Presumptive primary cardiac lymphoma in a cat causing pericardial effusion

We report a case of primary cardiac lymphoma in a cat, causing pericardial effusion. A 13-year-old castrated male Himalayan cat was evaluated for chronic weight loss and radiographic finding of cardiomegaly. Pericardial effusion and a heart mass were detected via echocardiography. Pericardiocentesis and ultrasound-guided fine needle aspirate of the heart mass were performed under sedation. Antemortem diagnosis of cardiac lymphoma was made based on cytology of pericardial fluid. Based on physical examination, laboratory tests and abdominal radiographs, primary cardiac lymphoma was established as the presumptive clinical diagnosis. Treatment with chemotherapeutic agents was initiated.     

Immunophenotypic comparison of blood and lymph node from dogs with lymphoma

Peripheral blood and lymph node tissue from 12 dogs with lymphoma was immunophenotyped. Additionally, the bone marrow was immunophenotyped in 6 dogs. The lymphomas were characterized as B-cell in 11 dogs and T-cell in 1 dog. Immunophenotypic patterns in the peripheral blood and bone marrow were variable. The trend in dogs with B-cell lymphoma was normal to increased percentage of IgG-positive cells, decreased percentage of pan-T-positive cells, decreased percentage of CD4-positive cells, and decreased CD4/CD8 ratio. Simultaneous immunophenotyping of lymph node, blood and bone marrow cannot be recommended routinely without further studies to document its value as an independent prognostic indicator. However, it is potentially useful for tumor staging and monitoring remission, especially in lymphoma patients with a leukemic phase.     

What is your diagnosis? Cervical mass in a cat

An 8-year-old female spayed domestic shorthair cat was presented for several months of weight loss, decreased appetite, and 2 bilateral, ventral cervical masses. Initial cytologic samples were interpreted as reactive lymphoid hyperplasia. Evaluation of subsequent mass aspirates revealed small numbers of large binucleated and multinucleated cells resembling Reed-Sternberg cells admixed with more numerous small and intermediate-sized lymphocytes. In histopathologic sections, the normal architecture of the lymph node was largely effaced by a slightly heterogeneous mass composed of round cells arranged in densely cellular sheets with a minor population of large (25-mum diameter) mononuclear cells and a few very large (30-40-mum diameter) binucleated or multinucleated cells interpreted as Reed-Sternberg-like cells. Immunohistochemically, the large neoplastic (Reed-Sternberg-like) cells were negative for CD18, CD3, CD20, and CD79a while the background population consisted of about 70% T cells and 30% B cells. This pattern of immunohistochemical staining along with cytologic and histopathologic findings supported a diagnosis of Hodgkin's-like lymphoma, specifically, the lymphocyte-rich subtype. Hodgkin's-like lymphoma has been reported previously in cats and should be suspected when Reed-Sternberg-like cells are observed in cytologic preparations of lymph node aspirates. Histopathology and immunohistochemistry are necessary for a definitive diagnosis.     

基于中医传承辅助平台分析傅汝林教授治疗淋巴瘤的组方及用药规律

目的 通过中医传承辅助平台软件分析傅汝林教授治疗淋巴瘤的组方及用药规律。方法 通过对傅汝林教授2012年9月至2015年8月期间治疗淋巴瘤的中医治疗处方进行收集、整理以及筛选,将符合标准的数据录入中医传承辅助平台软件（V2.0）,运用软件进行数据统计分析,探讨傅汝林教授治疗淋巴瘤的临床特点。结果 对筛选出的符合标准的55例处方以及其中涉及到的103味中药进行分析,初步得出傅汝林教授在治疗淋巴瘤方面善用北沙参、南沙参、白芍等益气养阴之品扶助正气,适当辅以鳖甲、莪术等养阴散结之品配合猫爪草、白花蛇舌草、生甘草、夏枯草等清热解毒之品以消癥瘕。结论 傅汝林教授治疗淋巴瘤多采用益气养阴、散结解毒之品,再根据不同体质状态临证选药,多辅以理气活血、化痰除湿之品,诸药合用,祛邪扶正,标本兼治,从多途径增强抗癌之效,临床疗效显著,为临床更好地运用中医药治疗淋巴瘤提供了新的治疗思路。     

Prognostic value of pretreatment plasma D‐dimer level in dogs with intermediate to high‐grade non‐Hodgkin lymphoma

