom ).
epiteliale
tegumentare.
Cu toate
ca
of the
granulations
densificate
contain
luand aspectul
sau
"pata
neagra",
structura nucleului.
--------------------------
de "manta"
nerespectand
fact
that
the
aspect
is relatively
of the
uniform
and
granulations
that are
NiCOLAE
MANOLESCU,
0-
136 --------------------------
EMILIA BALINT
without obeying
nucleus.
the structure
of the
0 -
Atlas de oncocitomorfologie
Fig. 1
Fig.
2
137
88~
iN/Tv'S
'v'17/W3 'n:JS370N'v'W
3'v'70:J1N
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
6
139
----------------------~---
Ov~
3117001N
Atlas de ancacitamanalagie
Fig.
Fig. 10
--------------------------141
--------------------------
GV~
Atlas de oncocitomorfologie
Fig. 13
Fig. 14
--------------------------
143
--------------------------
9t
.iN/Tv'S
VV~
-{j!d
'v'17/W3 'n:JS370N'v'/N
3'v'70:J1N
Atlas de oncocitomorfologie
Fig. 17
Fig. 18
--------------------------
145
'"
9v~
..
j
'
..'W
II
.lNI7\1B
\l17/w3
'nOS370N\l1/V
3\17001N
Atlas de oncocitomorfologie
Fig. 21
Fig.
22
147
--------------------------
8v~
Atlas de oncocitomorfologie
..
--------------------------
Fig.
25
Fig.
26
149
--------------------------
lN17'v'8
os~
FIBROSARCOMUL
are 0
Forma maligna
de fibrosarcom
localizare
very
putand
3 se prezinta
aspectul
citoplasma
cat
and there
is no
fibroblastice.
Imaginile
arata
ca
fibroblastul tumoral este de talie mare,
at at
high incidence
has a
i?i prelungirile
fig.1-3
morphological
is
present
the
cyto-
aspects of a fibroblastic
have an obvious
Se prezinta
ca 0 masiva
tendency.
proliferation
obvious
se observe
diviziunilor
citoplasma
bazofile.
In fig. 8 -
sunt intens
of elongated
tendency
Celulele
to confluation.
The
17 se prezinta 0 forma
cells with an
and prolongations
NiCOLAE
MANOLESCU,
EMILIA BALINT
can be extremely
polymorphous.
They
variable
pe care
0 vom
este nevoie de 0
Imaginea A In rabdomiosarcom
which
is
either
The
rabdomyosarcoma
which
we will
se
cytoplasm,
clear
image
of
the
fibroblastic
distinge
0 proliferare
masiva _ de
rabdomioblaste care au 0 talie mare 30 !-t
cu un monomorfism elocvent. Celulele,
short presentation
sarcoma.
cu
citoplasma
larga,
bazofila
9i
of
the
rabdomy-
30
a massive
proli-
cromatina
In "bulgari"
9i un nucleol
cytoplasm with
two prolongations.
gigant.
!-t,
se vizualizeaza
The
big
nuclei
are
situated
eccentrically,
have the chromatin
"lumps" and a giant nucleolus.
in
rabdomysarcoma)
!-t
152 --------------------------
Atlas de oncocitomorfologie
oligocroma.
out- several
prolongations
to
both
de
throughout
parti moi.
tendency.
the whole
cytoplasm,
Every nucleus
their
leaves us to
rabdomysarcoma
theoretically
fibrosarcoma,
compared
to
confuse
it could
but
the
images
--------------------------153
witch
leaves no
",l
i
.;. t
-~""
lNI7\fB
Atlas de oncocitomorfologie
..
Fig.
Fig.
--------------------------155
.iN/WB
9S~
Atlas de oncocitomorfologie
Fig.
Fig.
---------------------------157
-------------------------
8S~
Atlas de oncocitomorfologie
Fig. 11
It
Fig. 12
--------------------------
159
09~
Atlas de oncocitomorfologie
Fig. 15
Fig. 16
--------------------------161
--------------------------
G9~
RABDOMIOSARCOMUL
Rabdomiosarcomul
este
0 tumora
RABDOMYOSARCOMA
Rabdomysarcoma
is the malignant
tumour of the striated muscular tissue.
This on frequently met in the case of
pets. As we have already seen in the
chapter
on
fibroblastic
sarcoma,
rabdomysarcoma needs a very careful
diagnosis which should be different form
Jhe fibroblastic sarcoma, the giganticcellular form. In both form of evolution of
cancer, the main means of diagnosis is
the cyto-morphologic test made after the
bio-punction of the tumoral formation.
The localization is situated wherever
there are striated muscular structures.
