Zytologischer Nachweis eines hepatozytotropen T-Zell-Lymphoms bei einem 15 Jahre alten Kater

Zusammenfassung

Die Kasuistik beschreibt ein seltenes Phänomen der Emperipolese-ähnlichen Invasion von lymphatischen Blasten in die Hepatozyten eines 15 Jahre alten Europäisch Kurzhaar-Katers. Der Kater wurde mit unspezifischen Symptomen (Inappetenz und Gewichtsverlust) vorgestellt. Die zytologische Untersuchung eines ultraschallgestützt entnommenen Feinnadelaspirates der Leber zeigte einige Hepatozyten mit einer Emperipolese-ähnlichen Invasion von lymphatischen Blasten. Ganz vereinzelte extrazellulär gelegene lymphatische Blasten wiesen eine Erythrophagie auf. Nach der zytologischen Diagnosestellung eines großzelligen Lymphoms wurde der Kater nach einer zweiwöchigen Monotherapie mit Prednisolon aufgrund seines schlechten Allgemeinbefindens euthanasiert. Zur Bestätigung der zytologischen Verdachtsdiagnose eines hepatozytotropen Lymphoms erfolgte eine postmortale Probenentnahme aus der Leber. Die Histopathologie konnte die zytologischen Befunde bestätigen. Immunhistochemisch waren die lymphatischen Zellen CD3 positiv, sodass die Diagnose eines bisher nur selten beschriebenen hepatozytotropen T-Zell-Lymphoms gestellt werden konnte.

Abstract

This case report describes the rare phenomenon of emperipolesis-like invasion of lymphatic blasts into the hepatocytes of a 15-year-old European Shorthair cat. The cat presented with nonspecific clinical signs (inappetence and weight loss). Cytologic examination of an ultrasound-guided fine-needle aspirate of the liver showed a subset of hepatocytes with emperipolesis-like invasion by lymphatic blasts. Few extracellularly located lymphatic blasts exhibited erythrophagia. Following the cytological diagnosis of large cell lymphoma and 2 weeks of monotherapy with prednisolone, the patient was euthanized due to his poor general condition. A post-mortem sample was obtained from the liver to confirm the suspected cytological diagnosis of hepatocytotropic lymphoma. Histopathology subsequently confirmed the cytologic findings. Immunohistochemically, the lymphatic blasts were positive for CD3 leading to a diagnosis of hepatocytotropic T-cell-lymphoma, which has rarely been described so far.

Schlüsselwörter

Zytologie - Leber - Hepatozyt - lymphatischer Blast - Emperipolese - Erythrophagie

