{"id":26273,"date":"2024-03-22T16:20:40","date_gmt":"2024-03-22T15:20:40","guid":{"rendered":"https:\/\/www.mylav.net\/?p=26273"},"modified":"2024-09-11T11:39:53","modified_gmt":"2024-09-11T09:39:53","slug":"cytologie-des-masses-gastro-intestinales-quand-elle-est-utile-et-quand-elle-lest-moins","status":"publish","type":"post","link":"https:\/\/www.mylav.net\/fr\/cytologie\/cytologie-des-masses-gastro-intestinales-quand-elle-est-utile-et-quand-elle-lest-moins\/","title":{"rendered":"Cytologie des masses gastro-intestinales: quand elle est utile et quand elle l&rsquo;est moins"},"content":{"rendered":"<p>Les masses gastro-intestinales chez les chiens et les chats sont souvent abord\u00e9es dans un premier temps par imagerie et pr\u00e9l\u00e8vement cytologique par aspiration \u00e0 l&rsquo;aiguille fine (FNA). Mais quelle est la pr\u00e9cision de la cytologie dans ces situations?<\/p>\n<p>Nous devons tout d&rsquo;abord souligner que l&rsquo;utilit\u00e9 du pr\u00e9l\u00e8vement cytologique pour obtenir un \u00e9chantillon ad\u00e9quat en vue d&rsquo;une \u00e9valuation cytologique pr\u00e9cise et fiable d\u00e9pend principalement de deux facteurs (Turner et al 2021):<\/p>\n<p>1) <strong>L&rsquo;\u00e9paisseur de la l\u00e9sion<\/strong>: les l\u00e9sions d&rsquo;une \u00e9paisseur sup\u00e9rieure \u00e0 20 mm sont plus susceptibles de conduire \u00e0 des \u00e9chantillons cytologiquement ad\u00e9quats; \u00e0 l&rsquo;inverse, une cytologie non diagnostique est beaucoup plus susceptible d&rsquo;\u00eatre obtenue. Ce r\u00e9sultat est facile \u00e0 deviner et \u00e0 interpr\u00e9ter, car plus la l\u00e9sion est \u00e9paisse, plus il sera facile pour l&rsquo;op\u00e9rateur d&rsquo;introduire l&rsquo;aiguille dans la partie significative et d&rsquo;obtenir un \u00e9chantillon suffisamment cellulaire.<\/p>\n<p> 2) <strong>Nombre d&rsquo;\u00e9chantillons obtenus par FNA \u00e9choguid\u00e9e<\/strong>: comme on peut le deviner, un plus grand nombre d&rsquo;\u00e9chantillons et de frottis cytologiques est plus susceptible de conduire \u00e0 des \u00e9chantillons ad\u00e9quats pour l&rsquo;\u00e9valuation microscopique. Un nombre d&rsquo;\u00e9chantillons par FNA de 3-4 ou plus est consid\u00e9r\u00e9 comme n\u00e9cessaire pour avoir une bonne chance d&rsquo;obtenir un \u00e9chantillon diagnostique.<\/p>\n<p>Un autre aspect \u00e0 prendre en compte pour une pr\u00e9cision diagnostique satisfaisante est le type de processus pathologique en cours (Bonfanti et al 2006). Dans les quelques \u00e9tudes publi\u00e9es, la pr\u00e9cision globale \u00e9tait en fait sup\u00e9rieure \u00e0 60-70 %, mais elle variait consid\u00e9rablement si l&rsquo;on consid\u00e9rait les types de pathologie gastro-ent\u00e9rique s\u00e9par\u00e9ment.<\/p>\n<p>Par exemple, pour les tumeurs \u00e0 cellules rondes (lymphome, mastocytome, etc.) et les tumeurs \u00e9pith\u00e9liales (carcinomes), la sensibilit\u00e9 de la cytologie et la concordance avec l&rsquo;examen histologique \u00e9taient excellentes\/bonnes.<\/p>\n<figure id=\"attachment_26287\" aria-describedby=\"caption-attachment-26287\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.mylav.net\/wp-content\/uploads\/2024\/03\/blog_Lymphome-a-lymphocytes-granuleux.jpg\" alt=\"Lymphome \u00e0 lymphocytes granuleux chez un chat\" width=\"900\" height=\"570\" class=\"size-full wp-image-26287\" \/><figcaption id=\"caption-attachment-26287\" class=\"wp-caption-text\">Figure 1. Lymphome \u00e0 lymphocytes granuleux chez un chat, avec phlogose neutrophile\/macrophage associ\u00e9e. Il s&rsquo;agit d&rsquo;une tumeur lympho\u00efde maligne \u00e0 cellules rondes fr\u00e9quente dans l&rsquo;intestin du chat.