An unusual case of enteropathy-associated T-cell lymphoma with CD20 positivity

Misra, Deepti Shukla; Bhardwaj, Mukesh; Bahuguna, Gauri; Malhotra, Veena

doi:10.4103/0377-4929.142727

Cited by 3 publications

(3 citation statements)

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“…4 ), with a B-cell phenotype observed in the remaining 10% of cases [ 6 , 8 , 10 , 11 , 58 , 63 , 75 , 97 ]. However, there is increasing evidence that some human and canine T-cell lymphomas co-express the B-cell marker CD20 [ 123 – 125 ]. In a three-case series reported by Nolan and Kiupel (2018), the majority of neoplastic CD3 + lymphocytes expressed CD20 but not Pax5.…”

Section: Diagnosismentioning

confidence: 99%

Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease

et al. 2018

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BackgroundLow-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions.ResultsA total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. 130 studies were found from the veterinary literature and 46 from the human medicine literature. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract.ConclusionsThe pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine.

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Section: Diagnosismentioning

confidence: 99%

Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease

et al. 2018

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“…1,4,11 In humans, reports include 2 descriptions of enteropathy-associated T-cell lymphoma with CD20 expression, one of which was initially misdiagnosed as B-cell lymphoma. 6,11 The prognostic and therapeutic implications of such CD20 expression is unclear. Follow-up information in the human cases was limited, but 1 of the 2 reports indicated a poor prognosis.…”

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confidence: 99%

Coexpression of CD3 and CD20 in Canine Enteropathy-Associated T-cell Lymphoma

Noland

Kiupel

2018

Vet Pathol

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The majority of primary intestinal lymphomas in dogs are T-cell lymphomas, with enteropathy-associated T-cell lymphoma (EATL) large cell type (type 1) being the most common. While most T-cell lymphomas express the T-cell marker CD3, there is increasing evidence that some human and canine T-cell lymphomas coexpress the B-cell marker CD20. We describe 3 cases of CD3, CD20, Pax5 EATL type 1 in dogs. All 3 cases had clonal rearrangement of T-cell receptor gamma. Initial clinical signs included weight loss, inappetence, diarrhea, and/or vomiting. The mean age was 9 years (range 3-12). Survival was highly variable ranging from 20 days to longer than 1.6 years. Considering the different chemotherapeutic response of T-cell versus B-cell lymphomas, accurate diagnosis of lymphomas coexpressing CD3 and CD20 as EATL type 1 based on histologic features and clonality results is important. Regardless, the clinical and/or prognostic significance of neoplastic T cells expressing CD20 is unclear.

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“…Aberrant expression of CD20 in T-cell lymphomas was also described in two cases of intestinal lymphoma associated with enteropathies in humans [ 22 , 23 ] and three cases in dogs [ 10 ]. Three hypotheses support possible causes for this co-expression in humans, but its origin and prognosis are still unclear and must be investigated in veterinary medicine.…”

Section: Discussionmentioning

confidence: 98%

Co-Expression of T- and B-Cell Markers in a Canine Intestinal Lymphoma: A Case Report

Peleteiro

Carvalho²,

Leal

et al. 2022

Animals

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An 8-year-old female neutered Labrador retriever was presented for a second opinion consultation due to vomiting and lethargy, having failed to respond to symptomatic therapy. Blood analysis revealed hyperbilirubinemia and hypoalbuminemia, associated with hypocobalaminemia. An abdominal ultrasound identified diffused bowel thickening and hypoechoic hepatomegaly. An ultrasound-guided liver fine-needle aspiration was performed for cytology and also for cell block immunocytochemistry. Gastric and duodenal biopsies were collected by gastroduodenoscopy. Liver cytology showed numerous lymphocytes, suggesting lymphoma at the hepatic infiltration stage, and immunocytochemistry in the cell block of the hepatic aspirate indicated co-expression of CD3 and CD20 in the lymphoid cells present. The histopathology of gastric and duodenal biopsies supported the hypothesis of gastrointestinal lymphoma due to heavy lymphoid infiltration of the gastric epithelium and intestinal mucosa, including the villi. Concurrent immunohistochemistry was performed using CD3, CD20, PAX5, and CD79αcy antibodies. Immunomarking was positive for CD3 and CD20, which overlapped populations of lymphoid cells, and was negative for all other antibodies. In the clonality test, lymphocyte co-expression of CD3 and CD20 was confirmed by monoclonal rearrangement of T-cell gamma receptors. The final diagnosis was type 2 enteropathy-associated T-cell lymphoma with hepatic infiltration. Co-expression was examined in conjunction with the PARR result in the presence of T-cell monoclonal rearrangement.

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An unusual case of enteropathy-associated T-cell lymphoma with CD20 positivity

Cited by 3 publications

References 0 publications

Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease

Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease

Coexpression of CD3 and CD20 in Canine Enteropathy-Associated T-cell Lymphoma

Co-Expression of T- and B-Cell Markers in a Canine Intestinal Lymphoma: A Case Report

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