Magnol J P, Ghernati I, Marchal T, Chabanne L, Delverdier A, Fournel C
Ecole Vétérinaire de Lyon, Unité de Dermatologie Marcy l'Etoile.
Bull Acad Natl Med. 1996 Feb;180(2):449-62.
Our serie of ten canine cutaneous epitheliotropic T-cell lymphomas (CTCL), is found in old dogs, belonging mainly to the Boxer breed. Site on the mucous membranes (especially buccal), the muco-cutaneous junctions, their clinical expression is polymorphous. Lesions, follow on one after another (erythema, plaques, nodules) and are diversely associated in a given animal, the borders between the different stages often being difficult to establish. Adenopathies noted at the time of the diagnosis or during the course of the condition are accompanied by an involvement of the blood and organs (analogous to Sézary's disease). The progression of the disease can be very rapid in the buccal forms, which are generally aggressive, and in cases of violent, uncontrollable pruritus, which may be disturbing for the owner (with requests for euthanasia). The neoplastic infiltrate is constituted of small lymphocytes with hyperchromatic, convoluted nuclei (incipient stages), then large cells with a "histiocytic" appearance for the nodules. Epitheliotropism, which is maximal for the infiltrated plaque stage, shows up either in the form of a flux of totally epitheliotropic isolated cells (Ketron-Goodman type) or in that of Pautrier abscess-like collections. THe veterinary literature is in agreement that the CTCL cell expresses CD3, but two recent studies are in contradiction as regards its membership of helper or cytotoxic/suppressor populations. For our 10 cases, all the cells of lymphocytic morphology were, without exception, CD3+ and CD45+, irrespective of their situation within the epithelium or the chorion. The CD3+ cells in the epithelium were systematically CD8+, CD4- (confirming P.F. Moore's observations), expressing CD5 in a variable way, and, mostly, the Ki-67 nuclear proliferation Ag. The CD3+ cells of the chorion were exclusively, or mainly, CD8+, and occasionally CD4+. They expressed CD5 in a variable way, and, for a minority, the Ki-67 nuclear proliferation Ag. On the pathogenic level, it may be suggested that a T clone, CD8+, undergoes the "homing" phenomenon within the epithelium, enters the cell cycle, then manifests a tropism towards the chorion, which it infiltrates. Despite some particularities, which may be clinical (serious mucous attacks), cytological (the "histiocytic" appearance of the nodule cells) or immunophenotypic (expression of CD8, similar to what is observed in man in a considerable number of Pagetoid reticulosis), CTCL constitutes an interesting model of spontaneous pathology, and could prove useful in: - identifying various etiological factors (given that the dog, as a close commensal of man, is subject to the same environmental factors).
我们的10例犬皮肤嗜上皮性T细胞淋巴瘤(CTCL)系列病例,多见于老年犬,主要为拳师犬品种。病变部位在黏膜(尤其是颊部)、黏膜皮肤交界处,其临床表现多样。病变相继出现(红斑、斑块、结节),在同一动物身上有多种表现形式,不同阶段之间的界限往往难以界定。诊断时或病程中发现的淋巴结病伴有血液和器官受累(类似于塞扎里氏病)。颊部型疾病进展可能非常迅速,通常具有侵袭性,剧烈且无法控制的瘙痒症状可能会让主人困扰(甚至要求安乐死)。肿瘤浸润由核深染、卷曲的小淋巴细胞组成(初期阶段),随后结节处出现具有“组织细胞样”外观的大细胞。嗜上皮性在浸润斑块阶段最为明显,表现为完全嗜上皮的单个细胞流(凯特朗 - 古德曼型)或类似帕特里尔脓肿的聚集形式。兽医文献一致认为CTCL细胞表达CD3,但最近两项研究在其属于辅助性或细胞毒性/抑制性群体方面存在矛盾。对于我们的10例病例,所有淋巴细胞形态的细胞无一例外均为CD3 + 和CD45 +,无论其在上皮或绒毛膜内的位置如何。上皮内的CD3 + 细胞系统性地为CD8 +、CD4 -(证实了P.F. 摩尔的观察结果),以可变方式表达CD5,且大多表达Ki - 67核增殖抗原。绒毛膜的CD3 + 细胞仅为或主要为CD8 +,偶尔为CD4 +。它们以可变方式表达CD5,少数表达Ki - 67核增殖抗原。在发病机制层面,可能提示一个CD8 + T克隆在上皮内经历“归巢”现象,进入细胞周期,然后表现出对绒毛膜的嗜性并浸润其中。尽管存在一些特殊性,可能是临床方面(严重的黏膜侵袭)、细胞学方面(结节细胞的“组织细胞样”外观)或免疫表型方面(CD8表达,类似于在相当数量的佩吉特样网状细胞增多症患者中观察到的情况),CTCL构成了一个有趣的自发病理模型,并且可能在以下方面证明有用: - 识别各种病因因素(鉴于犬作为人类的亲密共生者,受到相同的环境因素影响)。