Immunohistochemical characterization of lymphosarcoma in two alpacas (Lama pacos)

Neoplasia and Proliferative Lesions of New World Camelids: A Systematic Literature Review and Retrospective Study of Cases Submitted to Colorado State University From 1995 to 2020

Camelid pathology submissions to veterinary diagnostic laboratories are on the rise given the increasing popularity and population of llamas and alpacas especially in the western United States. When compared to other animals, the field of camelid neoplasia has a relative paucity of cases reported in the literature. The Colorado State University Veterinary Diagnostic Laboratories (CSU-VDL) has had a steady increase in the numbers of camelid pathology submissions allowing for a robust review of diagnoses of neoplasia in new world camelids. Here we present a retrospective analysis of camelid neoplastic and proliferative lesions diagnosed at the CSU-VDL from 1995 to 2020, followed by an extensive literature review. Results show increasing incidence of camelid neoplasia reported in the literature, therefore becoming a common diagnosis in llamas and alpacas. Proliferative and neoplastic lesions were diagnosed in 8.8% of new world camelid submissions to CSU-VDL with the most common tumors being lymphomas, squamous cell carcinomas, fibromas, and adenocarcinomas. Risk factors are female sex and increased age except in the case of lymphoma, which tends to occur in younger camelids. Lymphomas, melanomas, and adenocarcinomas (especially of gastrointestinal tract) carry an increased risk of multiple-organ system involvement often with widespread metastases. Conditions described in camelids for the first time include osteosarcoma, cutaneous hemangiosarcoma, myxosarcoma, pilomatricoma, ovarian theca cell tumor, congenital nevus with malignant transformation, and various other neoplasia. This article will provide an operational guide for camelid neoplasia to further assist veterinary laboratory diagnosticians, researchers, and practicing veterinarians in the field of camelid medicine and pathology.

Pagetoid reticulosis (epitheliotropic cutaneous T-cell lymphoma) in an adult alpaca (Vicugna pacos)

A 9-year-old, intact female alpaca (Vicugna pacos) was presented for a second opinion with a 1-year history of nonpruritic, multifocal scaling and crusted cutaneous lesions, mainly involving skin on the face, axillae, and ventral abdomen. Clinical abnormalities were limited to the skin, and the alpaca was otherwise healthy. The initial veterinarian had examined the alpaca, found no evidence of ectoparasites with laboratory testing, and had tried several trial therapies including oral antibiotics, ivermectin, and topical use of betadine solution. At the time of presentation, the lesions had neither improved nor worsened with any attempted therapy, and multiple skin biopsies were collected. Histopathology and immunohistochemical staining findings were consistent with the pagetoid reticulosis type of cutaneous epitheliotropic T-cell lymphoma. Our report describes the clinical, histopathologic, and immunophenotypic features of pagetoid reticulosis epitheliotropic cutaneous T-cell lymphoma in an alpaca.

Resident lymphocytes in the dermis of the normal dorsolateral thoracic skin of alpacas

BACKGROUND

Small numbers of resident T lymphocytes are present in the dermis of normal skin of humans, cattle and sheep.

HYPOTHESIS/OBJECTIVES

We wanted to determine the prevalence, numbers and immunophenotype of lymphocytes in the dermis of healthy skin from alpacas.

ANIMALS

Skin biopsy specimens were collected from the dorsolateral thorax of 31 alpacas with normal skin.

METHODS

Skin biopsy specimens were evaluated for the prevalence and numbers of CD3+ and CD79a+ lymphocytes.

RESULTS

Resident CD3+ and CD79a+ lymphocytes were found around the superficial and deep dermal blood vessels. The CD3+ lymphocytes were more numerous than CD79a+ lymphocytes. Both CD3+ and CD79a+ lymphocytes were more numerous around superficial dermal blood vessels.