The cytomorphological
test
NiCOLAE
MANOLESCU,
gigantii
multinucleatii,
zisa ~i "In
paianjen". Aceste celule pot ajunge pana
la 150 /-!, ~i pot contine pana la 50 de
nuclei, unele dintre ele pot avea multiple
prelungiri.
Nucleii sunt normocromi
avand 1-2 nucleoli de talie mica.
Citoplasma este. bazofila sau acidofila.
Numarul de mitoze este procentual marit
(fig. 20 - 24).
Tabloul celular al rabdomiosarcomului
este cel mai polimorf din toate formele de
cancer
cunoscute,
este
cea
mai
anaplazica tumora, ceea ce ne face sa
conchidem ca este cea mai maligna, cu
evolutia cea mai scurta ~i cea mai
rezistenta la terapia cu citostatice.
EMILIA BALINT
164 --------------------------
Atlas de oncocitomorfologie
"
Fig. 1
Fig.
2
165
99~
lNITv'B 1117IVV3
'n~S370NIIW 31170~1N
Atlas de oncocitomorfologie
Fig.
Fig.
6
167
--------------------------
89~
Atlas de oncocitomorfologie
Fig.
Fig. 10
169
--------------------------
.LN/7'v'B
V17IVV3 'n:JS370NVI/V
OL~
3V70:J1N
Atlas de oncocitomorfologie
Fig. 13
.,
:\Ii-:g
...
~~
.. ~
,.,..,.
. ."".,. t- " .
..
,.
::to
,"~
r
Fig. 14
171
--------------------------
J.N17VB V17IW3
GL~
'n~S:nONVW3V70~1N
Atlas de oncocitomorfologie
Fig. 17
Fig. 18
--------------------------
173
--------------------------
vL~
3117001N
Atlas de oncocitomorfologie
Fig.
21
Fig.
22
--------------------------
9L~
HEMANGIOSARCOMA
HEMANGIOSARCOMUL
In oncologia animalelor de companie
aceasta
forma
este
foarte
rara,
reprezentand
malignizarea
teritoriului
vascular, care poate avea loc Tn orice
surpriza de necropsie.
Hemangiosarcoma
Hemangiosarcomul
Examenul citomorfologic
Fig. 1-12: Proliferarea
maligna a
tesutului vascular se vizualizeaza pentru
specialist sub forma unui melanj celular
alcatuit din:
- celule musculare
de tip vascular
(miocite) malignizate
(fig. 1-3);
- celule endoteliale malignizate (fig.
4-10);
- celule adventiciale malignizate (fig.
11-12);
Miocitele vasculare tumorizate (fig.
1-3) sunt celule ovoidale de 20-25 1-1,
avand nucleul situat central. Nucleul este
tachicrom,
nucleolii
sunt neevidentiati.
, ,
endoteliale
proliferate
----------------~----------
Cytomorphological test
Fig 1-12 Malignant proliferation of the
vascular tissue appears to the specialist
under the form of a cellular mixture made
up of:
- malignized
muscular cells of a
vascular type (miocites) (fig. 1-3)
- malignized endothelial cells (fig.
4-10)
- malignized adventicial cells (fig.
11-12)
Tumorized vascular myocytes (fig.
1-3) are ovoid cells of 20-25
1-1,
whose
177
NiCOLAE
noase
de
talie
mare,
peste
MANOLESCU,
30
Il.
178 --------------------------
EMILIA BALINT
Atlas de oncocitomorfologie
Fig. 1
Fig.
2
179
~~-~~---~-----------------
lNl7l1B
1117/w3 'n:JS370NIIW
08~
31170:J1N
Atlas de oncocitomorfologie
Fig.
Fig.
--------~-~---------~--~--181
-------------------------GB~
Atlas de oncocitomorfologie
Fig.
Fig. 10
--------------------------183
--------------------------
vB~
3'r:f700IN
Atlas de oncocitomorfologie
Fig. 13
Fig. 14
--------------------------185
--------------------------
9B~
iCA~ITQLllt.-15..LCI:tAeIER~t5
OSTEOSARCOAME
In lumea animala tumorile maligne
osoase au 0 inalta frecventa fiind c1asate
aproape In toate datele statistice epidemiologice In primele locuri. In cazuistica
noastra frecventa acestor neoplazii este
foarte ridicata.
Diagnosticul
acestor
forme tumorale beneficiaza de 0 serie de
particularitati comparativ cu alte localizari
ale neoplaziilor.
---------------------------187
OSTEOSARCOMA
In the world of animal, the malignant
tumors of the bone have a high rate of
frequency, being classified almost in all
epidemiological statistics in top positions.