Key words

Cytology - liver - hepatocyte - lymphatic blast - emperipolesis - erythrophagia

Publication History

Received: 31 August 2022

Accepted: 30 May 2023

Article published online:
06 December 2023

• Literatur

• 1 MacVean DW, Monlux AW, Anderson PS. et al. Frequency of canine and feline tumors in a defined population. Models for the study of cancer biology and treatment. Vet Pathol 1978; 15: 700-715 10.1177/030098587801500602
• 2 Hardy WD.. Hematopoietic tumors of cats. Journal of the American Animal Hospital Association 1981; 921-940
• 3 Kessler M. Hrsg. Kleintieronkologie. Diagnose und Therapie von Tumorerkrankungen bei Hund und Katze. 4. Aufl. Stuttgart: Georg Thieme Verlag KG; 2022. 10.1055/b-006-163261
• 4 Taylor SS, Goodfellow MR, Browne WJ. et al. Feline extranodal lymphoma. Response to chemotherapy and survival in 110 cats. J Small Anim Pract 2009; 50: 584-592 10.1111/j.1748-5827.2009.00813.x
• 5 Valenciano AC, Cowell RL. Hrsg. Cowell and Tyler's diagnostic cytology and hematology of the dog and cat. The liver. 5. Aufl. Elsevier; 2020. 10.1016/C2016-0-02017-X
• 6 Valli VE, Jacobs RM, Norris A. et al. The histologic classification of 602 cases of feline lymphoproliferative disease using the National Cancer Institute working formulation. J Vet Diagn Invest 2000; 12: 295-306 10.1177/104063870001200401
• 7 Valli VE. Hrsg. World Health Organization international histological classification of tumors of domestic animals. Histological classification of hematopoietic tumors of domestic animals. Vol. VIII. 2. Aufl.. Washington, D.C: Armed Forces Institute of Pathology in Cooperation with the American Registry of Pathology and the World Health Organization Collaborating Center for Worldwide Reference on Comparative Oncology;; 2002
• 8 Wolfesberger B, Fuchs-Baumgartinger A, Greß V. et al. World Health Organisation classification of lymphoid tumours in veterinary and human medicine. A comparative evaluation of gastrointestinal lymphomas in 61 cats. J Comp Pathol 2018; 159: 1-10 10.1016/j.jcpa.2017.12.006
• 9 Krecic MR, Black SS.. Epitheliotropic T-cell gastrointestinal tract lymphosarcoma with metastases to lung and skeletal muscle in a cat. J Am Vet Med Assoc 2000; 216: 517-524
• 10 Fontaine J, Heimann M, Day MJ.. Cutaneous epitheliotropic T-cell lymphoma in the cat. A review of the literature and five new cases. Vet Dermatol 2011; 22: 454-461 10.1111/j.1365-3164.2011.00972.x
• 11 Otrocka-Domagala I, Procajlo Z, Pazdzior K. et al.  Immunohistochemical profile of multicentric cutaneous epitheliotropic T-cell lymphoma with generalised lymphadenopathy in a Holstein-Friesian cow. A case report. Veterinarni Medicina 2012; 57: 251-257 10.17221/5956-VETMED
• 12 Suzuki M, Kanae Y, Kagawa Y. et al. Emperipolesis-like invasion of neoplastic lymphocytes into hepatocytes in feline T-cell lymphoma. J Comp Pathol 2011; 144: 312-316 10.1016/j.jcpa.2010.10.005
• 13 Humble JG, Jayne WH, Pulvertaft RJ.. Biological interaction between lymphocytes and other cells. Br J Haematol 1956; 2: 283-294 10.1111/j.1365-2141.1956.tb06700.x
• 14 Gupta N, Jadhav K, Shah V.. Emperipolesis, entosis and cell cannibalism. Demystifying the cloud. Journal of Oral and Maxillofacial Pathology : JOMFP 2017; 21: 92-98 10.4103/0973-029X.203763
• 15 Rastogi V, Sharma R, Misra SR. et al. Emperipolesis - a review. J Clin Diagn Res 2014; 8: ZM01-2 10.7860/JCDR/2014/10361.5299
• 16 Tetikkurt S, Taş F, Emre F. et al. Significant neutrophilic emperipolesis in squamous cell carcinoma. Case Rep Oncol Med 2018; 2018: 1301562 10.1155/2018/1301562
• 17 Ossent P, Stöckli RM, Pospischil A.. Emperipolesis of lymphoid neoplastic cells in feline hepatocytes. Vet Pathol 1989; 26: 279-280 10.1177/030098588902600315
• 18 Heinrich D, Sturos M, Smith K. et al. What is your diagnosis? Liver aspirate from a cat. Vet Clin Pathol 2016; 45: 513-514 10.1111/vcp.12382
• 19 Ii T, Chambers JK, Segawa K. et al. Hepatosplenic T-cell lymphoma with hepatocytotropism in a cat. JFMS Open Rep 2021; 7 20551169211005914 10.1177/20551169211005914
• 20 Keller SM, Vernau W, Hodges J. et al. Hepatosplenic and hepatocytotropic T-cell lymphoma. Two distinct types of T-cell lymphoma in dogs. Vet Pathol 2013; 50: 281-290 10.1177/0300985812451625
• 21 Carreras JK, Goldschmidt M, Lamb M. et al. Feline epitheliotropic intestinal malignant lymphoma. 10 cases (1997-2000). J Vet Intern Med 2003; 17: 326-331
• 22 Richter KP.. Feline gastrointestinal lymphoma. Vet Clin North Am Small Anim Pract 2003; 33: 1083-98, vii 10.1016/s0195-5616(03)00054-8
• 23 Davies SP, Terry LV, Wilkinson AL. et al. Cell-in-cell structures in the liver. A tale of four E's. Front Immunol 2020; 11: 650 10.3389/fimmu.2020.00650
• 24 Madewell BR, Munn RJ, Phillips LP.. Endocytosis of erythrocytes in vivo and particulate substances in vitro by feline neoplastic mast cells. Can J Vet Res 1987; 51: 517-520
• 25 Carter JE, Tarigo JL, Vernau W. et al. Erythrophagocytic low-grade extranodal T-cell lymphoma in a cat. Vet Clin Pathol 2008; 37: 416-421 10.1111/j.1939-165X.2008.00073.x
• 26 Mochizuki H, Sherrick E, Mastromauro M. et al. What is your diagnosis? Lymphocytes engulfing erythrocytes in a cat. Vet Clin Pathol 2019; 48: 768-770 10.1111/vcp.12744
• 27 Oliveira Conrado Fd, Stern JK, Griffin FC.. What is your diagnosis? Peripheral blood smear and splenic fine-needle aspirate from a cat. Vet Clin Pathol 2020; 49: 367-370 10.1111/vcp.12817
• 28 Barger AM, Skowronski MC, MacNeill AL.. Cytologic identification of erythrophagocytic neoplasms in dogs. Vet Clin Pathol 2012; 41: 587-589 10.1111/j.1939-165x.2012.00472.x
• 29 Moore PF, Affolter VK, Vernau W.. Canine hemophagocytic histiocytic sarcoma. A proliferative disorder of CD11d+ macrophages. Vet Pathol 2006; 43: 632-645 10.1354/vp.43-5-632