Paraneoplastic hypereosinophilia in a dog with intestinal T-cell lymphoma

A 9-year-old, intact male Doberman Pinscher was examined because of anorexia and weakness. Results of a CBC showed severe, microcytic, hypochromic anemia with mild eosinophilia (2944 cells/microL, reference interval 100-1250/microL) and thrombocytosis. Hypoferremia, hypoferritinemia, and a positive fecal occult blood test supported a diagnosis of iron deficiency anemia secondary to chronic intestinal hemorrhage. Abdominal ultrasound evaluation showed a thickened small intestinal loop, of which representative specimens were obtained during exploratory laparotomy. Histologically, the intestinal wall was infiltrated by a neoplastic population of large, round, lymphoid cells with vesicular chromatin, 1 or more prominent nucleoli, and a high number of mitotic figures. The cells were closely admixed with mature eosinophils, but were negative for metachromatic granules with toluidine blue. Immunohistochemically, tumor cells were positive for CD3, and negative for CD21, Pan B, and CD79a. A diagnosis of intestinal T-cell lymphoma was made. Chemotherapy was begun, with 30 mg/m;2 of doxorubicin administered intravenously every 3 weeks. Eosinophil concentration was 880/microL 2 weeks after surgery (on day 15 after presentation) but increased markedly to 62,914/microL on day 30, 62,400/microL on day 37, and 39,444/microL on day 58 after presentation. An association between hypereosinophilia and T-cell lymphoma is well established in human patients, in whom production of IL-5 by neoplastic T cells has been demonstrated. Hypereosinophilia has been reported only rarely with intestinal lymphoma in cats and horses, and with T-cell lymphoma in dogs.     

Solitary nonepitheliotropic T-cell lymphoma in a dog

A 7-year-old male Golden Retriever with swelling of the rostral bridge and right wing of the nasal areas, sneezing, and inspiratory difficulty was referred to a neighbor veterinarian. Except for those in the nasal area, no lesions were noted during routine physical examination. The mass occupying the nasal cavity was not observed radiographically. Punch biopsy of the affected lesions revealed nonepitheliotropic lymphoma. Immunohistochemical staining for CD3 antigen was positive. The dog was diagnosed with solitary nonepitheliotropic T-cell lymphoma. Local radiotherapy and systemic chemotherapy with doxorubicin were instituted and resulted in total clinical remission. The dog has remained disease free for 30 months.     

