Neurenteric cysts account for 0.7-1.3% of spinal axis tumors. These rare lesions result from the inappropriate partitioning of the embryonic notochordal plate and presumptive endoderm during the third week of human development. Heterotopic rests of epithelium reminiscent of gastrointestinal and respiratory tissue lead to eventual formation of compressive cystic lesions of the pediatric and adult spine. Histopathological analysis of neurenteric tissue reveals a highly characteristic structure of columnar or cuboidal epithelium with or without cilia and mucus globules. Patients with symptomatic neurenteric cysts typically present in the second and third decades of life with size-dependent myelopathic and/or radicular signs. Magnetic resonance imaging and computed tomography are essential diagnostic tools for the delineation of cyst form and overlying osseous architecture. A variety of approaches have been employed in the treatment of neurenteric cysts each with a goal of total surgical resection. Although long-term outcome analyses are limited, data available indicate that surgical intervention in the case of neurenteric cysts results in a high frequency of resolution of neurological deficit with minimal morbidity. However, recurrence rates as high as 37% have been reported with incomplete resection secondary to factors such as cyst adhesion to surrounding structure and unclear dissection planes. Here we present a systematic review of English language literature from January 1966 to December 2009 utilizing MEDLINE with the following search terminology: neurenteric cyst, enterogenous cyst, spinal cord tumor, spinal dysraphism, intraspinal cyst, intramedullary cyst, and intradural cyst. In addition, the references of publications returned from the MEDLINE search criteria were surveyed in order to examine other pertinent reports.
Lymphosarcoma in cattle can be divided into enzootic lymphosarcoma and sporadic lymphosarcoma.1 Enzootic bovine lymphosarcoma is caused by bovine leukemia virus (BLV), a retrovirus that is horizontally spread in cattle by infected lymphocytes.2 , 7 Sporadic lymphosarcoma has an unknown etiology, but there is no evidence that BLV is involved in this form of the disease. The sporadic form usually affects young cattle, and most cases can be further classified as juvenile, thymic, or skin forms.1 Multicentric lymphosarcoma not associated with BLV infection has been reported only rarely in mature dairy cattle. 3,5,6 A 3-year-old Holstein bull owned by a commercial breeding company was presented to Cornell University because of anorexia of 5 days duration and abnormally dark-colored manure for 3 days. Prior to hospital admission, the bull had been treated once with orally administered electrolytes a mixed in water and 3 g phenylbutazolidine.b Nonsteroidal anti-inflammatory drugs had not been administered to the bull prior to the clinical signs. On hospital examination, the abnormalities noted were depression, pale mucous membranes, cardiac arrhythmia, and melena. The packed cell volume was 15%, and the plasma protein concentration was 4.0 g/dl. The combination of clinical and laboratory finding were suggestive of hemorrhage into the upper intestinal tract. A macrocytosis (mean corpuscular volume = 63 fl), basophilic stippling, and Howell-Jolly bodies were present in the hemogram and were suggestive of a regenerative anemia most likely associated with the intestinal blood loss. The cardiac arrhythmia was further investigated by electrocardiographic examination. Ventricular premature contractions (VPCs) with an identical pattern were noted, suggesting that the VPCs were originating from the same site in the myocardium. The findings in this bull were thought to be most consistent with a diagnosis of multicentric enzootic lymphosarcoma caused by BTV infection. Examination of the medical records of the Received for publication February 4, 1994. bull revealed that he had been seronegative on 4 occasions for BLV antibody with the agar gel immunodiffusion (AGID) assay. The most recent assay had been performed just 4 weeks prior to hospital admission. Support for the diagnosis of lymphosarcoma and/or BLV infection could not be gathered from the leukogram; a lymphopenia (1,800 cells/µl) was noted. A peritoneal tap&as performed because it was considered the least invasive procedure that might supply information supportive of the diagnosis oflymphosarcoma. A large amount of light' red peritoneal fluid was easily obtained from the peritoneal cavity with an 18-gauge 3.8-cm needle inserted into the abdominal cavity at the lower right flank. The fluid contained <2.5 g of protein/liter and 54,400 white blood cells/µl. Lymphoblasts were numerous on cytologic examination of the fluid (Fig. 1). A diagnosis of lymphoma was made, and the bull was euthanized. Lymphosarcoma involving the sternal lymph nodes, tracheobronchial lymph nod...
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