LGL lymphoma

  • 文章类型: Journal Article
    淋巴瘤是家猫最常见的肿瘤,最常发生在小肠。猫小肠淋巴瘤主要显示通过具有CD3的T细胞的标准免疫阳性或具有CD20的B细胞的标准免疫阳性鉴定的T细胞免疫表型。相比之下,根据WHO分类,在人类中应用了广泛的免疫组织化学抗体来诊断各种特定的淋巴瘤亚型。我们的目的是增加我们对在肠道中形成宏观肿块的猫科动物非B细胞淋巴瘤的免疫表型的了解。我们评估了15例患者的免疫组织化学和流式细胞术联合发现。93%(14/15)的肿瘤淋巴样细胞对CD3免疫阳性,颗粒酶B占87%(13/15),CD5在20%(3/15),13%的CD8(2/15),7%(1/15)的CD4和7%(1/15)的CD56病例。仅在13%(2/15)的病例中通过组织病理学和在47%(7/15)的病例中通过细胞学鉴定了表明肿瘤细胞的细胞毒性起源的细胞毒性颗粒。没有细胞毒性蛋白颗粒酶B的免疫组织化学标记,在46%(6/13)的细胞学切片和85%(11/13)的组织病理学切片中,细胞毒性状态会被遗漏.这些发现表明,更复杂的免疫表型可能会增进我们的理解,并有助于预测猫的小肠T细胞淋巴瘤。
    Lymphoma is the most common tumour of domestic cats, developing most frequently in the small intestine. Feline small intestinal lymphoma predominantly demonstrates a T-cell immunophenotype identified by standard immunopositivity for T cells with CD3 or immunopositivity for B cells with CD20. In contrast, a wide spectrum of immunohistochemical antibodies are applied in humans to diagnose the various specific lymphoma subtypes according to the WHO classification. Our aim was to augment our knowledge of immunophenotypes in feline non-B-cell lymphomas forming macroscopic masses in the intestinal tract. We evaluated the combined immunohistochemistry and flow cytometry findings from 15 cases. Neoplastic lymphoid cells were immunopositive for CD3 in 93% (14/15), granzyme B in 87% (13/15), CD5 in 20% (3/15), CD8 in 13% (2/15), CD4 in 7% (1/15) and CD56 in 7% (1/15) of cases. Cytotoxic granules indicating a cytotoxic origin of the neoplastic cells were identified by histopathology only in 13% (2/15) and by cytology in 47% (7/15) of the cases. Without immunohistochemical labelling of the cytotoxic protein granzyme B, the cytotoxic status would have been missed in 46% (6/13) of the cytological and in 85% (11/13) of the histopathological slides. These findings suggest that more complex immunophenotyping may advance our understanding and help prognosticate small intestinal T-cell lymphoma in cats.
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  • 文章类型: Case Reports
    一名11岁的绝食雌性美国可卡猎犬有4周的厌食症史和1周的腹胀史。临床病理和影像学异常包括腹腔内出血,腹腔液涂片中的颗粒淋巴细胞(GL),脾肿块,肝肿大伴弥漫性多发低回声结节。根据细胞学,组织学,和免疫组织化学评估脾脏和肝脏,诊断为GLs的肝脾T细胞淋巴瘤(HSTCL)。术后,这只狗在化疗后保持良好状态(ACNU[尼莫司汀],L-天冬酰胺酶,和泼尼松龙)。然而,在第85天,超声引导下细针穿刺肝脏发现与GLs无关的肥大细胞增生。该狗被诊断患有源自肝脏的内脏肥大细胞瘤(MCT)。化疗改用长春碱和托卡尼布。狗保持良好状态直到第141天,但在第158天因MCT进展而死亡。第155天肝脏细胞学检查显示无GLs,尽管HSTCL被认为对化疗有抗性。在明确诊断HSTCL后,我们用血液检查监测了这个病人对化疗的反应,包括全血细胞计数,超声成像,和肝脏的细胞学抽吸物。虽然犬HSTCL预后较差,新肿瘤的可能性,包括内脏MCT,应该考虑。在接受HSTCL化疗的狗中,定期进行肝脏细胞学检查可能是值得的。
    An 11-year-old spayed female American Cocker Spaniel was presented with a 4-week history of anorexia and a 1-week history of abdominal distension. Clinicopathologic and imaging abnormalities included intra-abdominal hemorrhage, granular lymphocytes (GLs) in abdominal fluid smears, a splenic mass, and hepatomegaly with diffuse multiple hypoechogenic nodules. Based on the cytologic, histologic, and immunohistochemical evaluation of the spleen and liver, the diagnosis was hepatosplenic T-cell lymphoma (HSTCL) of GLs. Postoperatively, the dog was maintained in good condition with chemotherapy (ACNU [nimustine], L-asparaginase, and prednisolone). However, on day 85, ultrasound-guided fine-needle aspiration of the liver revealed a proliferation in neoplastic mast cells not associated with the GLs. The dog was diagnosed with a visceral mast cell tumor (MCT) originating from the liver. The chemotherapy was switched to vinblastine and toceranib. The dog remained in good condition until day 141 but died due to the progression of MCT on day 158. Liver cytology on day 155 showed no GLs, although HSTCL is thought to be resistant to chemotherapy. After the definitive diagnosis of HSTCL, we monitored this patient\'s response to chemotherapy with blood tests, including complete blood counts, ultrasound imaging, and cytologic aspirates of liver. Although canine HSTCL has a poor prognosis, the possibility of a new neoplasm, including visceral MCT, should be considered. Periodic liver cytology might be worthwhile in dogs receiving chemotherapy for HSTCL.
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