CONCLUSIONS AND CLINICAL IMPORTANCE

Resident CD3+ and CD79a+ lymphocytes are present around superficial and deep dermal blood vessels in normal skin from alpacas; hence, the presence of lymphocytes in these locations without obvious features of inflammation must be interpreted cautiously when evaluating skin biopsy specimens from alpacas with skin disease.

Pathologic and immunophenotypic characterization of 26 camelid malignant round cell tumors

Lymphoma and/or leukemia was diagnosed in 26 camelids (20 alpacas and 6 llamas) out of 110 camelid neoplasia archived January 1995 through January 2012 at the Colorado State Veterinary Diagnostic Laboratories (CSU-VDL). Some of the tumors presented a diagnostic challenge because they could not be distinguished on the basis of gross or microscopic morphology. Immunohistochemistry using a T-cell marker (cluster of differentiation [CD]3), a B-cell marker (paired box protein [PAX]-5), a leukocyte integrin beta-2 marker (CD18), and a neuroendocrine marker (synaptophysin) was employed to help differentiate between lymphoma and other malignant round cell tumors. Alpaca lymphomas presented as either juvenile disseminated lymphoma in crias ≤ 2 years of age (n = 8) or adult multicentric lymphoma and/or leukemia (n = 12). Lymphomas in alpacas were of T-cell origin (n = 13), non-B-cell, non-T-cell origin (n = 4), B-cell origin (n = 2), or myelogenous leukemia (n = 1). Abdominal organs, predominantly the liver, were commonly involved in both the crias and adult alpacas. Lymphomas in llamas presented as either adult multicentric lymphoma of B-cell origin in animals younger than 7 years of age (n = 2), or T-cell lymphoma (n = 2), and non-B-cell, non-T-cell lymphoma (n = 1) in animals 7 years of age or older. The thorax was commonly involved in llamas, with infiltration of neoplastic cells into hilar and mediastinal lymph nodes. A rare type of lymphoma diagnosed in the llamas was cutaneous, epitheliotrophic T-cell lymphoma (n = 1).

Brain tumours in two Bactrian camels: a histiocytic sarcoma and a meningioma

Primary brain tumours were identified in two Bactrian camels (Camelus bactrianus) living at the Zoological Society of London's two zoos. Histology and immunohistochemistry were used to diagnose a histiocytic sarcoma in a 16-year-old female and a fibroblastic meningioma in a 13-year-old male. Before one died and the other was euthanased both camels had shown progressive neurological signs, including circling and ataxia.

Malignant round cell neoplasia in llamas and alpacas

Malignant round cell neoplasia was identified in 12 llamas and 12 alpacas aged 0-23 years. Mean age of affected alpacas (3.1 years) was significantly less than that of affected llamas (8.0 years). Tumor cell morphology varied from large and often pleomorphic (11 tumors) to small and often homogeneous (13 tumors). Neoplastic lesions were multicentric in 12 cases. Other sites were gastric (5 cases), intra-abdominal (perirenal; 4 cases), intrathoracic (2 cases), and cervical (1 case). Immunohistochemistry with antibodies to CD79alpha, BLA36, and CD3 identified B-cell lymphoma (12 cases) and T-cell lymphoma (6 cases). Six tumors did not express any lymphoid marker and were further immunostained for neuron-specific enolase (NSE), synaptophysin, S-100, glial fibrillary acidic protein (GFAP), and chromogranin A. All 6 of these tumors were negative for GFAP and chromogranin A but expressed 1 or more of the neural markers NSE, synaptophysin, and S-100 and were classified as primitive malignant round cell tumors (PMRCT). Tumor types could not be distinguished on the basis of animal age, gross pathologic appearance, tumor morphology, or tumor location. All animals with lymphoma and 5 with PMRCT died or were euthanatized. One alpaca with a focal cervical PMRCT lived for at least 20 months after diagnosis. Results of this study indicate that malignant round cell tumors in llamas and alpacas are a heterogeneous group that cannot be distinguished on the basis of signalment, postmortem findings, or routine light microscopic findings. Immunohistochemistry is a valuable diagnostic procedure when evaluating malignant round cell neoplasia in llamas and alpacas.

