Carcinoma of the Tonsil in a Common Wolf (Canis lupus)

  • View
    218

  • Download
    5

Embed Size (px)

Transcript

  • d . C:arcinoiria of tlie Tonsil in :L (*oitiinon Wolf ( Canis / u p s ) . By H. Hanor,u SCOTT, M.D., F.R.(:.l'.Loncloii, F.lLS.E., F.Z.S., Milii(3r Hesearch Fellow i n Coil*- parativc Patliology, IJonclolt Scliool of Hygiclne and Tropical Xedicine ; Pat l io l r~gis t to the Zoological Society of London.

    [Received November 14,1927 : Head February 21,1928.1

    (Plates I.-III.")

    h-o norlis on vetei inaiy pathology which J I i n ~ e been able t o conslilt make a n y irientioii of priinary maligiiant disease of tlie tonsils a& occurring among tlornestiwted animals. nur can I find any reference to such as hiiig fount1 in captive wild :xnini:xls. Cases are by no niearis frequently encountered even in h2ari-hence the follonirig i s deemed woi tliy of rpcord.

    A female Wolf, Cffimas Ztcpus, which l i d been iii tlie Gardens of tlie Society since J u l y 14th, 1922, was ieniovecl t o t h e Saiiatoiium towaids t h e riid of Bpi11 1'327, on account of a, large chschargiiig woiiiid i n connection witli a swelliiig i n the riglit sitle of the neck wntl throat . 'l'lie a r i i ~ i i ~ ~ l appexied to be iri consitleiable tlistress and, peihnps pnin, and would xlloiv no one t o appioacli it ; it was, thriefoie, lrilletl on Apri l 30th :in11 an : t u t o p y w~ds perfot nietl iiiiriiedihtely a f te rn nrds.

    i'lie giantis on the i ight side of t h e neck were s\\olleil antl 11:11 d , although they coritained treaking down iieci utic foci, ant1 t h e surrounding muscles and tissues n ere h i t 1 i ~ n d intilti-itted. Tiieio wits a n ulcer with irregiilar rnggetl iiiitigin, the exteinwl opeiiirig of wliicli measured 8 ciii. in length by 3 cm. i n its greatest widtli, ant1 dischargeil foul blood-tinged pur. 'l'iiese eiilaigecl antl breaking clowii glands 11 ere secondary t o a growth of t h e r ight tonsil. The tonsil itself liad piacticnlly disappeared (P1 I fig. 1). ant[ its p1:tce mas oc-cnpietl by w tlepressed iilcei \%itli :in nrie\eri base and a h i d , 111 parts furig:ttinS, giowtli witli eroded and everted hoitler. Bi 0111 th is R s i i i ub extended to t h e enlaigetl and neclotiLirig glands. The tori\illar eroiion was about the side of half R - C ~ O T V I I . The fai&cl pillais were practically n n i n ~ o l v r t l ; t h e base of tlie toiigue was free fioiii groirth, and t h e left tonsil naL quite norinal.

    The contlition, pc>thologicxlly, was a malignant neoplasiii of tlie riglit toniil, witli secoiitlnry irivasioii of the cert ical glantls, inliltlation into tlie s u i ~ o u n d i n g structures, adhesion to tlie overlying cutaneous tissues and hreakinq down t o open externally by it ragged ulcer.

    Foi eiplanation of the PI

  • hlici,osco~)ic;tl!y, ~ , h t : picture preseiitetl m:is iiiost iiiterestiny. Vrorti the gciiel:iI c1,;ir:rcteis :riitl tlie \t.itlespi.e:tii intiltrntion of tlic si1ii:triioiis epitlielial cells growth illust liitve originated, i io t i i 1 tlie ~):ireiiciiyiiiatous tissue of t'iie tonsil itself, b u t in its cpithe!ial covering. \Ve see gronl~s and I X I R S P ~ S o f epitiio1i;il cells, soiiie i n sitiall rreg:rtiorrs, otliers in large

    Intirig aiid iiisinmiting tlieinselres iiit,o t h e Between tlie islets

    ot tlie c.:troinorina.tous cells t h e w is a fair ly well-developetl stroiiix : L I I ~ ~ tlie celis i n n imy placeR teiid to :issiirrie an ;~lt.eoln.r (lisl)ositioii, iii others they :~ppe 1muicliiiig coluiiiiis. \There tlie 1il)roiis st ro i i i :L is abiiiitliint euclosetl areas of trne gromtli sliou. iiecrosis i t i varyiiig tlrgree.

