Successful Management with CHOP for Pulmonary Lymphomatoid Granulomatosis in a Dog

Abstract

ABSTRACT. A 3-year-old, spayed female miniature dachshund was presented for vomiting and anorexia. Thoracic radiographs and CT scan revealed abnormal pulmonary opacities at bilateral caudal lobe. Cytological analysis of the pulmonary mass revealed the presence of large lymphohistiocytic cells and small lymphocytes with occasional neutrophils and plasma cells. An open lung biopsy was performed and a diagnosis of pulmonary lymphomatoid granulomatosis (LYG) was made. The dog was administered CHOP based therapy (modified UW-25), and it survived for 1,022 days after admission. Immunohistochemistry revealed pulmonary lesions consisted of many CD79a positive B cells aggregation and proliferation with prominent angiocentric pattern. This was the first case of canine pulmonary LYG managed by CHOP chemotherapy.KEY WORDS: canine, CHOP, lymphomatoid granulomatosis, pulmonary.J. Vet. Med. Sci. 73(4): 527-530, 2011 Lymphomatoid granulomatosis (LYG) is a unique form of pulmonary angiitis and granulomatosis which was first described by Liebow et al. in 1972 [12]. Histologically it is a necrotizing angiocentric and angiodestructive infiltrative process composed of small lymphocytes, plasma cells, histiocytes and atypical lympho-reticular cells [11,12]. In veterinary medicine, canine pulmonary LYG is a rare pulmonary lymphoproliferative disease; very few treatment studies have been conducted and no standard treatment is established [2,17]. In this report, we describe clinical and pathological findings of a canine LYG, which results in long-term survive with CHOP therapy, modified version of the University of Wisconsin-Madison (UW-25) protocol for canine lymphoma [7].A 3-year-old, spayed female miniature dachshund, weighing 3.5 kg, was presented to Osaka Prefecture University Veterinary Clinical Center for 4 week-history of vomiting and anorexia. Clinical examination revealed pyrexia and dyspnea. A peripheral lymphadenopathy was not recognized. There was no evidence of hepatomegaly or splenomegaly. A complete blood count showed abnormal leukocytosis (40,100 cell/µl; reference range 6,000 to 17,000/µl) with mature neutrophilia (23,258 cell/µl; reference range 3,000 to 11,500 /µl) and lymphocytosis (16,441 cell/µl reference range 1,000 to 4,800/µl). The blood biochemical findings included an increased total protein concentration (8.4 g/dl) with a high globulin concentration (A/ G=0.5). Increased α-2 and γ fraction were identified via serum electrophoresis. The dog was negative for Dirofilaria immitis infestation. Thoracic radiographs revealed abnormal pulmonary opacities at bilateral caudal lobe (Fig. 1). Radiographic evidence of sterna lymphadenopathy was also noted. A chest computed tomographic (CT) scan of the thorax showed bilateral, wedge-shaped opacities (Fig. 2). Cytological analysis of the pulmonary mass, which was performed by fine-needle aspiration revealed the presence of large lymphohistiocytic cells and small lymphocytes with occasional neutrophils and plasma cells. The dog was treated with Enrofloxacin (5 mg/kg po ...

Uncommon anatomical sites and anatomopathological presentations of lymphoma in dogs

“…Corroborating the rarity of its occurrence, lymphomatoid granulomatosis corresponded to 2% of the lymphoma presentations in dogs in the present study. The macroscopic pattern observed in the lungs and the location of the metastases described herein are similar to what has been reported in the veterinary literature (Berry et al 1990, Fitzgerald et al 1991, Park et al 2007, Hatoya. et al, 2011.…”

“…However, only lymphomatoid granulomatosis and lymphomas that develop after skin injections have been established by WHO as angiocentric (Valli 2002). In addition, the most current classifications suggested for hematopoietic tumors in dogs include only lymphomatous granulomatosis as an angiocentric lymphoma (Valli 2007, Valli et al 2016, similarly to cases reported in dogs (Berry et al 1990, Fitzgerald et al 1991, Shimazaki et al 2010, Hatoya et al 2011. Given that the lungs and skin were not affected in either of the two cases of angiocentric lymphoma described here, which would enable the diagnoses of lymphomatoid granulomatosis or post-vaccine lymphoma, respectively, and that the neoplastic lymphocyte population not mixed as classically observed in lymphomatoid granulomatosis, but rather monomorphic, anatomical sites of angiocentric T-cell lymphoma not previously reported in the veterinary literature are described in this study.…”

Angioinvasive lymphoma (lymphomatoid granulomatosis) in a cat, with cutaneous and ocular metastasis

“…2,3,10,13 In canine cases in which immunophenotypic characterization was documented, the infiltrating lymphocytic population appeared mixed with combinations of CD3, CD20, and CD79 positivity. 3,6 Immunophenotypic characterization was only defined in one of the previously reported feline cases in which, again, a mixed population was reported with BLA36 and CD3 positivity suggestive of B and T cell, respectively. 7,12 Dogs often develop eosinophilia, lymphocytosis, and hyperglobulinemia.…”

“…Histologic findings include a necrotizing angiocentric and angioinvasive process involving small lymphocytes, plasma cells, histiocytes, and atypical lymphoreticular cells, primarily in the lung, although other sites have been reported. 2,3,10,13 In canine cases in which immunophenotypic characterization was documented, the infiltrating lymphocytic population appeared mixed with combinations of CD3, CD20, and CD79 positivity. 3,6 Immunophenotypic characterization was only defined in one of the previously reported feline cases in which, again, a mixed population was reported with BLA36 and CD3 positivity suggestive of B and T cell, respectively.…”

“…8 In dogs, the disease is characterized as a T-cell angiotropic lymphoma; however, a few reports have demonstrated a mixed population of small lymphocytes, plasma cells, histiocytes, and atypical lymphoreticular cells. 1,3–6,10 Clinical signs vary extensively and are related to the organ systems involved.…”