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En una canal de vaca, de raça creuada, de 13 anys d'edat, s'observen múltiples lesions nodulars endurides, de mida variable al pulmó, pleura parietal i visceral i també al peritoneu. Els nòduls limfàtics toràcics estan augmentats de mida i, al tall, presenten lesions d'aspecte granulomatós. (EV)
Múltiples nòduls groguencs endurits a la pleura parietal.
Detalls dels nòduls pleurals, algun d'ell coalescents i amb adherències fibroses a la pleura visceral. Observis que també n'hi a l'altre costat del diafragma al peritoneu (meitat superior de la imatge).
Detall de la lesió pulmonar, a l'interior del parènquima també es podia palpar nòduls.
Imatge de la lesió al seccionar el nòdul limfàtic mediastínic caudal.
Quin és el teu diagnòstic? (94)
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La histopatologia va confirmar que es tractava de lesions compatibles amb tuberculosi. Lesions cròniques multifocals a pulmó i pleura, però també amb disseminació hematògena/limfàtica cap a peritoneu. La PCR va confirmar la presència de DNA de Mycobacterium tuberculosis complex (MTC). Es desconeix si es tracta d'un animal anèrgic (negatiu a prova de pell), d'una infecció recent amb generalització precoç o d'un animal que no ha estat correctament diagnosticat. En qualsevol cas es reforça la rellevància de mantenir alerta els mecanismes de vigilància passiva de TB a escorxador i la necessitat d'un estudi laboratorial de qualsevol lesió compatible ja que, en aquest cas, en tractar-se d'un animal molt gran, sotmès a vigilància anual, moltes apostes anaven a favor d'una neoplàsia com el mesotelioma.
Your answers are highlighted below.
Question 1
Quin és el teu diagnòstic?
A
Te pinta de tuberculosi crònica, que ha començat a generalitzar.
B
És una vaca de 13 anys: Mesotelioma segur!
C
Vaca vella! És neoplàsia fijo, però un carcinoma de cèl·lules escamoses.
D
Poliserosistis bacteriana cronificada, és clar que si fós TB l'haurien diagnosticat abans.
E
Granulomes parasitaris (Echinococcus granulosus).
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On vas a parar, si estava cantat que era tuberculosi!
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