    1';trts of tlie growt,li tleitionsti*a.te very well t h e polyiiiorphic l i ~ ~ ~ ~ ~ : l o p ~ l e ~ l t of' c:rrcinornntous cells and t h e xu:iylnstic c1i:triges wliicli :ire :i coninioii fea,tiire of uiany 1ii:tligrinnt epithelial iiw1)I:isiiis. :Clius, i r i places we c i ~ n irlinost trace the stages of t,i.:iiisition froin t h e nsmtl romitletl type of scliin,lnio~is cell i,o t,Itt+ tlrn.\vii-out spiritlie-cell (Pl. 11. fig. 3 & PJ. 111. fig. 4). Lig,iiii. :it i,lie pr ipl iery of soine of the i r i g w b tltc cells are seen i;o be sepii,ratetl, becoiiiiiig iiiore loosely disposed, [ierli;11);j frayetl out,, :~nt l a picture st,mngly snggestive of: :I. sar- coiii:itons cli:i.iige of sti.orna is presentetl.

    'l'lit: lytttp\ioi(l torisiilar reninaiits i n most w e a s where titey ;ire lirc'seent, e;isily tlistiiiguisliabie from th is looseiiing of c~:ri~ciiiorn~~t,oiis crlls :i,iicl polyiiiorphisiii by t h e closeness with witicit t h e gl:~~itlalar lyniplioicl cells itre packed. I n soiiie sitnations t'lie :i.tlvaricing clrimp of epitlielinl cells is nlriiost abruptly siiri-ouiicled by such masses of small ronritl lyinphoid cells, wliiolr Z take to be t h e iiornia.1 lymphoid tissue of the gI:r~rtl beiitg inr7:ltletl hiit iiot get r(+cetl by t h e growth.

    Aii:ii)lzisi:i, is f iir%lier evidenced by t h e defective keratinizat>ion iii (~)nsitler;il)le xre:~s of the growth, thougli in other par ts th i s is fairly ilinrlted itnd cell-nest foriiia.tion extensive (PI. 111.

    Y t t oiie otliei. point of interest is I.)~eseiited---rinmely, t h e re-tlifjl.eiitiatiuii mliich exists, some of the sqiiairioiis epitlielio- 1ii:i t;oris foci hcconiiiig tra.iisformec1 into a.pp:trent adenocnrcino- iii:LtJoiis islets.

    W i t ere we lmow 1)ra.cticnlly nothing of the history, as in tliis cme, owing t,o tlie iirtpossibility o f exaniination during lifca, i r e can only infer tliat tlie ra te of growth in t h e original s i k ~v: i s probiibly iiot very rapid ; iii some parts t h e stroma

    ely ul)imdant a r i d not very vascular, ba t , on t h e other 1i:ri i 1 only n fern giant-cells :ire met witli. There was very

    is not iiiiusnal, different rates of growth i n different the tiiiiioiir, for, ill contrast mitli what has just been

    iiteiitionetf, in otlier sites the stronin is much less a.nd, moreover, is (quite riclll~7 crl1nl;tr.

    opinions aye at, vwiance regarding the frequency of neoplnsms

    il (PI. 11. fig. 2).

    fi::s. 4 fi 5).