<\/figcaption><\/figure>\n<figure id=\"attachment_26281\" aria-describedby=\"caption-attachment-26281\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.mylav.net\/wp-content\/uploads\/2024\/03\/blog_Neoplasme-intestinal-a-cellules-rondes.jpg\" alt=\"N\u00e9oplasme intestinal \u00e0 cellules rondes d&#039;un chat\" width=\"900\" height=\"570\" class=\"size-full wp-image-26281\" \/><figcaption id=\"caption-attachment-26281\" class=\"wp-caption-text\">Figure 2. N\u00e9oplasme intestinal \u00e0 cellules rondes d&rsquo;un chat pouvant \u00eatre assimil\u00e9 \u00e0 un mastocytome mal granul\u00e9.<\/figcaption><\/figure>\n<p>En revanche, pour les n\u00e9oplasmes m\u00e9senchymateux, ces valeurs \u00e9taient nettement inf\u00e9rieures (par exemple, un l\u00e9iomyome, un l\u00e9iomyosarcome ou une tumeur stromale gastro-intestinale &#8211; GIST).<\/p>\n<figure id=\"attachment_26275\" aria-describedby=\"caption-attachment-26275\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.mylav.net\/wp-content\/uploads\/2024\/03\/blog_leiomyome-gastrique.jpg\" alt=\"l\u00e9iomyome gastrique chez un chien\" width=\"900\" height=\"570\" class=\"size-full wp-image-26275\" \/><figcaption id=\"caption-attachment-26275\" class=\"wp-caption-text\">Figure 3. l\u00e9iomyome gastrique chez un chien. Dans ces n\u00e9oplasmes tr\u00e8s compacts, il n&rsquo;est pas facile d&rsquo;obtenir une exfoliation cellulaire suffisante.<\/figcaption><\/figure>\n<p>L\u00e0 encore, il est facile de comprendre la raison de ces diff\u00e9rences: les n\u00e9oplasmes \u00e0 cellules rondes et \u00e9pith\u00e9liaux sont plus susceptibles de lib\u00e9rer du mat\u00e9riel cellulaire lorsqu&rsquo;ils sont \u00e9chantillonn\u00e9s (quelle que soit la technique d&rsquo;\u00e9chantillonnage), alors que les n\u00e9oplasmes m\u00e9senchymateux, \u00e9tant beaucoup plus compacts, sont beaucoup moins susceptibles de lib\u00e9rer suffisamment de mat\u00e9riel.<\/p>\n<div class=\"riferimenti\">\n<strong>Bibliographie<\/strong><\/p>\n<p>Bonfanti et al (2006) Diagnostic value of cytologic examination of gastrointestinal tract tumours in dogs and cats: 83 cases. JAVMA 229: 1130-1133.<\/p>\n<p>Turner et al (2021) Assessment of the clinical usefulness of ultrasound-guided cytological specimens obtained from gastrointestinal lesions in dogs and cats. J Small Anim Pract 62:114-122.<\/p>\n<p><strong>Walter Bertazzolo<\/strong>, Med. Vet. EBVS Sp\u00e9cialiste europ\u00e9en en pathologie clinique v\u00e9t\u00e9rinaire (Dipl. ECVCP); Directeur Scientifique de MYLAV.\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Les masses gastro-intestinales chez les chiens et les chats sont souvent abord\u00e9es dans un premier [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[1118],"tags":[],"class_list":["post-26273","post","type-post","status-publish","format-standard","hentry","category-cytologie"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cytologie des masses gastro-intestinales: quand elle est utile et quand elle l&#039;est moins - MyLav<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mylav.net\/fr\/cytologie\/cytologie-des-masses-gastro-intestinales-quand-elle-est-utile-et-quand-elle-lest-moins\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cytologie des masses gastro-intestinales: quand elle est utile et quand elle l&#039;est moins - 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