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Wolfesberger B, Burger S, Kummer S, Walter I, Tichy A, Klinger S, Alton K, Burgener IA, Liehmann L, Hammer SE, Rütgen BC, Fuchs-Baumgartinger A. Proliferation Activity in Canine Gastrointestinal Lymphoma. J Comp Pathol 2021; 189:77-87. [PMID: 34886989 DOI: 10.1016/j.jcpa.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/14/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Gastrointestinal lymphomas are uncommon in dogs and little is known about their distinct subtypes or proliferation rate. The aim of this study was to stratify 33 canine gastrointestinal lymphoma samples according to the latest World Health Organization classification and to determine the Ki67 proliferation index by manual counting, digital image analysis and visual estimation. The Ki67 index was then correlated with subtype, immunophenotype, mitotic index, grade and tumour location. The mitotic index correlated positively with the Ki67 index. A significantly higher number of Ki67-positive cells was found in enteropathy-associated T-cell lymphoma type I and in diffuse large B-cell lymphoma compared with enteropathy-associated T-cell lymphoma type II. There was also a significant difference in Ki67 immunolabelled cells between grade 1 and grade 2 lymphomas. Moderate agreement was found between the Ki67 index as obtained by manual counting and visual estimation, but there was strong agreement between manual counting and digital image analysis. The user-friendly digital imaging system used in this study could have potential for future determination of the Ki67 index in lymphoid neoplasms.
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Affiliation(s)
- Birgitt Wolfesberger
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.
| | - Stefanie Burger
- VetCORE-Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - Stefan Kummer
- VetCORE-Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - Ingrid Walter
- VetCORE-Facility for Research, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Sabine Klinger
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Klemens Alton
- Practice for Veterinary Pathology, Korneuburg, Austria
| | - Iwan A Burgener
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Lea Liehmann
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Sabine E Hammer
- Department of Pathobiology, University of Veterinary Medicine, Vienna
| | - Barbara C Rütgen
- Department of Pathobiology, University of Veterinary Medicine, Vienna
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Freiche V, Paulin MV, Cordonnier N, Huet H, Turba M, Macintyre E, Molina T, Hermine O, Couronné L, Bruneau J. Histopathologic, phenotypic, and molecular criteria to discriminate low-grade intestinal T-cell lymphoma in cats from lymphoplasmacytic enteritis. J Vet Intern Med 2021; 35:2673-2684. [PMID: 34374109 PMCID: PMC8692189 DOI: 10.1111/jvim.16231] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Differentiation of low-grade intestinal T-cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. OBJECTIVE Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. ANIMALS Forty-four client-owned cats, 22 diagnosed with LGITL and 22 with LPE. METHODS Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full-thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. RESULTS A monomorphic lymphocytic population (22/22, 100%) and in-depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical-to-basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki-67 20%- and 30%-thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3- and pSTAT5+. T-cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). CONCLUSIONS AND CLINICAL IMPORTANCE We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE.
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Affiliation(s)
- Valérie Freiche
- Ecole Nationale Vétérinaire d'AlfortCHUVA, Unité de Médecine InterneMaisons‐Alfort F‐94700France
| | - Mathieu V. Paulin
- Department of Small Animal Clinical SciencesWestern College of Veterinary Medicine, University of SaskatchewanSaskatoonSKCanada
| | - Nathalie Cordonnier
- Pathology DepartmentEcole Nationale Vétérinaire d'Alfort, BiopôleMaisons‐Alfort F‐94700France
| | - Hélène Huet
- Pathology DepartmentEcole Nationale Vétérinaire d'Alfort, BiopôleMaisons‐Alfort F‐94700France
| | | | - Elizabeth Macintyre
- Laboratory of Onco‐Hematology, Hôpital Necker‐Enfants Malades, Assistance Publique des Hôpitaux de ParisUniversity of ParisParisFrance
- INSERM U1151, Necker‐Enfants Malades InstituteUniversity of ParisParisFrance
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
| | - Thierry‐Jo Molina
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Pathology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
| | - Olivier Hermine
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
- Hematology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
| | - Lucile Couronné
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
- Cytogenetics Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
| | - Julie Bruneau
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Pathology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
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Freiche V, Fages J, Paulin MV, Bruneau J, Couronné L, German AJ, Penninck D, Hermine O. Clinical, laboratory and ultrasonographic findings differentiating low-grade intestinal T-cell lymphoma from lymphoplasmacytic enteritis in cats. J Vet Intern Med 2021; 35:2685-2696. [PMID: 34687072 PMCID: PMC8692195 DOI: 10.1111/jvim.16272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Low‐grade intestinal T‐cell lymphoma (LGITL) is the most common intestinal neoplasm in cats. Differentiating LGITL from lymphoplasmacytic enteritis (LPE) is challenging because clinical signs, laboratory results, diagnostic imaging findings, histology, immunohistochemistry, and clonality features may overlap. Objectives To evaluate possible discriminatory clinical, laboratory and ultrasonographic features to differentiate LGITL from LPE. Animals Twenty‐two cats diagnosed with LGITL and 22 cats with LPE based upon histology, immunohistochemistry, and lymphoid clonality. Methods Prospective, cohort study. Cats presented with clinical signs consistent with LGITL or LPE were enrolled prospectively. All data contributing to the diagnostic evaluation was recorded. Results A 3‐variable model (P < .001) consisting of male sex (P = .01), duration of clinical signs (P = .01), and polyphagia (P = .03) and a 2‐variable model (P < .001) including a rounded jejunal lymph node (P < .001) and ultrasonographic abdominal effusion (P = .04) were both helpful to differentiate LGITL from LPE. Conclusions and Clinical Importance Most clinical signs and laboratory results are similar between cats diagnosed with LGITL and LPE. However, male sex, a longer duration of clinical signs and polyphagia might help clinicians distinguish LGITL from LPE. On ultrasonography, a rounded jejunal lymph node, and the presence of (albeit small volume) abdominal effusion tended to be more prevalent in cats with LGITL. However, a definitive diagnosis requires comprehensive histopathologic and phenotypic assessment.
