Rogato Francesco, Szladovits Balazs, Martineau Henny, Yale Andrew D, Mitchell Jordan L, Holmes Emma J, Gardner Rachel H, Guillén Alexandra
Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.
Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK.
Vet Clin Pathol. 2024 Dec;53(4):448-457. doi: 10.1111/vcp.13382. Epub 2024 Sep 17.
An eight-year-old male neutered crossbreed dog presented with erosive and ulcerative cutaneous lesions in the inguinal regions, the medial aspect of both thighs, and the stifles. Hematologic assessment revealed nonregenerative anemia, thrombocytopenia, and high numbers of neoplastic mononuclear cells with a variable degree of maturation. The mononuclear neoplastic cells, with nuclei measuring 10-20 microns in diameter, accounted for 57% of the nucleated blood cells. In addition, the blood contained increased numbers of mature neutrophils and monocytes with atypical morphology. Cytologic examination of the right popliteal lymph node found high numbers of large mononuclear cells with similar morphology to those in the peripheral blood. Flow cytometry of peripheral blood revealed expression by the mononuclear neoplastic cells of the pan-leukocyte marker CD45 and myeloid markers CD14, MAC387, and myeloperoxidase (MPO). These results confirmed a diagnosis of acute myeloid leukemia (AML). Computed tomography found moderate nodular hepatosplenomegaly and multifocal bi-cavitary lymphadenopathy. Histopathologic examination of biopsies from the cutaneous lesions identified infiltration of the dermis by intermediate to large neoplastic round cells. Further treatment was declined, and the owners elected euthanasia. Postmortem examination confirmed AML involvement in the bone marrow, peripheral and intracavitary lymph nodes, heart, liver, kidney, and skin. Neoplastic cells in the bone marrow and skin showed positive immunolabeling for ionized calcium-binding adaptor protein 1 and MPO. To the best of our knowledge, this is the first report of ulcerative cutaneous lesions observed among the presenting clinical signs in a dog with AML and secondary leukemia cutis.
一只八岁已绝育的杂种雄性犬，腹股沟区、双侧大腿内侧及膝关节处出现糜烂性和溃疡性皮肤病变。血液学评估显示为非再生性贫血、血小板减少，以及大量不同成熟度的肿瘤性单核细胞。这些单核肿瘤细胞直径为10 - 20微米，占核血细胞的57%。此外，血液中成熟中性粒细胞和单核细胞数量增加，且形态异常。右腘窝淋巴结的细胞学检查发现大量大单核细胞，其形态与外周血中的相似。外周血的流式细胞术显示，单核肿瘤细胞表达全白细胞标志物CD45以及髓系标志物CD14、MAC387和髓过氧化物酶（MPO）。这些结果确诊为急性髓系白血病（AML）。计算机断层扫描发现肝脏和脾脏中度结节性肿大以及多灶性双腔性淋巴结病。皮肤病变活检的组织病理学检查发现真皮有中等至大的肿瘤性圆形细胞浸润。主人拒绝进一步治疗并选择了安乐死。尸检证实AML累及骨髓、外周及腔内淋巴结、心脏、肝脏、肾脏和皮肤。骨髓和皮肤中的肿瘤细胞对离子钙结合衔接蛋白1和MPO呈阳性免疫标记。据我们所知，这是首例在患有AML和继发性白血病性皮肤炎的犬中，将溃疡性皮肤病变作为主要临床症状观察到的报告。
