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

Abstract

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.

Aspectos epidemiológicos, clínicos y de diagnóstico del ViLeF y VIF: una revisión actualizada

“…2) Oncogénesis: linfomas y leucemias. La oncogénesis ocurre mediante inserción del provirus cerca del oncogén celular c-myc, que normalmente regula el ciclo celular (Hartmann & Levy, 2017;MacLachlan & Dubovi, 2017;Paulin et al, 2018). Los linfomas son originados por expansión clonal de linfocitos neoplásicos, y son el tipo de tumor más común en gatos.…”

“…Los linfomas son originados por expansión clonal de linfocitos neoplásicos, y son el tipo de tumor más común en gatos. Un 50-70 % de gatos con linfoma son positivos al ViLeF (Paulin et al, 2018). La presencia del virus empeora la prognosis, pues la infección progresiva incrementa 60 veces el riesgo de padecer linfoma (Hartmann & Levy, 2017 Las leucemias son neoplasias malignas de las células de la médula ósea, que pueden circular en sangre o no (Vail, 2017).…”

“…Los mecanismos de oncogénesis inducidos por este virus ocurren por inserción proviral cerca de un oncogen celular, del cual se altera su función reguladora del ciclo celular. Al haber linfocitos neoplásicos, pueden aparecer linfomas o leucemias (Hartmann & Levy, 2017;MacLachlan & Dubovi, 2017;Paulin et al, 2018). Los linfomas en gatos pueden ser de diferente origen anatómico, es decir, alimentario, mediastínico, multicéntrico y extranodal.…”

“…Los linfomas en gatos pueden ser de diferente origen anatómico, es decir, alimentario, mediastínico, multicéntrico y extranodal. Dependiendo del tipo de linfoma, existirá una relación alta o baja con este retrovirus, y los signos clínicos estarán relacionados con el órgano afectado (MacLachlan & Dubovi, 2017;Paulin et al, 2018;Vail, 2017). Por otro lado, se han descrito procesos leucémicos de tipo linfoblásticos agudos para este virus (Tomiyasu et al, 2018;Vail, 2016).…”

Differentiation of lymphocytic‐plasmacytic enteropathy and small cell lymphoma in cats using histology‐guided mass spectrometry

“…4,5 However, the specificity of polymerase chain reaction (PCR)based clonality tests has been questioned 6,7 and some consider a combination of histopathology and immunohistochemistry as the gold standard. 8 The sensitivity and specificity of clonality assays in human and veterinary medicine vary widely with sensitivities between 70.0 and 97.6% and specificities between 54.3-98.7%. 7,[9][10][11][12][13][14][15] These wide ranges are the result of a combination of technical and biological variability.…”