  • TIIK TO.\'sIL IS A co!.:?Jox TYC'LF. 45

    of tlie t,ousils i n &Tan: bgt,, generally spe:tl&ig, it woiiltl appe:rr tki:it turnours of these glands are iincoiiiinon. Of the k)eliigii foims pa,piIloniatn arid fibrous polyps occur, wliile both carciiro- rrlatous aiitl sa,rcoiiiii.tous forms of inalignant growtli are met, with. hccortling to liett,le, tlie tmisil is liable to two forrlis of sa,rcoiiia.--n:tmely, t h e round-celled and t h e Igniplios:~rcorn:r,- while Eexttie and I)ickson speak of a lympliosarconin mid it iiiixetl-relletl sarcoma. 'Fire dubious group, endothelioma, lias :i.lso been clescribetl as occnrring i n the tonsil.

    Wit11 reglrd t o c:ircinoiii:L, arising, of cowse! in tlie epitliclinl coveririg of t,he gl:r.iitl, the tluniour is genernlly i~ squariious epit1reIioin:t developing ei ther from t h e cells of t h e surface 01' i i i a. tonsillar crypt. Bland-Sntton stiites tlint squamous- celie,! c:Incer wising in tlie faiiciid pi1lai.s or in tlie tonsii is not, iincoiriinori, but Beattie and DicBsori ni:iintiLin tliai8, tlioiigli tlir coiiclition does occiir, it is nearly always a secoritl:ii,y inroloenieiit i n t h e tonsil. In S U C I I , t h e priniaiy site i s iisiiziliy t,hr h s c of t,tie toiigiie or the piilars of the fauces.

    Authorities m e , iro\\erer, practica.lly unaninions iii iiotiiig tlitl rapitiity of growtli, t h e early extension t o arljaceiit striict,iires, :mtl iiivolvenient of t h e regional 1y1i;pliatic g h t i s . In 11iiiiin.ri C N S ~ S destruction is great :rrd the pi1iai.s of tlie fauces ant1 t h e palate are often iniplicaterl aiitl t l i e r ~ is a tentleiicy t o invasioii of t,lie tongue. As regartls tlie exact site or so:irce of ovigiri, this is often iintleterniinetl j the epitlrelioiiia

    :ii.ise in the posterior par t of t]lie tongue, i n the pI~arpiipe:il eliiiin, o r in tlint of tlie tonsil. 111 fnct,, i t may grow iii

    :ally part of t h e inontli a n d wlieri in the r ~ x t e i i o r regions nearly d w a y s invades t h e fa.nces arid tlie toiisils. 1 1 1 Man t h e coii1'se is rnpid, death occurs withiii tlie yew, oEteii iir six 1-0 eight niontlis, t h e iininecli:vce caiise Leiiig a septic pnc~unionia, :I pivfuse h:enioi-rlinge from erosion of a 1:irgr vessel, or cedeni:~ of t l ~ c glottis. '!'he ra te of growth, holx-ever, is vei'y vari:il)le ;

    been sliown t o be rapid in a well-c!erelopetl inan of midd ie ;rge, a i i d glands a.re involved early, whei~ens in those of n t l ~ i n c e t l \ T A : L ~ S it niay be remarlraddy slow. Thus, R case i s on record of 8, in;in of 70 in wlioiri t h e cIiseuse 1x1~1 iieen present for tllree ypars ; nevertheless, rlestrnction was not great and tlie g$.l:%ndiil:rr involvement w:i s sligli t.

    111 the vast majority of tlniirals-1 SI3ea.k pnrticiilarly of mild :~,niuials,-the age is a mat ter of conjecture, nilless bir th lias t&en place (luring t h e mother's captivity. Wet,, again, we a,re still quite i n the clarli as to t h e correspondence, if :my exists, hetween t h e age of r7.n nnimr7.l and tllat of man. Even in human cases the age at wl~icli t h e condition has been met with varies within very wide limits. L. 1. Smith s ta tes tllut among his forty cases there were t)wenty-foiir hetween 50 n,nrl (jO years of age, t h e limits being 28 and 82, and the average 55 years. The youngest patient he could trace was only 18 years old.

  • 46 Dll . 11. 11. SCOTY' : CARCINOMA O F

    111 wiltl aniiiials tlie rapidity of growth of a neoplasm can orily I w seeii in its teriiriual stn.ges. A thyroid turnour may, afte