Laboratory of Small Animal Internal Medicine, School of Veterinary Medicine, Azabu University, Sagamihara, Japan.
Akiyoshi Animal Clinic, Yamato, Japan.
Vet Clin Pathol. 2022 Sep;51(3):414-421. doi: 10.1111/vcp.13086. Epub 2022 Jul 31.
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.
一只 11 岁已绝育的雌性美国可卡犬,表现出 4 周的厌食和 1 周的腹部肿胀病史。临床病理和影像学异常包括腹腔内出血、腹腔液涂片中有颗粒淋巴细胞 (GLs)、脾脏肿块和肝肿大伴弥漫性多发性低回声结节。根据脾脏和肝脏的细胞学、组织学和免疫组织化学评估,诊断为 GLs 引起的肝脾 T 细胞淋巴瘤 (HSTCL)。手术后,通过化疗(ACNU[洛莫司汀]、L-门冬酰胺酶和泼尼松龙)维持狗狗的良好状态。然而,在第 85 天,超声引导下对肝脏进行细针抽吸,发现与 GLs 无关的肿瘤性肥大细胞增殖。狗狗被诊断为起源于肝脏的内脏肥大细胞瘤 (MCT)。化疗药物更换为长春碱和托西莫单抗。狗狗的状况一直良好,直到第 141 天,但在第 158 天因 MCT 进展而死亡。第 155 天的肝脏细胞学检查未发现 GLs,尽管 HSTCL 被认为对化疗有抗性。在明确诊断为 HSTCL 后,我们通过血液检查、包括全血细胞计数、超声成像和肝脏细胞学抽吸来监测该患者对化疗的反应。尽管犬 HSTCL 的预后较差,但仍应考虑新的肿瘤的可能性,包括内脏 MCT。定期进行肝脏细胞学检查可能对接受 HSTCL 化疗的狗狗有益。