| Abstract | Hemangiosarkom (HSA) je maligna neoplazma karakterizirana agresivnim rastom,
ranim metastaziranjem i nepovoljnom prognozom. Tumor se najčešće javlja na
slezeni i srcu kod starijih pasa pasmina njemački ovčar, zlatni retriver i labrador
retriver.
Etiološko i stanično porijeklo hemangiosarkoma još nije u potpunosti razjašnjeno.
Prema istraživanjima, HSA potječe od multipotentnih progenitorskih stanica
hematopoetskog podrijetla koje se mogu diferencirati tri različita molekularna podtipa
HSA. Za rast i razvoj tumora, bitan je i odnos malignih stanica i njihovog okoliša.
Psi oboljeli od hemangiosarkoma često ne pokazuju kliničke znakove, a kad se
klinički znakovi pojave vezani su uz koagulopatiju, srčanu aritmiju ili spontanu rupturu
HSA.
HSA se manifestiraju kao pojedinačne, multifokalne ili mješovite crveno-ljubičaste
tvorbe. Na prerezu nalazimo nježno, hemoragično neoplastično tkivo dok su solidna
područja čvrsta i bijele boje. Histološki tipovi hemangiosarkoma su kapilarni tip,
kavernozni tip i solidni tip. Stanice HSA su često vretenog oblika sa okruglom,
ovalnom ili pleomorfnom jezgrom, istaknutom staničnom jezgricom i citoplazmom
koja je obilna, bazofilna i vakuolizirana.
Nakon postavljene sumnje dijagnoza se postavlja pomoću hematološke i biokemijske
pretrage krvi, koagulacijskog test krvi, radiografije i ultrazvuka toraksa i abdomena.
Dijagnoza se potvrđuje histološkom i imunohistološkom pretragom.
Prvi izbor u liječenju hemangiosarkoma je primjena kemoterapije koja se bazira na
doksorubricinu, uz ili bez dodatka vinkristina i ciklofosfamida. Moguće je i
operacijski, ekszicijom, ukloniti tumor ali sama operacija, bez primjene kemoterapije,
ne omogućuje preživljavanje pasa dulje od 2-3 mjeseca dok je primjena
kemoterapeutika dovela do preživljavanja od 5-6 mjeseci. Uz operaciju i
kemoterapiju, u posljedenje vrijeme se razvijaju nove metode liječenja a to su:
inhalacijska kemoterapija, aplikacija sterilni stabiliziranih liposoma i intraabdominalna
aplikacija kemoterapeutika. Preporučuje se i promjena prehrane kod pasa oboljelih
od HSA. |
| Abstract (english) | Hemangiosarcoma (HSA) is malignant neoplasm characterized by aggressive
growth, early metastasis and unfavorable prognosis. The tumor most commonly
occurs in the spleen and heart in older dogs, most commonly affecting breeds like
German Shepherd Dog, Golden Retriever and Labrador Retriever.
Etiology and cellular origin of hemangiosarcoma has not yet been fully clarified.
According to some research, HSA originates from multipotent progenitor cells of
hematopoietic origin that can differentiate into three different molecular subtypes of
HSA. For the tumor growth and development, the relationship between malignant
cells and their environment is also essential.
Dogs with hemangiosarcoma often show no clinical signs, and when clinical signs
appear, they are associated with coagulopathy, cardiac arrhythmia or spontaneous
rupture of HSA.
Tumors can be found as single, multifocal or mixed red-purple nodules. Cross
section of the tumor shows delicate, hemorrhagic neoplastic tissue while the solid
areas are firm and white in color. Histologic types of hemangiosarcoma are capillary
type, cavernous type and solid type. HSA cells are often spindle shaped with a
round, oval or pleomorphic nucleus, prominent cell nucleolus and cytoplasm that is
abundant, basophilic and vacuolated.
Haematological and biochemical blood tests, coagulation blood test, radiography and
ultrasound of thorax and abdomen are useful in diagnosis of the HSA, but the final
diagnosis has to be confirmed by histological and immunohistological examination.
The first choice in treating hemangiosarcoma is to use doxorubricin-based
chemotherapy, with or without the addition of vincristine and cyclophosphamide.
It is possible to remove the tumor surgically by excision, but with surgery itself,
without the use of chemotherapy, the median survival time of dogs is no longer than
2-3 months, while with the use of chemotherapy the median survival time is 5-6
months.
In addition to surgery and chemotherapy, new methods of treatment have recently
been developed: inhalation chemotherapy, the administration of sterile stabilized
liposomes, and the intra-abdominal chemotherapy application. Changing the diet in
dogs with HSA is also recommended. |
