Indolent cutaneous T-cell lymphoma presenting as cutaneous lymphocytosis in dogs

Canine T zone lymphoma is a tumor of mature, previously activated αβ T cells

T cell lymphomas are a diverse group of tumors found in both dogs and humans, originating from various normal T cell types. Identifying the origin of neoplastic lymphocytes can offer valuable insights into the pathogenesis and clinical behavior of these tumors. T zone lymphoma (TZL) in dogs is characterized by the absence of CD45 expression, a strong breed predilection, and its association with adult-onset demodicosis-a condition believed to be linked to immunosuppression. In this study, our aim was to employ transcriptomic and functional data to determine the normal counterpart of TZL. Identifying the normal counterpart may help us understand both how these tumors arise and explain their clinical behavior. Gene expression profiling using NanoString and RNA seq was used to compare the transcriptome between neoplastic T zone cells, normal canine T cells and publicly available gene sets using Gene Set Enrichment Analysis. Mitogen, anti-CD3 stimulation and PMA/ionomycin stimulation were used to assess T cell proliferation in vitro, and intracellular cytokine production was measured by flow cytometry. Gene expression profiling revealed that TZL is most likely derived from an activated or memory alpha-beta T cell but the cells do not fall cleanly into an effector subtype. TZL cells express CD4-specific transcription factors GATA3 and THPOK, even though TZL cells more commonly express CD8, or neither CD4 nor CD8. TZL cells produce high levels of interferon gamma and tumor necrosis factor alpha when stimulated, further supporting the hypothesis that they are derived from an antigen experienced T cell. TZL cells do not proliferate when stimulated through the T cell receptor but will divide when the T cell receptor is bypassed with PMA and ionomycin. The observation that these cells are derived from a mature, previously activated T cell is the first step in understanding the genesis of this unique T cell tumor.

A 40-YEAR (1980-2019) RETROSPECTIVE REVIEW OF MORBIDITY AND MORTALITY OF FENNEC FOXES (VULPES ZERDA) AT THE BRONX AND PROSPECT PARK ZOOS

The Wildlife Conservation Society (WCS) has housed fennec foxes (Vulpes zerda) at its facilities since the early 1900s and currently has one of the largest populations managed by the fennec fox Species Survival Plan. Of the 83 foxes held by WCS institutions between 1980 and 2019, 52 medical records and 48 postmortem reports were available for review. Common causes of morbidity included trauma and dermatologic disease, especially atopic dermatitis. Average age at death for animals surviving past 10 wk was 9.76 yr. Common causes of death or euthanasia were neoplasia (15/48, 31%) and infectious disease (14/48, 29%), with neoplastic processes incidentally identified in an additional seven animals. Significant antemortem cardiac changes were identified in 22 animals. Hepatocellular carcinoma (HCC) was diagnosed in nine animals, consistent with previous documentation of HCC as one of the most common neoplasms in this species. Four animals were suspected to have succumbed to vaccine-induced canine distemper virus after receiving a modified live vaccine. No canine distemper infections have been documented after 1981 in this population and since the use of a canarypox-vectored recombinant vaccine. Recommendations for management of this species include routine screening for hepatic neoplasia in adult animals, regular cardiac evaluations including electrocardiogram, echocardiogram, and dermatologic examination as described by the current consensus statement on canine atopic dermatitis. This descriptive morbidity and mortality report is the first for the fennec fox.

Feline and Canine Cutaneous Lymphocytosis: Reactive Process or Indolent Neoplastic Disease?

Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.

Treatment of indolent cutaneous T-cell lymphoma with hypofractionated radiation therapy in three cats

BACKGROUND

Feline indolent cutaneous T-cell lymphoma (ICL) is an uncommon neoplastic disease. There is currently no consensus on treatment recommendations for ICL.

OBJECTIVE

To report the clinical outcome of three cats with ICL treated with hypofractionated electron-beam radiotherapy (RT).

ANIMALS

Three privately owned cats with ICL.

MATERIALS AND METHODS

Medical records and client surveys were reviewed. A diagnosis of probable ICL was based on history, clinical presentation and histopathological findings, and confirmed using CD3 immunohistochemical analysis and PCR for antigen receptor gene rearrangement (PARR). All cats were treated with hypofractionated RT (four fractions of 8 Gy).

RESULTS

All cats presented with skin lesions characterised by erythema and alopecia that were refractory to previous treatment with systemic glucocorticoids. Before hypofractionated RT treatment, lesions were histologically described as having diffuse infiltration of the dermis with CD3+ T cells. Molecular clonality analysis revealed clonal T-cell receptor gamma gene rearrangement. After RT, two cats showed histological improvement defined by decreased infiltration of lymphocytes, with cellular infiltrate present only in the deeper dermis; one cat had near complete histological resolution of lesions with only minimal residual lymphocytes. One cat was determined to have a complete clinical response while the other showed partial responses. No acute adverse effects of radiation were observed; chronic effects included leukotrichia, partial alopecia and mild fibrosis. All clients reported improvement in quality of life for their cats.

CONCLUSIONS AND CLINICAL IMPORTANCE

Clinical and histological improvement in these cats suggests that hypofractionated RT can be a useful treatment modality for cats with ICL.