Treatment of cutaneous T-cell lymphoma with dacarbazine in a dog

Abstract Epitheliotropic cutaneous T-cell lymphoma in a Lhasa Apso dog treated with dacarbazine is reported. Clinical disease consisted of a 4 × 4-cm ulcerated mass over the mandibular symphysis and bilateral lymphadenopathy of the submandibular lymph nodes. Skin biopsy sections were díagnostic for epitheliotropic cutaneous T-cell lymphoma, and immunohistochemistry staining for the CD3 antigen was positive. Tissue samples were submitted for chemosensitivity testing and dacarbazine was shown to be 60% effective. Treatment with dacarbazine resulted in total clinical remission. The dog remains disease free 1 year after treatment. Résumé— Les auteurs décrivent un cas de lymphome cutané T épithéliotrope chez un Lhassa Apso traitéà la dacarbazine. Le tableau clinique était caractérisé par la présence d'une masse ulcérée de 4 × 4 cm sur la symphyse mandibulaire et par une adénopathie bilatérale des ganglions sous mandibulaires. Les biopsies posèrent le díagnostic de lymphome cutané T et l'immunomarquage fut positif pour l'antigène CD3. Des prélèvements tissulaires fürent soumis à des tests de chimiosensibilité et la dacarbazine se révéla efficace à 60%. Le traitement à la dacarbazine entraina une rémission clinique totale. Le chien ne présente pas de récidive un an après le traitement. [Lemarié, S. L., Eddlestone, S. M. Treatment of cutaneous T-cell lymphoma with dacarbazine in a dog. (Traitement d'un lymphome cutané T à la dacarbazine chez un chien.) Veterinary Dermatology 1997; 8 : 41–46.] Resumen Se describe el tratamiento con dacarbazina de un linfoma cutáneo epiteliotrópico de células T en un Lasha Apso. La presentación clinica consistia en una masa ulcerada de 4 × 4 cm por encima de la sinfisis mandibular y linfadenopatia bilateral de los ganglios linfáticos submandibulares. El estudio histológico cutáneo permitió un díagnóstico de linfoma cutáneo epiteliotrópico de celulas T, con positividad inmunohistoquimica al antigeno CD3. Se remitieron muestras tisulares para pruebas de quimiosensibilidad, en las que la dacarbazina mostró una efectividad del 60%. El tratamiento con dacarbazina llevó a una remisión clinica total. El perro sigue sano un año después del tratamiento. [Lemarié, S. L., Eddlestone, S. M. Treatment of cutaneous T-cell lymphoma with dacarbazine in a dog. (Tratamiento del linfoma cutáneo de celulas T con dacarbazina en un perro.) Veterinary Dermatology 1997; 8 : 41–46.] Zusammenfassung— Es wird über eine epitheliotropes kutanes T-Zell-Lymphom bei einem Lhasa Apso berichtet, das mit Dacarbazin behandelt wurde. Die klinische Erkrankung bestand in einer 4 × 4 cm großen ulzerierten Masse über der Symphyse der Mandibula sowie einer bilateralen Lymphadenopathie der submandibulären Lymphknoten. Die Hautbiopsien ergaben die Diagnose epitheliotropes kutanes T-Zell-Lymphom, die immunohistochemische Färbung auf CD3-Antigen fiel positiv aus. Die Gewebsproben wurden einer Chemosensitivitätsprobe unterzogen und Dacarbazin erwies sich zu 60% wirksam. Die Behandlung mit Dacarbazin führte zu einer vollständigen klinischen Remission. Der Hund blieb frei von Krankheitssymptomen seit einem Jahr nach der Behandlung. [Lemarié, S. L., Eddlestone, S. M. Treatment of cutaneous T-cell lymphoma with dacarbazine in a dog. (Die Behandlung eines kutanen T-Zell-Lymphom mit Dacarbazin bei einem Hund.) Veterinary Dermatology 1997; 8 : 41–46.]     

Primary hypoaldosteronism in a dog with pituitary and adrenal T-cell lymphoma

A 7-year-old mixed breed dog was presented with a 2-week history of vomiting, diarrhoea, weakness and loss of appetite. Initial laboratory tests revealed hyponatraemia and hyperkalaemia consistent with hypoadrenocorticism. Basal plasma cortisol and adrenocorticotropic hormone concentrations were not suggestive of primary hypoadrenocorticism but the aldosterone concentration was undetectable. Abdominal ultrasound scan showed a mass within the left kidney and a nodular enlargement of the left adrenal gland. Cytological analysis revealed a large granular lymphoma. The dog died 17 days later. Post mortem histological and immunohistochemical examinations revealed a diffuse large granular T-cell lymphoma involving the mediastinal lymph node, kidneys, pancreas, adrenal and pituitary glands.     

Bilateral renal oncocytoma in a Greyhound dog

A bilateral, locally invasive renal oncocytoma was diagnosed in a 10-year-old spayed female Greyhound dog. The diagnosis was based on positive staining of the tumor with the periodic acid-Schiff reaction prior to diastase treatment, on the immunohistochemical expression of cytoplasmic cytokeratin, and on the prominence of mitochondria in the tumor cells.     

Gamma/delta T-cell lymphoma in a dog

A 15-month-old dachshund was presented for examination because of a cough. Thoracic radiographs revealed the presence of a mass in the upper mediastinum. A diagnosis of γδ T-cell lymphoma was made by biopsy and flow cytometry analysis. The dog was treated with chemotherapy and remains asymptomatic after 24 months.     

Synovial T-cell lymphoma of the stifle in a dog

A 6-year-old, 43-kg, spayed female rottweiler was presented for a 1-month history of progressive, left hind-limb lameness. Upon physical examination, a cranial drawer sign and joint distention were present in the left stifle. Radiographically, the stifle had evidence of effusion, remodeling of the patella, and an enlarged popliteal lymph node. Marked synovial thickening and an intact cranial cruciate ligament were noted during surgery. Despite finding a nonspecific, mixed inflammatory response on joint fluid cytopathology, histopathology demonstrated T-cell lymphoma of the synovium. Lameness may be the sole presenting clinical sign in canine lymphoma.     

