Peer-reviewed veterinary case report
Diagnosing T cell-rich large B cell lymphoma in a young dog using
By Lee, Gary Kwok Cheong et al.·Published in BMC veterinary research·2021·Department of Pathobiology, Canada·View original on PubMed →
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Original publication title: Use of immune repertoire sequencing to resolve discordant microscopic and immunochemical findings in a case of T cell-rich large B cell lymphoma in a young dog.
- Species:
- dog
Plain-English summary
A 10-month-old Great Dane was brought in for severe fluid buildup in the abdomen, known as ascites. Tests showed a mix of lymphocytes, leading to a diagnosis of lymphoma, but the dog's condition worsened quickly, and it was euthanized. A post-mortem examination revealed a rare type of lymphoma called T cell-rich large B cell lymphoma, where B cells were found in the liver but not in the abdominal fluid. Advanced testing helped clarify the diagnosis by distinguishing between cancerous and reactive cells. Unfortunately, despite the efforts to diagnose and treat, the dog did not survive.
People also search for: Great Dane ascites · dog lymphoma diagnosis · T cell-rich large B cell lymphoma treatment
Abstract
BACKGROUND: Lymphocytic neoplasms with frequent reactive lymphocytes are uncommonly reported in dogs, and can pose a diagnostic challenge. Different diagnostic modalities such as cytology, flow cytometry, histopathology, immunohistochemistry, and clonality testing, are sometimes required for a diagnosis. This report illustrates the value of using a multi-modal diagnostic approach to decipher a complex lymphocytic tumor, and introduces immune repertoire sequencing as a diagnostic adjunct. CASE PRESENTATION: A 10-month-old Great Dane was referred for marked ascites. Cytologic analysis of abdominal fluid and hepatic aspirates revealed a mixed lymphocyte population including numerous large lymphocytes, yielding a diagnosis of lymphoma. Flow cytometrically, abdominal fluid lymphocytes were highly positive for CD4, CD5, CD18, CD45, and MHC II, consistent with T cell lymphoma. Due to a rapidly deteriorating clinical condition, the dog was euthanized. Post mortem histologic evaluation showed effacement of the liver by aggregates of B cells surrounded by T cells, suggestive of hepatic T cell-rich large B cell lymphoma. Immune repertoire sequencing confirmed the presence of clonal B cells in the liver but not the abdominal fluid, whereas reactive T cells with shared, polyclonal immune repertoires were found in both locations. CONCLUSIONS: T cell-rich large B cell lymphoma is a rare neoplasm in dogs that may be challenging to diagnose and classify due to mixed lymphocyte populations. In this case, the results of histopathology, immunohistochemistry and immune repertoire sequencing were most consistent with a hepatic B cell neoplasm and reactive T cells exfoliating into the abdominal fluid. Immune repertoire sequencing was helpful in delineating neoplastic from reactive lymphocytes and characterizing repertoire overlap in both compartments. The potential pitfalls of equating atypical cytomorphology and monotypic marker expression in neoplasia are highlighted.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33602231/