Prevalence of neoplasia in llamas and alpacas (Oregon State University, 2001-2006)

Prevalence and type of neoplastic disease were determined in 551 camelid submissions (368 alpacas [Lama pacos], 180 llamas [Lama glama], and 3 cases in which species was not identified) over a 5-year period. Forty neoplasms were identified in 38 animals (6.9%). Prevalence of neoplasia in llamas was higher (11%) than in alpacas (4.9%). Mean age of camelids with neoplasia was 9.42 +/- 4.9 years. Mean age of alpacas with neoplasia (5.48 +/- 3.7 years) was significantly less than of llamas with neoplasia (12.53 +/- 3.2 years; P < 0.001). Cutaneous and mucocutaneous fibroma/fibropapilloma was most common (10 animals), followed by cutaneous and mucocutaneous squamous cell carcinoma (6 animals), disseminated lymphoma (5 animals), and fibrosarcoma (4 animals). Four of 5 animals with lymphoma were alpacas, aged 0.21 to 4 years. Lymphoma occurred in 1 aged llama (15 years). Disseminated carcinoma and adenocarcinoma occurred in 4 llamas and 2 alpacas, and included biliary (2), gastrointestinal (2), mammary gland (1), and unknown (1) origin. Mean age of camelids with any type of carcinoma or adenocarcinoma (12.36 +/- 2.8 years) was significantly greater than that of camelids with lymphoma (4.24 +/- 6.2 years; P = 0.02). Results indicate that neoplasia is relatively common in camelids and that there are differences between llamas and alpacas as regards prevalence of neoplasia, tumor types, and age at diagnosis.

Immunophenotyping of lymphosarcoma in South American camelids on six British premises

Six cases of lymphosarcoma (LSA) in South American camelids (SACs) were selected from submissions to a diagnostic laboratory network servicing England and Wales. Immunophenotyping was carried out using anti-human CD3 and anti-human CD5 for T-cells; and anti-human CD79a and anti-human CD79b for B-cells/plasma cells. On the basis of labelling with mainly anti-CD3, four of the tumours were classified as T-cell tumours. One case was labelled with anti-CD79a and anti-CD79b, and was classified as a B-cell tumour. In the other case the majority of cells were labelled with anti-CD3, anti-CD79a and anti-CD79b, and was classified as a mixed T- and B-cell tumour. To the authors' knowledge this is the first reported attempt at immunophenotyping LSA in SACs on British premises and is only the second time that a presumptive mixed T- and B-cell LSA has been reported in alpacas and the veterinary literature in general.

Multicentric T-cell lymphosarcoma in an alpaca

A two-year-old female alpaca with multicentric lymphosarcoma presented because of progressive weakness and recumbency. The diagnosis of lymphosarcoma was based on the detection of immature and atypical lymphocytes in a lumbosacral CSF sample. Post mortem examination confirmed multicentric lymphosarcoma involving multiple organs. Immunophenotyping using cross reactive T- and B-cell antibodies characterized the tumour as a T-cell lymphosarcoma.

MULTICENTRIC T-CELL LYMPHOMA IN A DROMEDARY CAMEL (CAMELUS DROMEDARIUS)

A 7-yr-old female dromedary camel (Camelus dromedarius) was evaluated for inappetence, weight loss, polyuria, and polydipsia. The animal did not respond to antibiotic and supportive therapy, became recumbent, and died. Gross examination revealed nodules in the liver, mesenteric and perirenal lymph nodes, and both kidneys, with segmental thickening of the small intestine. Histopathologic examination revealed multifocal lymphoma with moderate mitotic activity. Immunohistochemical staining of neoplastic cells was uniformly CD3-positive, indicating a T-cell lymphoma.