Renal T-cell lymphoma with cerebral metastasis in a dog with chronic canine ehrlichiosis

A renal T-cell lymphoma with exclusive cerebral metastasis was diagnosed in a 5-year-old Staffordshire bull terrier bitch euthanased for aggression. This is the first recorded case of primary renal lymphoma in a dog. Immune suppression, due to chronic canine monocytic ehrlichiosis, may account for the unusual primary site and metastatic pattern of the tumour.     

Bilateral ectopic ureters in a male dog with unilateral renal agenesis

A 1-year-old neutered male mixed-breed dog was evaluated because of signs of urinary incontinence. Retrograde positive contrast urethrocystography and excretory urography with pneumocystography revealed bilateral intramural ectopic ureters and absence of the right kidney. During abdominal exploratory surgery, only the left kidney was located. The left intramural ectopic ureter was repaired by neoureterostomy (creation of a new opening for the ureter to enable urine to empty into the bladder). The right ectopic ureter was ligated at its entrance into the urinary bladder serosa. Results of excretory urography (performed immediately after surgery and repeated 8 weeks later) revealed successful correction of the left intramural ectopic ureter. Twelve weeks after surgery, the dog remained continent. To the authors' knowledge, there are few reports of ectopic ureters in male dogs; furthermore, the urinary tract abnormalities detected concurrently in this dog are also unusual.     

Bilateral hydronephrosis secondary to anticoagulant rodenticide intoxication in a dog

Objective: To describe an unusual site of hemorrhage in a case of anticoagulant rodenticide toxicity. Case summary: A dog treated for Brodifacoum anticoagulant rodenticide intoxication was referred for treatment of thrombocytopenia and dysuria. Sonographic examination revealed a large blood clot within the urinary bladder, extending proximally along both ureters, and a bilateral hydronephrosis. In this dog, management of the vitamin K₁‐dependent coagulopathy was unusually complicated by uremia and thrombocytopenia. New information provided: This is the first reported case of hydronephrosis secondary to anticoagulant rodenticide intoxication in a dog.     

Progression of an orbital T-cell rich B-cell lymphoma to a B-cell lymphoma in a dog

An 11-year-old Shetland Sheepdog was presented for exophthalmos caused by a locally extensive, poorly defined mass located behind the right eye. The primary orbital mass was identified by light microscopy and immunohistochemistry as a T-cell rich B-cell lymphoma (TCRBCL) composed predominantly of BLA.36-positive large neoplastic lymphoid cells admixed with fewer CD3- and CD79a-positive small lymphocytes. The dog was treated for lymphoma, but 6 months after presentation it was euthanatized for suspected hepatic and gastrointestinal metastasis. Gross findings revealed an enlarged liver with multiple well-demarcated, randomly distributed 0.1-1.5-cm white nodules, five firm white submucosal jejunal nodules, and ileocecal, mediastinal, and hilar lymphadenopathy. Metastatic liver lesions consisted of sheets of monomorphic large neoplastic lymphoid cells that effaced and expanded portal and centrilobular zones. These cells were morphologically similar to the large neoplastic cells of the original orbital tumor and were CD3-negative and variably BLA.36-positive, consistent with B-cell lineage. Similar cells comprised the jejunal nodules and effaced the lymph nodes. The progression of TCRBCL to a diffuse B-cell lymphoma in this case is consistent with reported human cases and has not been previously reported in the dog.     

Primary T-cell lymphoma of the central nervous system in a dog

Primary T-cell lymphoma is a rare form of CNS neoplasia. Diagnosis may be aided by use of cytologic examination of CSF. Primary CNS T-cell lymphoma should be considered in a patient with multiple cranial nerve abnormalities, even if results of imaging studies are considered normal.     