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Affiliation(s)
- Valérie Freiche
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Unité de Médecine Interne, Maisons-Alfort, France
| | | | - Mathieu Victor Paulin
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine-University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Julie Bruneau
- Pathology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
| | - Lucile Couronné
- Cytogenetics Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
| | - Alexander J German
- Institute of Life Course and Medical Sciences, University of Liverpool, Merseyside, United Kingdom
| | - Dominique Penninck
- Diagnostic Imaging Section, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Olivier Hermine
- Hematology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP); Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
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Gianella P, Pietra M, Crisi PE, Famigli Bergamini P, Fracassi F, Morini M, Boari A. Evaluation of clinicopathological features in cats with chronic gastrointestinal signs. Pol J Vet Sci 2017; 20:403-410. [PMID: 28865226 DOI: 10.1515/pjvs-2017-0052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Food-responsive enteropathy (FRE), idiopathic inflammatory bowel disease (IBD), and alimentary tract lymphoma (AL) are often the remaining differentials for cats presenting with chronic gastrointestinal (GI) signs. Differential diagnosis is further complicated by overlapping clinicopathological features and histopathological changes, however. In this study we describe the clinical presentation of cats with chronic GI signs secondary to FRE, IBD, and AL, and evaluate possible associations between clinical, clinicopathological, ultrasonographic findings and diagnosis. The medical records of client-owned cats with chronic GI signs secondary to FRE, IBD, and AL were reviewed. Univariate and multivariate logistic regression models and receiver-operating characteristic curve (ROC) analysis were used for testing the data. Of the 56 cats included in the study, 22 were diagnosed with FRE (mean age, 70 months ± 49), 17 with IBD (mean age, 101 months ± 40), and 17 with AL (mean age, 122 months ± 45). Cats with FRE were younger and presented more often with diarrhea and less frequently with muscle wasting than cats with IBD or AL. In cats with AL, serum cobalamin levels were lower than in those with FRE or IBD (239 ± 190 ng/L vs. 762 ± 408 ng/L and 625 ± 443 ng/L, respectively) and folate levels were higher than in cats with IBD (18.2 ± 4.2 μg/L vs. 9.1 ± 4.7 μg/L, respectively). Multivariate/ROC curve analysis showed increased values of BUN (sensitivity 100, specificity 29.4, criterion >37 mg/dl) and serum folate (sensitivity 80, specificity 100, criterion >15.6 μg/L) and reduced values of cobalamin (sensitivity 100, specificity 62.5, criterion ≤540 ng/L), which suggested a diagnosis of AL versus IBD. Some clinicopathological features evaluated at diagnosis might suggest AL; however, because differentiating AL from IBD is often difficult, definitive diagnosis should be based on invasive diagnostic workup.
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Ohmura S, Leipig M, Schöpper I, Hergt F, Weber K, Rütgen BC, Tsujimoto H, Hermanns W, Hirschberger J. Detection of monoclonality in intestinal lymphoma with polymerase chain reaction for antigen receptor gene rearrangement analysis to differentiate from enteritis in dogs. Vet Comp Oncol 2015; 15:194-207. [PMID: 25988583 DOI: 10.1111/vco.12151] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/27/2015] [Accepted: 04/04/2015] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- S Ohmura
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - M Leipig
- Institute of Veterinary Pathology, Ludwig Maximilian University, Munich, Germany
| | - I Schöpper
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - F Hergt
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - K Weber
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - B C Rütgen
- Department of Pathobiology, Clinical Pathology Platform, University of Veterinary Medicine, Vienna, Austria
| | - H Tsujimoto
- Department of Veterinary, Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - W Hermanns
- Institute of Veterinary Pathology, Ludwig Maximilian University, Munich, Germany
| | - J Hirschberger
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
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