In practice, the frequency of these
neoplasias is of course very high. If
compared to other locations of this
disease the diagnosis for those forms of
cancer
benefits
from a series
of
particularities.
The
cytomorphological
aspect.
NiCOLAE
MANOLESCU,
colorat
cu
rari
nucleoli,
pe
EMILIA BALINT
Atlas de oncocitomorfologie
--------------------------189
plasmatic
vacuoles
and many
hydroxypatite
inclusions.
An
important feature, revealed during
the cytologic examination, is the
identification of many osteoblastic
tumoral cells of some cytoplasmatic
shorter or longer extensions;
- Osteoclastic osteosarcoma (fig.
7-15). This giant cellular form is
made up of different types of
extremely anaplastic cells, with
frequent mitoses and high abnormalities.
Within this tumoral
variety we identify three types of
proliferated cells, as follows:
1. the tumoral quasi classic osteoblast, previously described, with
only one observation that the
cytoplasm is highly basophilic and
mostly devoid of hydroxyapatite
inclusions;
2. the atypical tumoral osteblast
which is either a relatively roundoval cell or a fusiform one with a
small thick extension, having an
extremely basophilic cytoplasm
with multiple
vacuoles
and
without hydroxyapatite crystals.
An important feature is the
existence of a high number of bior tri- nucleus cells. The nuclei of
these cells contain multiple and
atypical nucleoli.
3. the tumoral osteoclast is a very
large size (over 70 Il), giant,
multi-nucleus cell with a variable
number of nuclei, from 4-30.
Nuclei have a high level of
abnormality with the presence of
multiple
giant nucleoli.
The
NiCOLAE
70
MANOLESCU,
EMILIA BALINT
cytoplasm
is basophilic,
wide,
cu
un numar variabil de nuclei, intre
de
de
atipism
cu
prezenta
(fig .16-
4.
Osteochondrosarcoma
16-24).
This
highly
malignant
of classical
(os),
tumoral chondrocytes
giant
described
larga bazofila
multinucleara
~i 0
de
190 --------------------------
(fig.
tumoral
(cdrbl).
(cdr) and
chondroblasts
Because
tumoral
classical
the classical
osteocyte
has
above,
describe
only
chondral cells.
the
been
we
will
tumoral
The
nucleus
with
is normochrom,
(30-40
basophilic
tumoral
are large-size
Il)
with a highly
cytoplasm
and
multinuclear
structure usually
blossomed .. The nuclei allow to
distinguish
the presence
nucleolar structures.
of
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
2
191
--------------------------
IN/Tv'g
'v'17/W3 'n;JS370N'v'/IV
G6~
3'v'70;J1N
Atlas de oncocitomorfologie
Fig.
Fig.
---------~----------------193
--------------------------
v6~
8 "61::1
3'tf70:J1N
Atlas de oncocitomorfologie
Fig.
Fig. 10
--------------------------
195
96~
Atlas de oncocitomorfologie
Fig. 13
Fig. 14
--------------------------197
--------------------------
86~
..
iN/We
Atlas de oncocitomorfologie
Fig. 17
"
Fig. 18
--------------------------
199
--------------------------
oo~
3'v'70:J1N
Atlas de oncocitomorfologie
Fig.
21
Fig. 22
--------------------------
201
--------------------------
GOG
.-
..
.~'W'
..
~.L
//
CA~IIOLULJ.6_LCHA~T.EB~1
SINOVIOMUL MALIGN
MALIGNANT SYNOVIOMA
This form of expression of malignant
are 0 incidenta
redusa
animalele
la
Localizarea
de
companie.
frequency
also
quite
reduced
pe
the
baza
zonele
unde
se
examenului
anatomo-clinic,
radiologice
9i pe examenul
rezultatele
Examenul citomorfologic
In
fig.
1 se prezinta
anatomic
clinical,
radiological
citomorfologic al biopunctiei.
(fig. 1 - 5)
un caz de
~
::~.:.
conglomerat
din celule
1\'"
'\
has
toate
variabila
disease
putand
sau
este
destul de
Cytomorphologic
examination
(fig.
1 - 5)
In fig.
1 we
present
a case
of
of a cellular
monomorphic
\~:<
which
\\\
\-;\\\\ Nucleul
rotund
este
hipocrom
\'\\\\\ structura cromatiniana condensata.
cu
Nu
~\0.~se
disting
nucleolii.
Celulele
din
\\\Y::. conglomerat
au tendinta de a conflua.
\\;~\'.: In fig. 2 - 5 se prezinta aspectul de
takes
pseudoepithelial
cytoplasm
"'1"'\
\)\~,.:
sinoviom malign pseudofibrob/astic.
\;\\\\\Celulele sinoviale
Imbraca
aspectul
\\\\\lseudofibroblastic.