Pretreatment D‐dimer levels have been reported to predict survival in several types of malignancies in human patients. The objective of this study was to evaluate the prognostic value of pretreatment D‐dimer level in dogs with intermediate to high‐grade non‐Hodgkin lymphoma (NHL). In a prospective, randomized, double‐blind study of F14512 vs etoposide phosphate, we assessed the prognostic value of pretreatment plasma D‐dimer level in 48 client‐owned dogs diagnosed with intermediate to high‐grade NHL. The correlation between pretreatment plasma D‐dimer level and various clinical features, progression‐free survival (PFS) and overall survival (OS) was analysed. The median value of pretreatment plasma D‐dimer level was 0.4 μg/mL (range: 0.1‐14.3 μg/mL). High pretreatment plasma D‐dimer level (>0.5 μg/mL) was detected in 44% (21/48) of dogs. High D‐dimer levels were not correlated with naive vs relapsed lymphoma, clinical stage, substage, immunophenotype or treatment group. D‐dimer levels >0.5 μg/mL were significantly associated with inferior median PFS (54 vs 104 days, P = .011) and OS (93 vs 169 days, P = .003). In the multivariate analysis, high D‐dimer levels remained an independent predictor for worse PFS (HR: 3.21, 95% CI: 1.57‐6.56, P = .001) and OS (HR: 3.87, 95% CI: 1.88‐7.98; P < .001). This study suggests that pretreatment plasma D‐dimer level can serve as a predictor of prognosis in dogs with intermediate to high‐grade NHL. Further studies are warranted to confirm these findings.     

Quantification of plasma DNA as a prognostic indicator in canine lymphoid neoplasia

Dogs have a similar incidence of spontaneous cancers as people, and a noninvasive test to monitor disease status in dogs would be of great value. Humans with cancer often have increased levels of cell‐free circulating DNA in their plasma, which has shown promise for diagnosis, prognosis and detection of residual disease. We hypothesized that dogs with cancer have increased circulating DNA compared with healthy dogs or dogs with non‐neoplastic diseases. Plasma DNA was measured in 40 healthy dogs, 20 dogs with non‐neoplastic diseases and 80 dogs with cancer. The reference interval for plasma DNA in healthy dogs was 1–15 ng mL^?1. Dogs with lymphoma and lymphoid leukaemia had significantly higher concentrations (range: 0–91 ng mL^?1, P < 0.0001). Antigen receptor rearrangement assays suggest that plasma DNA had the same clonality as the primary lymphoid tumours. Dogs with lymphoid neoplasia and plasma DNA >25 ng mL^?1 had shorter remission times than those with < 25 ng mL^?1 (P= 0.0116). In contrast to humans, where increased plasma DNA is seen in many diseases, dogs with nonlymphoid malignancies and non‐neoplastic diseases had plasma DNA concentrations similar to healthy dogs. This study shows that a portion of dogs with lymphoid neoplasia have increased tumour‐derived plasma DNA, which serves as a negative prognostic indicator.     

Gastric Helicobacter species as a cause of feline gastric lymphoma: a viable hypothesis

Gastric Helicobacter spp. are associated with chronic inflammation and neoplastic transformation in humans as well as domestic and laboratory species. The present study examined the association of Helicobacter heilmannii (Hhe) infection in pet cats with feline gastric mucosa associated lymphoid tissue (MALT) lymphoma. Tissues were collected via gastric biopsy or at necropsy from 47 pet cats with clinical signs of gastrointestinal disease, including vomiting and inappetance, and classified as gastritis (14/47), lymphoma (31/37), or normal (2/47). Tissues positive for argyrophilic organisms with Warthin–Starry stain (29/47) were assessed by fluorescent in situ hybridization (FISH) for the presence of Hhe strains 1–4 as well as with a fifth probe that detected Helicobacter salomonis, Helicobacter bizzozeronii, or Helicobacter felis. A significant association of positive Warthin–Starry status with Hhe infection was found in cases of sick cats (22/29; p < 0.05 by Chi-square; χ² = 7.034). Interestingly, a significant association between Hhe status and a diagnosis of lymphoblastic or lymphocytic lymphoma was observed as well in a subset of 24 Warthin–Starry positive lymphoma cases: of lymphoblastic lymphoma cases, 13/17 were positive for Hhe (p < 0.05; χ² = 4.854). Hhe strains 2 and 4 were most commonly found (18/29 and 17/29, respectively) among sick cats, although a higher than expected number of cats was also positive for Hhe1, which initial reports have described as rare in cats and common in humans. The association found between a positive Hhe status with the presence of feline gastric lymphoma, especially lymphoblastic lymphoma, argues for the need to conduct prospective studies to better identify the frequency and strain distribution of Hhe infection in both healthy and clinically ill cats, particularly those cats with gastric lymphoma.