Affolter Verena K, Gross Thelma Lee, Moore Peter F
Department of Pathology, Microbiology, Immunology (VM PMI), University of California Davis, CA 95616, USA.
Vet Dermatol. 2009 Oct;20(5-6):577-85. doi: 10.1111/j.1365-3164.2009.00833.x.
Cutaneous lymphoproliferative diseases encompass a spectrum of lesions, ranging from self-limiting, reactive infiltrates to high-grade lymphomas. In humans, cutaneous lymphocytosis (CL) refers to self-limiting or slowly progressive monomorphic lymphocytic infiltrates of mostly unknown cause. It morphologically mimics cutaneous lymphoma. CL in cats also is a slowly progressive disease. Immunophenotyping and clonality testing of feline CL support an indolent lymphoma for the majority of cases studied. This study reports CL in dogs. Erythematous, scaly and alopecic macules, patches or plaques were present in eight dogs. Breed predilection was not observed; six of eight dogs were females; and ages ranged from 5 to 14 years. Diffuse monomorphic non-epitheliotropic infiltrates of CD3(+) (eight of eight), CD45(-) (four of eight) or CD45(+/-) (four of eight) and CD45RA(-) (seven of eight) T lymphocytes were present in the superficial and mid-dermis. Further immunophenotyping of five cases revealed TCR-gammadelta(+) T cells (one of five) or TCR-alphabeta(+) (four of five) T cells. TCR-alphabeta(+) populations were either CD8(+) (two of four) or CD4(-)CD8(-) (2/4). Clonality testing found clonal (seven of eight) or pseudoclonal (one of eight) rearrangement of the TCR-gamma locus of the lesional T cells. Prednisone, prednisolone and methylprednisolone acetate were the most commonly administered drugs. The lesions remained stable for long periods up to 6 years. Five dogs were euthanized due to progression of the skin lesions (three of five), peripheral lymphadenopathy of unknown origin (one of five) or high-grade lymphoma (one of five). One dog was lost for follow-up and two dogs are still alive (17 and 9 months after diagnosis). Canine CL is best considered an initially indolent lymphoma, with slow progression and a potential for progression to high-grade lymphoma.
皮肤淋巴增生性疾病包括一系列病变,从自限性、反应性浸润到高级别淋巴瘤。在人类中,皮肤淋巴细胞增多症(CL)是指大多病因不明的自限性或缓慢进展的单形性淋巴细胞浸润。它在形态学上类似于皮肤淋巴瘤。猫的CL也是一种缓慢进展的疾病。对猫CL的免疫表型分析和克隆性检测表明,在大多数研究病例中为惰性淋巴瘤。本研究报告了犬的CL。8只犬出现了红斑、鳞屑性和脱毛性斑疹、斑块或丘疹。未观察到品种偏好;8只犬中有6只为雌性;年龄范围为5至14岁。在浅表和真皮中层存在弥漫性单形性非亲表皮性浸润的CD3(+)(8/8)、CD45(-)(4/8)或CD45(+/-)(4/8)以及CD45RA(-)(7/8)T淋巴细胞。对5例病例的进一步免疫表型分析显示TCR-γδ(+) T细胞(1/5)或TCR-αβ(+)(4/5)T细胞。TCR-αβ(+)群体要么是CD8(+)(2/4)要么是CD4(-)CD8(-)(2/4)。克隆性检测发现病变T细胞的TCR-γ基因座存在克隆性(7/8)或假克隆性(1/8)重排。泼尼松、泼尼松龙和醋酸甲泼尼龙是最常用的药物。病变长达6年保持稳定。5只犬因皮肤病变进展(5只中的3只)、不明原因的外周淋巴结病(5只中的1只)或高级别淋巴瘤(5只中的1只)而实施安乐死。1只犬失访,2只犬仍然存活(诊断后17个月和9个月)。犬CL最好被视为一种初始惰性淋巴瘤,进展缓慢且有进展为高级别淋巴瘤的可能性。