Celulele au lungi
~',\\\\\relungiri
cu
0
tenta
bazofila
neta. Nucleii
'. "~1'
(:\\\ynt alungiti, mariti In volum cu aceea9i
\\\\\------------------------;:\~:;\\
. ;~ \1'
fig.
we
present
the
appearance.
The
203
NtCOLAE
MANOLESCU,
EMILIA BALINT
exprima
prezenta
nucleolilor.
De
asemenea, In ambele forme diviziunile
basophilic
tendency.
The
nuclei
expressing
the
presence
of
204 --------------------------
are
is
with a low-
Atlas de oncocitomorfologie
Fig. 1
Fig.
--------------------------
2
205
--------------------------
90G
Atlas de oncocitomorfologie
Fig.
--------------------------
207
CA~ITOLUL 17 LCHA~IER_1Z
LlPOSARCOMUL
Este una dintre cele mai rare forme
citomorfologice
de cancer la specia
canina. EI face parte din categoria de
neoplazii maligne mezenchimale
ale
tesutului conjunctiv moale (sarcoame de
parti moi).
Proliferarea celulara (fig. 1 - 10) este
polimorfa In sensu I prezentei de celule
de la talie mica pfma la foarte mare (de la
20 /J. - 60 /J.). Aceste celule au un caracter
comun, acela al aspectului citoplasmei
care e alcatuita dupa forma unui veritabil
"fagure de miere". Citoplasma imprima ~i
aspectul general al celulei, ce poate fi
quasi-rotunda pana la fusiforma, cu una
sau mai multe prelungiri. Desigur ca
"ochiurile" din citoplasma sunt actualmente foarte goale datorita alcoolului
metilic care dizolva depozitele de lipide.
Nucleii celulari sunt plasati diferit, fie
central fie excentric,
cu cromatina
densificata
In diferite grade, iar In
structura cromatinei se identifica prezenta
unui nucleol. Caracteristic pentru aceasta
forma de cancer este prezenta In numar
mare a diviziunilor celulare amitotice (fig.
10). Un element constant este acela al
prezentei formelor atipice ~i gigante (fig.
LYPOSARCOMA
It
is
one
of
the
most
rare
5,6, 10).
--------------------------
209
--------------------------
O~G
3V70:J/N
--- ---
Atlas de oncocitomorfologie
---------------------------
Fig.
Fig.
4
211
---------------------------G~G
"
..
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
8
213
V~G
THE CANCER
OF THE MAMMARY GLAND
CANCERUL
GLANDEI MAMARE
Aceasta localizare a bolii canceroase
la can ide si
, la feline are 0 frecventa,
high frequency
presents
diagnostic,
de enunt
prognostic
cu implicatii
diagnosis,
changing
the prognostic
implication on its evolution, which has a
evolutiv
9i de
Tn zona tera-
series
very important
neoformatiunii
punction
Tn categoria
de tumora
in
of the
mammary
of
neo-formation
gland,
cytomorphological
followed
of the
by
the
examination, is meant
or malignant
slab
cells
diferentiate.
2.
Celule
diferentiate.
3. Celule
tumorale
tumorale
maligne
maligne
nedi-
ferentiate.
4. Celule tumorale maligne anaplazice.
2. poorly
tumoral cells
differentiated
malignant
NlCOLAE
MANOLESCU,
Adenocarcinom
mamar. - se
u90r fata de celelalte forme
pe seama prezentei celulelor
epiteliale cubice Tntr-o masa
cu infiltrat celular inflamator.
216 --------------------------
EMILIA BALINT
1) Cells
identified.
in
division
cannot
be
Atlas de oncocitomorfologie
redus de malignitate
l?i a celulelor
mioepiteliale (fig'. 10) care prezinta in
schimb un grad inalt de atipism celular.
In fig. 11 - 14 - se prezinta aspectele
speciale ale metastazei carcinomatoase
cu punct de plecare glanda mamara intrun limfonod, unde structura normala
limfocitara este invadata de una sau mai
multe celule carcinomatoase metastazante.
--------------------------
217
--------------------------
8~G
Atlas de oncocitomorfologie
Fig.
Fig. 4
--------------------------
219
--------------------------
.lNI7\1B
\l17/w3
'n:JS370N\I/N
0GG
3\170:J1N
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
8
221
--------------------------
GGG
lNl7lfB
1f17IVV3'n:JS370NlfW 3lf70:J1N
Atlas de oncocitomorfologie
Fig. 11
Fig. 12
--------------------------
223
--------------------------VGG
.LNI7't1B
'tI17/w3
'nOS370N'tIW
3't17001N
CAPITOLUL
19 I CHA
..
