PDF(Pubmed)
Abstract：
A 2-year-old neutered female Small Munsterlander dog was presented for an insect bite. Physical examination revealed a poor body condition, a peripheral lymphadenomegaly, and suspected splenomegaly. A complete blood count (Sysmex XN-V) revealed marked leukocytosis with lymphocytosis and abnormal dot plots. An abnormal monomorphic lymphoid population and marked rouleaux formation were noted on the blood smear. Lymph node aspirates contained an atypical bimorphic population of lymphocytes, either with a plasmacytoid or a blastic appearance. This double population was also found in the spleen, liver, bone marrow, tonsils, and other tissues. Peripheral blood and lymph node clonality assays revealed clonal BCR gene rearrangement. Flow cytometry revealed a mixed population of small-sized B-cells (CD79a+ CD21+ MHCII+) and medium-sized B-cells (CD79a+ CD21- MHCII-) in lymph nodes and a dominant population of small-sized mature B-cells (CD21+ MHCII+) in peripheral blood. Though normoproteinemic, serum protein electrophoresis revealed an increased α2-globulin fraction with an atypical restricted peak, identified as monoclonal IgM by immunofixation. Urine protein immunofixation revealed a Bence-Jones proteinuria. A diagnosis of Waldenström\'s macroglobulinemia was made. Chemotherapy was initiated, but the dog was euthanized 12 months after the initial presentation due to marked clinical degradation.
摘要：
一只2岁绝育的雌性小Munsterlander狗被昆虫咬伤。体格检查显示身体状况不佳，外周淋巴结肿大，怀疑脾肿大.全血细胞计数（SysmexXN-V）显示明显的白细胞增多，淋巴细胞增多和异常点图。在血液涂片上注意到异常的单形淋巴群和明显的rouleaux形成。淋巴结抽吸物含有非典型的双态淋巴细胞群，浆细胞样细胞或有缺陷的外观。在脾脏中也发现了这种双重种群，肝脏,骨髓,扁桃体,和其他组织。外周血和淋巴结克隆性检测显示克隆性BCR基因重排。流式细胞术显示淋巴结中有小尺寸B细胞（CD79aCD21MHCII）和中等尺寸B细胞（CD79aCD21-MHCII-）的混合群体，外周血中有小尺寸成熟B细胞（CD21MHCII）的优势群体。虽然蛋白是正常的，血清蛋白电泳显示α2-球蛋白分数增加，具有非典型限制性峰，通过免疫固定鉴定为单克隆IgM。尿蛋白免疫固定显示Bence-Jones蛋白尿。诊断为Waldenström巨球蛋白血症。开始化疗，但这只狗在初次就诊12个月后因明显的临床退化而被安乐死。
