Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer, often associated with Merkel cell polyomavirus (MCPyV). Recently, immunoglobulin (Ig) expression was reported in MCC, thereby suggesting that B cells might be their cellular ancestors. We tested 30 MCCs (20 MCPyV-positive and 10 MCPyV-negative) using immunohistochemistry for the expressions of IgG, IgA, IgM, Igκ, Igλ, terminal desoxynucleotidyl transferase, paired box gene 5 (PAX5), octamer transcription factor-2 (Oct-2), and sex-determining region Y-box 11 (SOX11). We performed in situ hybridization for Igκ-mRNA or Igλ-mRNA and Ig heavy chain (IgH) gene rearrangement (IgH-R) analyses. The expressions of PAX5, TdT, Oct-2, and SOX11 were not significantly different between MCPyV-positive and MCPyV-negative MCCs. At least 1 of IgG, IgA, IgM, or Igκ was expressed in MCPyV-positive (14/20, 70%) and none in MCPyV-negative MCCs (P=0.0003). There was a higher tendency for Igκ-mRNA expression (7/19, using in situ hybridization) and IgH-R (10/20, using polymerase chain reaction) in MCPyV-positive than in MCPyV-negative MCCs (0/10 and 2/10, respectively), thus suggesting a different Ig production pattern and pathogenesis between the 2 types of MCC. Ig expression or IgH-R in MCPyV-positive MCCs might be associated with MCPyV gene integration or expression in cancer cells but do not necessarily suggest a B-cell origin for MCCs. IgH expression or IgH-R nonsignificantly correlated with improved prognosis. However, these might be important factors that influence the survival of neoplastic cells and might allow the development of novel therapies for patients with MCPyV-positive MCCs.
ABSTRACT. A 5-year-old castrated mongrel dog was brought to our hospital with anorexia and vomiting. Laboratory testing revealed immune-mediated hemolytic anemia (IMHA), and so treatment was initiated with multiple immune-suppressing drugs, achieving partial remission from IMHA. However, cardiac tamponade due to purulent pericarditis was identified as a secondary disease. Culture of pericardial fluid yielded numerous Candida albicans and multidrug-resistant Acinetobacter sp. Pericardiocentesis was performed, and the condition of the dog improved. However, the dog died the next day. KEY WORDS: cardiac tamponade, immune-mediated hemolytic anemia, purulent pericarditis.J. Vet. Med. Sci. 71(5): 669-672, 2009 Pericardial effusion is found in 7% of canine cardiac diseases incidentally during echocardiography or as a result of clinical presentation associated with cardiac tamponade [13]. When pericardial effusion increases, intrapericardial pressure rises above the diastolic intracardiac pressure and results in cardiac tamponade. In cardiac tamponade, cardiac output is reduced, and this results in hypovolemia in peripheral tissue and ultimately cardiogenic shock [6,13,14]. Pericardial effusion is mostly commonly the result of a tumor or unknown cause (about 90% of cases), and other causes, such as infection or cardiac rupture, are rare [6,12]. Purulent pericarditis has been described in association with coccidioidomycosis, aspergillosis, actinomycosis, nocardiosis and tuberculosis [2,4,6,13,14]. Purulent pericarditis is also occasionally associated with biting and intrapericardial foreign body presentation [5]. The treatment for purulent pericarditis is removal of pericardial fluid by pericardiocentesis and administration of a suitable antibiotic. However, if the dog is stable enough for surgery, pericardectomy is recommended [6,13,14]. The present report describes a case of cardiac tamponade due to purulent pericarditis associated with Candida albicans and Acinetobacter sp. in a dog administered immunosuppressive drugs for treatment of immune-mediated hemolytic anemia (IMHA).A 5-year-old neutered male mongrel dog was brought to our hospital with vomiting, depression and anorexia. On clinical examination, the dog was found to be obese with slight pallor of the visible mucous membranes. No cardiac murmur was evident. Blood testing revealed anemia (packed cell volume 18%; reference range 33 to 55%) and increased levels of alkaline phosphatase (1628 U/l; reference range 47 to 254 U/l) and total bilirubin (0.8 mg/dl; reference range 0.1 to 0.5 mg/dl). No autoagglutination of blood was observed. Anisocytosis and polychromasia with a moderate number of spherocytes were observed. A large number of reticulocytes was also evident. A direct Coombs' test yielded positive results. Abdominal radiography showed severe splenomegaly, but ultrasonography of the spleen showed normal results.The clinical diagnosis for this dog was IMHA, so administration of prednisolone (2 mg/kg, once daily) was initiated. However, the packed cell vol...
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