1.9
THE CANCER
OF THE URINARY BLADDER
CANCERUL
VEZICII URINARE
Tumorile maligne ale vezicii urinare
au Tn cazuistica noastra
0 frecventa
ridicata la animalele de companie (caine
9i pisica).
Forma
citomorfologica,
cea
mai
Our
experience
shows
that
the
investigation
for
properly
cytoscopic
examination,
followed
of
directed
biopsy for histopatological
investigations.
The cytomorphological test reveals in
our case the following aspects:
1) Non-invasive papillary transitional
--------------------------
225
NtCOLAE
MANOLESCU,
mono-
proliferate
este
este
redusa
~i se
de
talie
citoplasma
bazofilica,
prezinta 1-2 nucleoli;
226 --------------------------
mareiar
cu
nucleul
EMILIA BALINT
new cellular
aspects
(in
comparison with those known as a noninvasive form) still exist to a large extent
together with cytomorphological aspects
offered by transitional epithelial cells that
started to proliferate malignantly, but
stopped in the process.
3.
Atlas de oncocitomorfologie
- cromatina
nucleara
19i schimba
aspectul fie din lax-buretos initial fie de
compactizare,
Intr-o structuralizare
lamelar fasciculata;
- multe celule sunt bi- sau tri- nucleate;
- diviziunile celulare se realizeaza nu
numai prin mitoza ci 9i prin amitoza.
the
following
--------------------------
227
--------------------------
lNITtfB
'v'171/IV3'nOS370N'v'W
SGG
3'v'7001N
Atlas de oncocitomorfologie
Fig.
Fig. 4
--------------------------
229
--------------------------
lNI7l;/8
l;/17//tV3
08c
'nOS370Nl;/W 3l;/700/N
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
8
231
--------------------------
2:82:
3'tf708/N
Atlas de oncocitomorfologie
Fig. 11
Fig. 12
--------------------------
233
--------------------------
lNl7vB
PSG
Atlas de oncocitomorfologie
Fig. 15
...
Fig. 16
--------------------------
235
--------------------------
98G
8t 'fJ!d
J.NlTtf8
If171W3 'nOS370NIfW
31f7001N
Atlas de oncocitomorfologie
Fig. 19
--------------------------
237
SEMINOMUL TESTICULAR
Este 0 tumora extrem de maligna,
generand de timpuriu metastaze In
pulmon ~i ficat. Seminomul se realizeaza
pe
suportul
malignizarii
celulelor
spermatogonice din testicul. EI are 0
frecven1a sub medie pentru animalele de
companie. In urma examenului anatomoclinic se poate formula diagnosticul
pozitiv
~i cel diferen1ial pe baza
examenului citomorfologic
consecutiv
biopunc1iei testiculare.
Examenul citomorfologic (fig. 1 - 3)
Se vizualizeaza diferite plaje celulare
epiteliale formate din celule de talie mare
> 25 f.l. Aceste celule poliedrice pot avea
o citoplasma bazofila sau acidofila, relativ
larga ~i agranulata. Nucleul este rotund,
mare, avand cromatina reticulata sub
forma de bulgari. Nucleii lasa sa se
observe 1-2 nucleoli de talie relativ mica.
TESTICULAR SEMINOMA
It is an highly malignant tumor that
generates early metastases in lungs and
liver. The seminoma appears due to the
malignization of the spermatogonic cells
of the testicles. It has a below average
frequency for pets. Unlike the anatomoclinical test, the cytomorphological test
made after the testicular punction can
give diagnosis.
The cytomorphological test (fig.1 - 3)
Various cellular epithelial
ranges
consisting of large cells size(> 25 f.l) can
be seen. These polyedrical cells can
have a basophilic or acidophilic cytoplasm,
which is relatively large and granulated.
The nucleus is round, large, with
reticulate chromatin having the form of
lumps. The nuclei allow us to see 1-2
nucleoli of a relatively small size. Mitoses
are frequent atypical. -
--------------------------
239
--------------------------OVG
iN17VB
V17lw3 'nOS370NVVV
3V7001N
Atlas de oncocitomorfologie
Fig.
--------------------------
241
CA~IIOLU.Ll21J
CI:U\P-.TER 21
SERTOLIOMA
SERTOLIOMUL
Este 0 tumora a tesutului de sustinere
a Iiniei seminale a testiculului semimaligna, care metastazeaza ~i are 0
frecventa redusa la canide ~i feline .
Tumorile testiculare, de regula, sunt
surprize ale interventiei
chirurgicale
specifice orhiepididimectomiei practicate
In alte scopuri (castrare).
