Veterinary clinical pathology最新文献

英文中文

Clinicopathologic findings of splenic marginal zone lymphoma with gallbladder involvement that progressed to diffuse large B-cell lymphoma in a dog 一只狗的脾边缘区淋巴瘤累及胆囊并发展为弥漫大 B 细胞淋巴瘤的临床病理结果。

IF 1.2 4区农林科学 Q2 Veterinary

Veterinary clinical pathology

Pub Date : 2024-05-28 DOI: 10.1111/vcp.13331

Makoto Akiyoshi, Masaharu Hisasue, Yuko Goto-Koshino, Midori Goto Asakawa, Sakurako Neo, Masami Akiyoshi, Hirotaka Tomiyasu

A 12-year-old spayed female Dalmatian presented with acute vomiting and anorexia. The clinicopathological and imaging abnormalities included icterus, biliary obstruction, and multiple diffuse splenic hypoechogenic nodules. Cholecystectomy was performed to remove the obstruction, followed by liver biopsy and splenectomy. Histopathological and immunohistology evaluation of the spleen, liver, and gallbladder revealed splenic marginal zone lymphoma (MZL) with gallbladder and hepatic infiltration of neoplastic CD20/CD79α-positive cells. Moreover, we observed clonal rearrangements of the immunoglobulin heavy-chain (IgH) gene in all three tissues. The dog was in good condition without chemotherapy. However, there was progressive elevation of liver enzymes, which could be attributed to neoplastic hepatic infiltration. Chlorambucil and prednisolone were administered until day 108, when the liver enzyme levels normalized. On day 156, the dog developed diffuse large B-cell lymphoma (DLBCL) of the peripheral lymph nodes. Sequence analysis of the clonally rearranged IgH gene revealed that all neoplastic cells in the spleen, gallbladder, and liver at initial presentation, as well as lymph nodes on day 156, possessed the same sequence identity of the amplified IgH fragments. This demonstrated that all neoplastic cells were derived from the same B-lymphocyte clone. The DLBCL was considered to have transformed from the splenic MZL, with gallbladder involvement. In cases of splenic MZL, it is important to consider gallbladder involvement and transformation to DLBCL. Moreover, gallbladder lymphoma should be included in the differential diagnosis of dogs with gallbladder abnormalities. Further studies are warranted to investigate the prognosis of splenic MZL.

一只 12 岁的绝育雌性达尔马提亚犬出现急性呕吐和厌食。临床病理和影像学异常包括黄疸、胆道梗阻和多发性弥漫性脾脏低瘀血结节。患者接受了胆囊切除术以清除梗阻，随后进行了肝活检和脾脏切除术。对脾脏、肝脏和胆囊进行组织病理学和免疫组织学评估后发现，脾脏边缘区淋巴瘤（MZL）伴有胆囊和肝脏肿瘤性CD20/CD79α阳性细胞浸润。此外，我们还在这三种组织中观察到免疫球蛋白重链（IgH）基因的克隆重排。该犬在未接受化疗的情况下状况良好。然而，肝酶进行性升高，这可能是由于肿瘤性肝浸润所致。它接受了氯霉素和泼尼松龙治疗，直到第 108 天，肝酶水平才恢复正常。第 156 天，该犬外周淋巴结出现弥漫性大 B 细胞淋巴瘤（DLBCL）。对克隆重组的 IgH 基因进行序列分析后发现，最初发病时脾脏、胆囊和肝脏中的所有肿瘤细胞以及第 156 天淋巴结中的所有肿瘤细胞都具有相同的扩增 IgH 片段序列。这表明所有肿瘤细胞都来自同一个 B 淋巴细胞克隆。DLBCL被认为是由脾脏MZL转化而来，并累及胆囊。在脾MZL病例中，考虑胆囊受累并转化为DLBCL非常重要。此外，胆囊淋巴瘤也应列入胆囊异常犬的鉴别诊断中。有必要进一步研究脾脏 MZL 的预后。

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