Primary epitheliotropic T-cell lymphoma of the urinary bladder in a dog

A 7-year-old, intact female mixed-breed dog was presented for evaluation of hematuria. Physical examination revealed a suprapubic mass. Ultrasonographic examination showed a large lobular mass occupying the urinary bladder. At the owners' request, the dog was euthanatized and a postmortem examination was performed. Necropsy confirmed the presence of a lobular mass of about 5- to 6-cm diameter protruding into the lumen of the bladder. Histologically, the mass was composed of a large number of atypical lymphoid cells in the lamina propria and mucosal epithelium. Immunohistochemically, the neoplastic cells expressed CD3 but not CD79alpha or keratin and vimentin, supporting a diagnosis of T-cell lymphoma.     

T-cell lymphoma with eosinophilic infiltration involving the intestinal tract in 11 dogs

Among the intestinal tumors of hematopoietic cell origin, lymphoma is the most common in the dog. Herein, we characterized the clinical and pathologic features of 11 dogs (average age, 10.6 +/- 2.5 years) with T-cell lymphoma of the intestinal tract with eosinophil infiltrates. No sex predominance was apparent. All had localized tumor masses in the small intestine. Grossly, the intestinal wall was thickened, and the lumen of the affected intestine was usually narrowed. Microscopically, we observed transmural diffuse invasion of round to pleomorphic tumor cells. Tumor cells showed varying morphology, from scanty to abundant cytoplasm, and round to ovoid nuclei with scattered to dense chromatin. In seven of the dogs, tumor cells had infiltrated into the epithelium. All showed infiltration of eosinophils and all 11 tumors had a T-cell phenotype (CD3+, CD79-). Only one tumor stained positive for the mast cell marker c-kit and none was positive for mast cell tryptase. We did not observe ultrastructurally apparent granules in any of the tumor cells. These results suggest that, in dogs, T-cell lymphomas of intestinal origin resemble mast cell tumors of intestinal origin with respect to cell structure and eosinophil infiltration. Therefore, in the absence of epitheliotropism, it is difficult to confirm the differential diagnosis without immunostaining for mast cell and lymphocyte markers, including mast cell tryptase, c-kit, CD3, and CD79.     

Bilateral laryngeal paralysis in a dog secondary to laryngeal osseous metaplasia

A 7-year-old spayed female Lurcher was evaluated for a chronic history of increased upper respiratory noise. Advanced imaging including digital radiography and pre- and post-contrast computed tomography (CT) scan confirmed the presence of an ill-defined soft tissue mineralized mass of the ventral larynx. Histopathology demonstrated pleocellular myositis and fasciitis with osseous metaplasia.     

Development of high-grade B-cell lymphoma concurrent with T-cell chronic lymphocytic leukemia in a dog

Second malignancies are frequent complications in human patients with chronic lymphocytic leukemia (CLL). However, the clinical details and outcome of this phenomenon were unclear in their canine counterparts. Here, we report a dog with high-grade lymphoma concurrent with T-cell CLL. A 10-year-old male golden retriever presented with lymphadenopathies. The lymph nodes contained large-sized lymphocytes, raising suspicion of high-grade lymphoma. Meanwhile, small lymphocytic lymphocytosis in the peripheral blood was consistent with CLL. Interestingly, molecular biological analyses revealed that CLL cells were of the T-cell type, whereas lymphoma cells were of the B-cell type. Chemotherapy using the L-VCA short protocol was effective for 155 days, but the dog died on day 194 after diagnosis, despite rescue therapies.     

Isoniazid-induced seizures with secondary rhabdomyolysis and associated acute renal failure in a dog

Isoniazid-induced seizures resulted in rhabdomyolysis and associated acute renal tubular necrosis in a dog. Rhabdomyolysis and myoglobinuric renal failure, although recognised in the dog, are reported infrequently as a consequence of seizures. The clinical presentation of isoniazid toxicity in a dog is described.     

Complete atrioventricular block secondary to cardiac lymphoma in a dog

Third degree atrioventricular (AV) block was observed in a patient with a roughly spherical mass measuring approximately 1 × 1 × 1 cm, visible in the basilar portion of the interventricular septum on 2-dimensional transthoracic echocardiographic examination. The patient had a brief history of lethargy and episodic collapse, and the owner elected to euthanize the dog after the mass lesion was discovered. Necropsy revealed multiple masses within the interventricular septum, ventricular free walls and atrial myocardium. The final diagnosis was large cell (T-cell) lymphosarcoma.