Irvine Katherine L, Raskin Rose E, Smith Lauren C, Friedrichs Kristen R
Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, USA.
Vet Clin Pathol. 2019 Sep;48(3):406-412. doi: 10.1111/vcp.12770. Epub 2019 Sep 19.
A 10-year-old female spayed Miniature Schnauzer was presented for investigation of an intra-nasal mass. The mass was diagnosed by histopathologic examination as an undifferentiated round cell neoplasm with an infiltrate of segmented leukocytes, interpreted as neutrophilic inflammation. The mass was treated with palliative radiation and systemic chemotherapy due to the presence of regional lymph node metastasis. During subsequent monitoring over several months, the peripheral leukocyte concentration was repeatedly within reference intervals to slightly increased with low numbers of toxic neutrophils. Four months after the initial diagnosis, there was a significant leukocytosis of 66 100 cells/μL, and 39 700 cells/μL of the leukocytes had variably mature, lobulated, and hypolobulated nuclei, and grey cytoplasm with clear vacuoles, resembling grey eosinophils. To further characterize these cells, peripheral blood smears from the patient and a canine control with eosinophilia were stained for alkaline phosphatase (AP), peroxidase, and esterase activities, and with Luxol fast blue (LFB). Histopathologic sections of the nasal mass were stained with LFB and immunohistochemically for tryptase. On blood smears, the cytoplasm of the suspected grey eosinophils stained for AP and granules stained with LFB confirmed that there was an eosinophilic lineage. Peroxidase staining was weak, and esterase staining was absent. On histopathologic sections from the nasal mass, the segmented leukocytes contained LFB-staining granules, indicating an eosinophilic infiltrate was present. Neoplastic cells expressed tryptase, which confirms a mast cell lineage. Our findings suggest that grey eosinophils might be under-recognized and interpreted incorrectly as toxic neutrophils. This report expands the canine breeds in which these eosinophils have been identified.
一只10岁已绝育的雌性迷你雪纳瑞因鼻腔肿物前来就诊。该肿物经组织病理学检查诊断为未分化的圆形细胞瘤，伴有分叶白细胞浸润，提示为嗜中性粒细胞炎症。由于存在区域淋巴结转移，该肿物接受了姑息性放疗和全身化疗。在随后几个月的监测中，外周血白细胞浓度多次处于参考区间内，或仅有少量毒性嗜中性粒细胞时略有升高。初次诊断四个月后，白细胞显著增多，达66100个/μL，其中39700个/μL白细胞的细胞核成熟度不一，有分叶和低叶现象，胞质呈灰色且有清晰空泡，类似灰色嗜酸性粒细胞。为进一步鉴定这些细胞，对该患者及一只嗜酸性粒细胞增多的犬类对照的外周血涂片进行碱性磷酸酶（AP）、过氧化物酶和酯酶活性染色，以及用卢氏固蓝（LFB）染色。鼻腔肿物的组织病理学切片用LFB染色，并进行免疫组化检测类胰蛋白酶。在血涂片上，疑似灰色嗜酸性粒细胞的胞质AP染色阳性，颗粒LFB染色阳性，证实其为嗜酸性粒细胞系。过氧化物酶染色弱阳性，酯酶染色阴性。在鼻腔肿物的组织病理学切片上，分叶白细胞含有LFB染色阳性的颗粒，表明存在嗜酸性粒细胞浸润。肿瘤细胞表达类胰蛋白酶，证实为肥大细胞系。我们的研究结果表明，灰色嗜酸性粒细胞可能未得到充分认识，且被错误地解读为毒性嗜中性粒细胞。本报告扩大了已发现这些嗜酸性粒细胞的犬种范围。
