Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis
| Autor: | Mathieu V Paulin, Maria-Elena Turba, Hélène Huet, Nathalie Cordonnier, Julie Bruneau, Lucile Couronné, Valérie Freiche, Thierry-Jo Molina, Elizabeth Macintyre, Olivier Hermine |
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| Rok vydání: | 2021 |
| Předmět: |
Pathology
Veterinary medicine JAK‐STAT clonality Standard Article Cat Diseases Cohort Studies full‐thickness intestinal biopsies SF600-1100 Prospective Studies education.field_of_study biology medicine.diagnostic_test Gastroenterology Standard Articles Enteritis gradient Intestines medicine.anatomical_structure Ki-67 immunohistochemistry Immunohistochemistry alimentary lymphoma medicine.medical_specialty Population monoclonal Lymphoma T-Cell PARR histology plaque inflammatory bowel disease Biopsy medicine Animals CD20 lamina propria education Ki‐67 Lamina propria General Veterinary nest business.industry fibrosis polyclonal Histology medicine.disease CD3 Lymphoma Cats biology.protein SMALL ANIMAL epithelium business |
| Zdroj: | Journal of Veterinary Internal Medicine, Vol 35, Iss 6, Pp 2673-2684 (2021) Journal of Veterinary Internal Medicine |
| ISSN: | 1939-1676 0891-6640 |
| Popis: | Background Differentiation of low-grade intestinal T-cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. Objective Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. Animals Forty-four client-owned cats, 22 diagnosed with LGITL and 22 with LPE. Methods Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full-thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. Results A monomorphic lymphocytic population (22/22, 100%) and in-depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical-to-basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki-67 20%- and 30%-thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3- and pSTAT5+. T-cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). Conclusions and clinical importance We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE. |
| Databáze: | OpenAIRE |
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