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.