Günay ALÇIGIR, Tuncer KUTLU, MEHMET ERAY ALÇIĞIR

İki Kedide Karşılaşılan Subakut Lobüller Kalsifiye Pannikülitisin Patomorfolojik ve İmmunohistokimyasal Bulguları

Sunulan bu iki olguda kedilerdeki kalsifiye pannikülitisin karakteristik özelliklerinin açığa çıkarılması amaçlandı. Sekiz aylık ve bir yaştaki iki erkek, tekir kedide lumbosakral bölgeden alınan biyopsiler değerlendirildi. Makroskopik olarak çapları 1.5-2.5 arasında değişen, sert kıvamda beyazımsı kitleler mevcuttu. Histopatolojik incelemede deri altı yağ dokusundaki lobüllerde dejeneratif ve nekrotik lipositler gözlendi. Bazı alanlarda lenfosit, makrofaj ve nötrofil lökosit infiltrasyonları ile bağ doku proliferasyonu vardı. Ayrıca dejenere-nekrotik yağ lobüllerinin merkezinde geniş kalsifiye alanlar da gözlendi. Alizarin Red S boyaması ile kalsifiye alanların, Masson'un trikrom boyamasıylada bağ doku proliferasyonunun ayrımını yapıldı. ABC-P yönteminde, CD3 lenfosit ve lenfoblastlarla hafif reaksiyonlar verdi. Vimentin nekrotik alanlarda ve septumda yer alan bağ doku proliferasyonlarıyla orta şiddette reaksiyon verdi. A1AC makrofajların sitoplazmasında ve perifer nekrotik alanlarda reaksiyon verdi. Sonuç olarak bu türden vakalar veteriner patolojide bildirilmemiştir. Her iki kedide de gelişen lezyonların patogenetik mekanizmasında böbrek yetmezliği ya da böbrek kökenli bir sendrom olabileceği düşünülmektedir. Ayrıca, serin proteinaz inhibitörü olan A1AT ekspresyonu olmamasına karşın başka bir serin proteinaz inhibitörü olan A1AC ekspresyonlarının bu tür olgularda rolü olduğuna inanılmaktadır

Pathomorphological and Immunohistochemical Findings of Subacute Lobullary Calcifying Panniculitis in Two Cats

This report aimed to reveal the characteristics of calcifying panniculitis in two cats. Two biopsies taken from the lumbosacral region of an 8-month old and a 1-year old, male, mixed breed cats were evaluated. Macroscopically, there were masses of different sizes varying from 1.5 to 2.5 cm in diameter. The masses had a generally firmness and were grayish-white in colour. Histopathology revealed necrotic and degenerative lipocytes in lobules of subcutaenous fat tissue. In some areas, there were lymphocyte, macrophage and neutrophil leukocytes infiltrations and connective tissue proliferation. There were also large calcifying areas at the centre of degenerated-necrotic fat lobules. Alizarin Red S detected the calcifying areas and Masson’s trichrome differentiated connective tissue proliferation. In ABC-P, CD3 slightly reacted with lymphocytes and lymphoblasts. Vimentin moderately reacted with connective tissue proliferation at the periphery of the necrotic areas and the septum. A1AC reacted in the cytoplasm of macrophages and peripheral necrotic areas. No reaction was determined with A1AT. In conclusion, such cases have not been documented in veterinary pathology. It is believed that the two cats possibly had a renal deficiency problem or nephrotic syndrome in the pathogenetic mechanism. It was also considered that A1AC (serine proteinase inhibitor) expressions could have a role in such cases despite there being no A1AT (another serine proteinase inhibitor) expression

PDF

___

1. Anonymous: “panniculitis” at Dorland’s Medical Dictionary. http:// web.archive.org/web/20090521170644/http://www.mercksource. com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/ dorlands/dorland/six/000077803.htm; Acessed: 20.03.2015.
2. Ginn PE, Mansell JEKL, Rakich PM: The skin and appendages. In, Maxie MG (Ed): Pathology of Domestic Animals. 5th edn., 745-746. Elsevier, Philadelphia, PA, 2007.
3. DermNet NZ: Panniculitis Online access: http://dermnetnz.org/ dermal-infiltrative/panniculitis.html, Accessed: 20. 03.2015. 4. Buchet S, Blanc D, Humbert P, Derancourt C, Arbey-Gindre F, Atallah L, Agache P: Calcifying panniculitis. Ann Dermatol Venereol, 119 (9): 659-666, 1992.
5. Campanelli A, Kaya G, Masouyé I, Borradori L: Calcifying panniculitis following subcutaneous injections of nadroparin-calcium in a patient with osteomalacia. Br J Dermatol, 153 (3): 657-660, 2005. DOI: 10.1111/j.1365- 2133.2005.06748.x
6. Elamin EM, McDonald AB: Calcifying panniculitis with renal failure: A new management approach. Dermatology, 192 (2): 156-159, 1996. DOI: 10.1159/000246347
7. Laurent R, Thiery F, Saint-Hillier Y, Blanc D, Agache P: Calcifying panniculitis associated with renal insufficiency: A tissue calciphylaxis syndrome. Ann Dermatol Venereol, 114 (9): 1073-1081, 1987.
8. Lugo-Somolinos A, Sánchez JL, Méndez-Coll J, Joglar F: Calcifying panniculitis associated with polycystic kidney disease and chronic renal failure. J Am Acad Dermatol, 22 (5 Pt 1): 743-747, 1990. DOI: 10.1016/0190- 9622(90)70101-M
9. Koch Nogueira PC, Giuliani C, Rey N, Saïd MH, Cochat P: Calcifying panniculitis in a child after renal transplantation. Nephrol Dial Transplant, 12 (1): 216-218, 1997.
10. Richens G, Piepkorn MW, Krueger GG: Calcifying panniculitis associated with renal failure: A case of Selye’s calciphylaxis in man. J Am Acad Dermatol, 6 (4): 537-539, 1982. DOI: 10.1016/S0190-9622 (82)70046-5
11. Poelman SM, Sasseville D: A Practical Approach to Panniculitis. Dearmatology Rounds. Division of Dermatology, Mc Gill University Health Center, Quebec, Canada, 6 (5); 1-6, 2007.
12. Walsh JS, Fairley JA: Calcifying disorders of the skin. J Am Acad Dermatol, 33, 693-706, 1995. DOI: 10.1016/0190-9622(95)91803-5
13. Rajpara A, Erickson C, Driscoll M: Review of alpha-1-antitrypsin deficiency associated panniculitis. Open Dermatol J, 4, 97-100, 2010.
14. Bleumink E, Klokke HA: Protease-inhibitor deficiencies in a patient with Weber-Christian panniculitis. Arch Dermatol, 120 (7): 936-940, 1984. DOI: 10.1001/archderm.1984.01650430122023
15. Stoller JK, Aboussouan LS: Alpha-1 antitrypsin deficiency. Lancet, 365, 2225-2236, 2005. DOI: 10.1016/S0140-6736(05)66781-5
16. Travis J, Salvesen GS: Human plasma proteinase inhibitors. Am Rev Biochem, 52, 655-709, 1983. DOI: 10.1146/annurev.bi.52.070183.003255