Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma

Kristina Meichner, Blaire H. Kraszeski, Jessica R. Durrant, Carol B. Grindem, Babetta A. Breuhaus, Peter F Moore, Jennifer A. Neel, Keith E. Linder, Luke B. Borst, Jonathan E. Fogle, Jaime L. Tarigo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

An 11-year-old, 443-kg Haflinger mare was presented to the North Carolina State University Veterinary Teaching Hospital with a 2-week history of lethargy and a 3-day duration of anorexia, pyrexia, tachycardia, and ventral edema. Severe pitting edema, peripheral lymphadenopathy, and a caudal abdominal mass were noted on physical examination. An extreme leukocytosis (154.3 × 103/μL) and microscopic hematologic findings suggestive of myelomonocytic leukemia were observed. Serum protein electrophoresis revealed a monoclonal gammopathy and urine protein electrophoresis revealed a monoclonal light chain proteinuria. Necropsy and histopathology confirmed widespread neoplastic infiltration in many organs with a heterogenous population of cells; there was no apparent evidence of bone marrow involvement. Immunohistochemistry confirmed presence of a majority of B cells with a limited antigen expression, admixed with a lower number of T cells. Molecular clonality analysis of IgH2, IgH3, and kappa-deleting element (KDE, B cell) on whole blood and KDE on infiltrated tissues revealed clonal rearrangements, and the KDE intron clones that amplified in blood and in infiltrated tissue were identical. In contrast, the clonality analysis of T-cell receptor γ revealed no clonality on blood cells and infiltrated tissues. In conjunction with the histopathologic changes, the lesion was interpreted to be composed of neoplastic B cells with a reactive T-cell population. Polymerase chain reaction testing for equine herpes virus 5 was negative. The final diagnosis was diffuse large B-cell lymphoma with a marked hematogenous component.

Original languageEnglish (US)
Pages (from-to)64-71
Number of pages8
JournalVeterinary Clinical Pathology
Volume46
Issue number1
DOIs
StatePublished - Mar 1 2017

Fingerprint

Lymphocytosis
Lymphoma, Large B-Cell, Diffuse
lymphoma
Horses
B-lymphocytes
B-Lymphocytes
horses
Electrophoresis
T-lymphocytes
Edema
edema
electrophoresis
T-Lymphocytes
Animal Hospitals
Lethargy
Paraproteinemias
Leukocytosis
Anorexia
T-Cell Antigen Receptor
Proteinuria

Keywords

  • Clonality
  • equine
  • leukemia
  • leukocytosis
  • lymphoid

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Meichner, K., Kraszeski, B. H., Durrant, J. R., Grindem, C. B., Breuhaus, B. A., Moore, P. F., ... Tarigo, J. L. (2017). Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma. Veterinary Clinical Pathology, 46(1), 64-71. https://doi.org/10.1111/vcp.12435

Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma. / Meichner, Kristina; Kraszeski, Blaire H.; Durrant, Jessica R.; Grindem, Carol B.; Breuhaus, Babetta A.; Moore, Peter F; Neel, Jennifer A.; Linder, Keith E.; Borst, Luke B.; Fogle, Jonathan E.; Tarigo, Jaime L.

In: Veterinary Clinical Pathology, Vol. 46, No. 1, 01.03.2017, p. 64-71.

Research output: Contribution to journalArticle

Meichner, K, Kraszeski, BH, Durrant, JR, Grindem, CB, Breuhaus, BA, Moore, PF, Neel, JA, Linder, KE, Borst, LB, Fogle, JE & Tarigo, JL 2017, 'Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma', Veterinary Clinical Pathology, vol. 46, no. 1, pp. 64-71. https://doi.org/10.1111/vcp.12435
Meichner, Kristina ; Kraszeski, Blaire H. ; Durrant, Jessica R. ; Grindem, Carol B. ; Breuhaus, Babetta A. ; Moore, Peter F ; Neel, Jennifer A. ; Linder, Keith E. ; Borst, Luke B. ; Fogle, Jonathan E. ; Tarigo, Jaime L. / Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma. In: Veterinary Clinical Pathology. 2017 ; Vol. 46, No. 1. pp. 64-71.
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abstract = "An 11-year-old, 443-kg Haflinger mare was presented to the North Carolina State University Veterinary Teaching Hospital with a 2-week history of lethargy and a 3-day duration of anorexia, pyrexia, tachycardia, and ventral edema. Severe pitting edema, peripheral lymphadenopathy, and a caudal abdominal mass were noted on physical examination. An extreme leukocytosis (154.3 × 103/μL) and microscopic hematologic findings suggestive of myelomonocytic leukemia were observed. Serum protein electrophoresis revealed a monoclonal gammopathy and urine protein electrophoresis revealed a monoclonal light chain proteinuria. Necropsy and histopathology confirmed widespread neoplastic infiltration in many organs with a heterogenous population of cells; there was no apparent evidence of bone marrow involvement. Immunohistochemistry confirmed presence of a majority of B cells with a limited antigen expression, admixed with a lower number of T cells. Molecular clonality analysis of IgH2, IgH3, and kappa-deleting element (KDE, B cell) on whole blood and KDE on infiltrated tissues revealed clonal rearrangements, and the KDE intron clones that amplified in blood and in infiltrated tissue were identical. In contrast, the clonality analysis of T-cell receptor γ revealed no clonality on blood cells and infiltrated tissues. In conjunction with the histopathologic changes, the lesion was interpreted to be composed of neoplastic B cells with a reactive T-cell population. Polymerase chain reaction testing for equine herpes virus 5 was negative. The final diagnosis was diffuse large B-cell lymphoma with a marked hematogenous component.",
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