Peer-reviewed veterinary case report
Dog with hemophagocytic syndrome that developed large granular
By Akiyoshi, Makoto et al.·Published in Veterinary clinical pathology·2019·School of Veterinary Medicine, Japan·View original on PubMed →
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Original publication title: A case of hemophagocytic syndrome progressing into large granular lymphoma in a dog.
- Species:
- dog
Plain-English summary
A 12-year-old mixed breed dog was brought to the vet because he was not eating, seemed very tired, and was experiencing vomiting, diarrhea, and weight loss. Tests showed low blood cell counts and an enlarged spleen, leading to a diagnosis of hemophagocytic syndrome (a serious condition where the body attacks its own blood cells). The dog was treated with immunosuppressive medication and initially did well, but seven months later, he developed a type of cancer called large granular lymphoma in the liver. Unfortunately, this case highlights how one serious condition can lead to another in dogs.
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Abstract
A 12-year-old castrated male mixed breed dog was presented with anorexia, lethargy, intermittent vomiting, diarrhea, and weight loss. Clinicopathologic and imaging abnormalities included pancytopenia, icterus, and splenomegaly with multiple minute hypoechogenic nodules. Bone marrow (BM) smears revealed 2.5% hemophagocytic macrophages. In addition, an increased number of small to intermediate lymphocytes (16.3%) and plasma cells (3.2%) were recognized in the BM smears. More than 80% of the lymphocytes contained multiple small intracytoplasmic magenta granules. Histopathologic findings of the spleen revealed hemophagocytosis. Large granular lymphocytes (LGLs) were not found on the liver cytology or splenic histopathology at this time. PCR for antigen receptor rearrangement (PARR) analysis showed a clonal reaction in the T-cell receptor ɤ (TCRɤ) gene in the BM sample. The dog was diagnosed with hemophagocytic syndrome (HPS). The dog was maintained in good condition with immunosuppressive therapy. However, the dog developed hepatic LGL lymphoma 7 months later. At this time, PARR analysis showed a clonal TCRɤ gene rearrangement in the hepatic LGL lymphoma samples. The BM and liver sample clonal rearrangements showed 100% homology, indicating that the small to intermediate granular lymphocytes in the BM at the HPS stage had progressed to hepatic LGL lymphoma. To our knowledge, this is the first report of canine secondary HPS caused by the occurrence of a BM LGL lymphoma clone that progressed to hepatic LGL lymphoma.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30811622/