Dupa
sectionarea
longitudinala
(equatoriala) a testiculului, tumora se
pune u~or
chimatos.
In
evidenta
intraparen-
1 - 3)
Aspectul este destul de caracteristic, de
proliferare celulara monomorfa, cu celule
at~H rotunde cat ~i u~or ovoidale. Nucleii
mari, veziculari, au 0 cromatina fin
reticulata lasand sa se vada 1-2 nucleoli
de talie mica.
Celulele au 0 citoplasma redusa,
intens bazofila, confluenta, fara a se
putea
identifica
Iimitele
acestora.
Mitozele ~i atipiile celulare sunt rare, din
loc In loc apar celule razlete Leydig
(secretorii), acestea fiind de talie mica, cu
nucleul grosolan, pozitionat excentric
fara
nucleoli.
Citoplasma
domina
0
cantitativ In structura celulara,avand
tenta bazofila bine evidentiata. Alaturi de
aceste celule pot fi observate celulele
specifice liniei seminale.
--------------------------
243
--------------------------
VV~
3\f7001N
Atlas de oncocitomorfologie
Fig.
--------------------------
245
ADAMANTINOMA
ADAMANTINOMUL
Este 0 tumora maligna a tesutului
adamantin de la nivelul gingiilor 9i a
alveolelor dentare care are 0 incidenta
foarte rara la animalele de companie, dar
acest fapt nu trebuie sa-l faca pe
specialist sa 0 ignore prin lipsa de
cunoa9tere.
Celulele proliferate (fig. 1 - 3) sunt
individualizate
sau
conglomerate.
Acestea au 0 talie relativ mare > 25 f.l,
forma este rotund-ovalara cu 0 larga
citoplasma intens bazofila. Nucleul este
de talie mare situat excentric. Cromatina
este
intens
cromofila,
lasand
sa se
--------------------------
It is a malignant
tumor of the
adamantin tissue of the gums and of the
dental alveoli, with very rare incidence in
pets, a fact which should not make the
specialist ignore it because of the lack of
knowledge.
The proliferated cells (fig.1 - 3) are
either individual or conglomerates. They
have a relatively big size> 25 f.l, the form
is round-oval with a large intensely
basophilic cytoplasm. The nucleus is big
situated eccentrically. The chromatin is
intensely chromophilic and dense and
reveals a gigantic nucleolus. The tumor
presents a high degree of abnormality
and even giant cells. The mitoses are
very rare.
247
--------------------------
Bt~
l "6!d
Atlas de oncocitomorfologie
Fig.
--------------------------
249
23
CA~ITciEIiE~31CH
EPITHELIAL MALIGNANT
TUMOURS
vom prezenta
Iiteratura
incidence
specialitate
relativ
indica
1.
Carcinomul
bazocelular
de
in
our
medical
practice,
scrub,
or
during
the
celulele
bazale
epidermice,
avand
un
with
anizocitoza
~i oligocromie
nucleara. Se
an
obvious
olygochromia.
degree
of
cellular
and nuclear
high
degree
of
random
cellular
proliferation, with an obvious blastisation,
without divisions or anaplastic features.
morfocitologice
cele mai frecvente la
canide In cazul cancerului tegumentar.
makes
spino-celular)
squamos,
carcinom
carcinom bazocelular.
---------------------------
nediferential
~i
up the
epidermal
neoplasm's
251
NiCOLAE
MANOLESCU,
de
4. Adenocarcinomul
vegetant al cavibitilor nazale (fig. 12 - 16) - este
cea mai frecventa forma de cancer din
EMILIA BALINT
position.
The chromatin
has
aceasta
categorie.
Diagnosticul
s-a
obtinut In urma lavajului cavitatilor
nazale, caredupa centrifugare, s-a etalat
l?i colorarat panoptic concentratul celular
obtinut.
252 --------------------------
The appearance
is classical
prolif-
Atlas de oncocitomorfologie
6. Adenocarcinomul vegetant de
prostata (fig. 20 - 24) - are aspect de
~. proliferare celulara epiteliala glandulara,
specifica structurii tesutului prostatic.
Celulele proliferate,
fie ca au fost
surprinse solitar, fie In
microplacard,
prezinta un avansat aspect de anaplazie
celulara, cu atipism 9i gigantism celular.
Raportul nucleo-citoplasmatic _este In
favoarea nucleului, acesta prezentand
nucleoli giganti.
--------------------------
253
--------------------------
PSG
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--------------------------
Fig.
Fig.
255
--------------------------
9Sc
IN/Ttf8
Atlas de oncocitomorfologie
---------------------------
Fig.
Fig.