Canine non-epitheliotropic CD4-positive cutaneous T-cell lymphoma: a case report

A 5‐year‐old, spayed female French Bulldog presented with multiple papules on the skin of the scapular area. Histopathological examination of punch biopsy samples revealed dense infiltration of small lymphoid cells in the superficial dermis and in areas surrounding hair follicles. Immunohistochemical analysis indicated that these cells were positive for CD3, CD4, and TCRαβ, but negative for CD1c, CD8α, CD8β, CD11c, CD20, CD45RA, CD90, MHC‐II, and TCRγδ. In addition, CD45 was highly expressed, and the proliferation fraction was very low. Molecular clonality of T‐cell receptor G chains yielded a clonal result. The skin lesions were surgically excised because they had progressed to the lateral front leg. Postoperative clinical course was favorable, and recurrence was not observed until the dog died in a traffic accident, approximately 1 year later.

Detection of monoclonality in intestinal lymphoma with polymerase chain reaction for antigen receptor gene rearrangement analysis to differentiate from enteritis in dogs

The diagnosis of canine intestinal lymphoma by morphological examination is challenging, especially when endoscopic tissue specimens are used. The utility of detection of antigen receptor gene rearrangement by polymerase chain reaction (PARR) in canine lymphoma has been well established, but its usefulness to distinguish enteritis and intestinal lymphoma remains unclear. In this retrospective study we assessed clonality of 29 primary canine intestinal lymphoma, 14 enteritis and 15 healthy control cases by PARR analysis, using formalin-fixed, paraffin-embedded full-thickness tissue specimens. We could detect monoclonal rearrangements in 22 of 29 canine intestinal lymphomas [76%; 95% confidence interval (CI) 56-90%] and polyclonal rearrangements in all of the enteritis and healthy control cases (100%; CI 88-100%). We revealed a predominance of T-cell phenotype compared to B-cell phenotype (85%; CI 65-96% and 15%; CI 4-35%, respectively). We showed that PARR analysis contributes to differentiation of canine intestinal lymphoma from enteritis and to phenotyping of lymphomas.

Feline cutaneous lymphocytosis: case report and summary of the literature

Practical relevance:

Feline cutaneous lymphocytosis is a rare disease characterized by proliferation of T and/or B lymphocytes in the dermis. Although some of the clinical and histopathologic findings of this condition can overlap with cutaneous lymphoma, it is important to distinguish these entities since their treatment and clinical outcomes vary greatly.

Scope:

This report presents a summary of the literature on feline cutaneous lymphocytosis and describes a case of this condition which showed some unique clinical features and was successfully controlled with oral glucocorticoids.

Beyond H&E: integration of nucleic acid-based analyses into diagnostic pathology

Veterinary pathology of infectious, particularly viral, and neoplastic diseases has advanced significantly with the advent of newer molecular methodologies that can detect nucleic acid of infectious agents within microscopic lesions, differentiate neoplastic from nonneoplastic cells, or determine the suitability of a targeted therapy by detecting specific mutations in certain cancers. Polymerase chain reaction-based amplification of DNA or RNA and in situ hybridization are currently the most commonly used methods for nucleic acid detection. In contrast, the main methodology used for protein detection within microscopic lesions is immunohistochemistry. Other methods that allow for analysis of nucleic acids within a particular cell type or individual cells, such as laser capture microdissection, are also available in some laboratories. This review gives an overview of the factors that influence the accurate analysis of nucleic acids in formalin-fixed tissues, as well as of different approaches to detect such targets.

Histomorphological and immunohistochemical characterization of 172 cutaneous round cell tumours in dogs

This paper describes the use of a panel of antibodies (CD117, CD3, CD79a, CD45, cytokeratin, vimentin and E-cadherin) on formalin-fixed, paraffin-embedded sections of canine cutaneous round cell tumours. Neoplastic tumours were diagnosed by histology and histochemical stains and included 107 mast cell tumours, 31 cutaneous histiocytomas, two localized histiocytic sarcomas, 21 cutaneous lymphomas, three plasma cell tumours, one transmissible venereal tumour and seven unclassified round cell tumours. The histologic diagnosis was modified in 39.5% of the total 172 neoplasms. The staining for CD45 and Ecadherin were variable, and therefore, the final diagnoses of cutaneous histiocytoma and localized histiocytic sarcoma were made based on histology in association with negative results for CD3, CD79a, CD117 and cytokeratin. The cellular origin of unclassified round cell tumours was defined in all cases. Cutaneous B-cell lymphoma and plasma cell tumours were CD79a-positive and could be distinguished from each other by the morphological characteristics. Mast cell tumours and T cell lymphoma were CD117 and CD3 positive, respectively. The positive staining for vimentin and the negative staining for CD3, CD79a, CD117 and cytokeratin favoured the diagnosis of transmissible venereal tumours. Thus, the final diagnosis of cutaneous round cell tumours should be based on the interpretation of immunohistochemical results together with the cellular morphology observed by histology. Therefore, more studies to optimize the specific markers in formalin-fixed, paraffinembedded tissues (especially for histiocytes) are required for definitive diagnosis of round cell tumours in dogs.