8
257
--------------------------
BS~
'6!d
Atlas de oncocitomorfologie
Fig. 11
Fig. 12
25
--------------------------
lNl7lfB
Oge
Atlas de oncocitomorfologie
,.
,.
Fig. 15
Fig. 16
--------------------------
261
--------------------------
G9(;
3't1708/N
Atlas de oncocitomorfologie
Fig. 19
Fig. 20
--------------------------
263
--------------------------
iNI7lf8
P9c
1f17IW3'nOS370NlfW 3lf700/N
Atlas de oncocitomorfologie
--------------------------
Fig.
23
Fig.
24
265
CAPIIOLUL
24 I CHAPTER 24
METASTAZE
C,ARCINOMATOASE
iN CAVITATILE
PERICARDICA,~
~
PLEURALA SI
, PERITONEALA
CARCINOMA METASTASES
IN THE PERICARDIAL,
PLEURAL AND PERITONEAL
CAVITY
Pentru
obtinerea
diagnosticului
citomorfologic
de metastaza carcinomatoasa, (fig. 1 - 11) este necesara
obtinerea lichidului prezent Intr-una din
Dupa
se va
bine
individualizate, fie
cu
individualized
forms easy, with the
metastasis of the malignant lymphoma,
or with any other form of malignant tumor
which can give metastasis in this area.
In some cases we cannot show the
visceral topography
that generates
the
iNI7\fB
89~
\f17//IV3'nOS370N\fVV 3\f7001N
Atlas de oncocitomorfologie
Fig.
Fig. 4
--------------------------
269
--------------------------
..
on~
Atlas de oncocitomorfologie
Fig. 7
Fig.
--------------------------
8
271
--------------------------
IN/Ttfg
GLG
Atlas de oncocitomorfologie
Fig.
--------------------------
11
273
TUMORILE MEZOTELIALE
MALIGNE SI
, METASTAZELE
SARCOMATOASE
iN CAVITATILE
, (PERICARDICA,
~
PLEURALA
~I PERITONEALA)
A. Tumorile
mezoteliale
maligne
ale
celulelor
seroaselor care
MALIGNANT MESOTHELIAL
TUMOURS AND THE
SARCOMATOUS METASTASIS
IN THE PREFORMED CAVITIES
(PERICARDIAL, PLEURAL
AND PERITONEAL)
A. Malignant mesothelial tumours
In this chapter we will present the
situation of malignant proliferations of
mesothelial cells that pad the three major
cavities
(serous
membranes),
the
pericardial, the pleural and the abdominal
(peritoneal) ones. In the literature of
specialty the incidence of these forms of
cancer is very rare, but in our experience
we have encountered this form rather
frequently. Irrespective of its cell form, the
mesothelium
has a high degree of
malignancy with a rapidly
Whatever of the cytologic
evolution.
form the
internationala.
Astfel vom descrie:
"
They are:
- The epithelial-like
mesothelium
NiCOLAE
MANOLESCU,
este amphofila,
membrana
lungi la
EMILIA BALINT
The nucleo-cytoplasmatic
ration
is
. slightly in favor of the nucleus. This one
present$ multiple nucleoli, with extremely
different volumes. Mitoses are frequent.
The cytoplasm is amphophile, the cell
membrane
revealing
a crown
of
microvillus and desmosomial structures.
The lymphoid-like mesothelium (fig.
4 - 10). This cellular form has the
sarcomatous
aspect
of neoplastic
prolifera~ion, simulating a malignant non
Hodgkin's
lymphoma.
The cytologic
features can be found in the following
characteristics:
- Monomorph massive proliferation with
discrete cell anaplasia;
- The nucleo-cytoplasmatic ratio definitely
favors the nucleus;
- Both the nucleus and the cytoplasm
are highly hyperchrome,
and the
cytoplasm is highly basophile;
- The cytoplasm emits a great quantity of
microvillar frequent and long structures
at cell membrane level;
- High frequency of cell divisions by
amitosis (fig. 4, 5, 7, 8, 9, 10).
The histiocytic-like mesothelium
(fig. 1 - 17). It is another cytological form
of expression
of the mesothelium
simulating a true histiocytic sarcoma.
Absolutely
all the attributes
of the
proliferation histio-macrophag
line are
present with this form of mesothelium.
The specific features of the histiomacrophag line can be synthesized as
follows:
- The nucleo-cytoplasmatic
nucleus;
favors the
Atlas de oncocitomorfofogfe
---------------------------
preformed
cavities
(peritoneal,
pericardial and pleural) (fig. 18 - 22)
In fig. (18 - 19) we can obseNe a
pleural metastasis of a malignant non
Hodgkin's B-cell lymphoma of the
Waldenstr6m type where there are
multiple lymphocyte adult cells together
with lymphoid "blasts" (prolymphoblasts
and Iymphoblasts). Also appear together
adult plasmocyte structures and atypical
plasmocytes (fig. 19).
In fig. (20 ~ 22) there are images of a
plasmocytum metastasis in the pericardial
cavity. The adult plasmocytes are equal
to the atypical plasmocytes (modified
because of the exudates from the
serous).
In fig. (23 - 27) there are images of
the pericardopleural metastasis of an
acute lymphoblastic leukemia.
277
--------------------------
iN/Tv'S
IfI7/VV3 'nOS370NIfVV
8LG
31f7001N
Atlas de oncocitomorfologie
Fig.
Fig. 4
--------------------------
279
--------------------------
OBG
Atlas de oncocitomorfologie
--------------------------
Fig.
Fig.
8
281
--------------------------
GBG
Atlas de oncocitomorfologie
Fig. 11
Fig. 12
283
------~------'--------------------'------.....
--------------------------
v8~
Atlas de oncocitomorfologie
Fig. 15
Fig. 16
--------------------------
285
--------------------------
geG
Atlas de oncocitomorfologie
Fig. 19
Fig.
--------------------------
20
287
--------------------------
BBG
3't170~1N
Atlas de oncocitomorfologie
Fig.
Fig.
--------------------------
23
24
289
--------------------------
.LN1Ttf8 1117IJ1V3
'n~S370NIIW
06G
31170~IN
Atlas de oncocitomorfologie
Fig.
--------------------------
27
291
CAPIJQL!JL26~LCJ:lA~TER26
GANGLIONEUROMUL
TESUTULUINERVOS
,
VEGETATIV
Este 0 tumorc'i rara la animalele de
.I
THE GANGLIONEUROMA
OF THE VEGETATIVE NERVOUS
TISSUE
The tumour
has semi-malignant
characters, consisting of several types of
nervous
and neurofibril
cells that
overlapping
in various
plans. The
majority of cells are Schwann and
sympathetic nervous cells; some of them
--------------------------
It
have amyelinic
prolongations,
while
others do not (fig. 1 - 7). Some cells have
a basophilic cytoplasm, while others have
an acidophilic cytoplasm. The nucleus is
smale, peripherical located chromatic
densified. Some reveal the presence of
one or two nucleoli. The cytoplasm of the
neurons is clearly crossed by a network
of filaments which are of a nervous origin.
293
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iN/Tv'S
t6c
Atlas de oncocitomorfologie
Fig.
Fig. 4
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295
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.IN/TtfB
96c
Atlas de oncocitomorfologie
Fig.
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297
TUMORA STICKER
Este 0 tumora relativ frecventa pentru
specia canina, de Inalta malignitate
transmisibila
pe cale sexuala.
In
momentul de fat a nu este precizata
originea acestei tumori.
Tumora se identifica u~or anatomoclinic, iar diagnosticul
citomorfologic
pozitiv se precizeaza In urma biopunctiei.
Fig. 1 - 4 ne ofera aspectul general al
tumorii cu Inalt grad de monomorfie, cu
raportul nucleo-citoplasmatic In favoarea
nucleului. Celulele sunt de talie medie,
circa 20-23 fl cu nucleul perfect rotund,
cromatina este dispusa In bulgari fini ~i In
ansamblu este areolata. In nucleu exista
1-2 structuri nucleolare fine. Citoplasma
redusa este slab bazofila, nu de putine
ori aceasta apare amfophila. Tumora are
un numar considerabil
de celule In
diviziune
mitotica.
anaplaziei, tumora
malignitate.
--------------------------
Cu
este
toata
lipsa
de 0 Inalta
STICKER'S TUMOUR
It is a relatively common
tumor in
canine
species,
of high malignity
transmissible trans-sexually. The origin of
this tumor it's not specified in this
moment.
The tumor is easily identifiable from
an anatomo-clinical point of view, the
cytomorphological
diagnosis
through
biopunction gives the positive diagnosis.
Fig. 1-4 shows us the general
appearance of the tumor with a high
degree of monomorphia, with the nucleocytoplasmatic
ratio in favor of the
nucleus. The cells are medium, about 2023 fl, with a perfectly round nucleus, the
chromatin is disposed in fine lumps and it
is areolate. There are 1-2 nucleolar fine
structures. The reduced cytoplasm is
slightly basophilic, and or autophilic. The
tumor has a considerable number of cells
in mitotic division. Despite the lack of
anaplasia, the tumor is highly malignant.
299
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00
3'r170:J1N
Atlas de oncocitomorfologie
Fig.
Fig. 4
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301
ISBN 978-973-1983-26-4
91178973111983264