Neurolymphomatosis in a Dog With B-Cell Lymphoma

Abstract

Lymphoma in the left femoral nerve of a 10-year-old English Cocker Spaniel caused complete paralysis of the affected limb. Neoplastic cells were immunopositive for CD79a and Pax5 and negative for CD3. Neoplastic cells were in multiple lymph nodes and one kidney but spared bone marrow. The clinical and histologic features in this case resemble those of the rare human condition of neurolymphomatosis.Keywords dogs, immunohistochemistry, lymphoma, neuroleukemiosis, neurolymphomatosis, peripheral neuropathy Neurolymphomatosis is a rare condition defined as infiltration of peripheral nerves or nerve roots by neurotropic lymphoma or leukemia.1-3 In humans, there are 4 basic clinical presentations: painful polyneuropathy or polyradiculopathy, cranial neuropathy, painless polyneuropathy, and peripheral mononeuropathy.1 The syndrome may occur as the initial manifestation of neoplastic disease, present concurrently with systemic neoplasia, or represent progression of disease in patients diagnosed and previously treated for lymphoma or leukemia. 1,3,7,8 Most human neurolymphomatosis cases are diffuse large B-cell lymphomas when classified by the Revised EuropeanAmerican Lymphoma or World Health Organization system. 3,4 Lymphoma and leukemia are well recognized in veterinary medicine, and lymphoma is one of the most common neoplasias of cats and dogs. The majority of lymphomas in these species occur in parenchymatous organs and/or peripheral lymph nodes, with occasional primary or secondary involvement of the brain and spinal cord.5,9-12 Involvement of peripheral nerves (neurolymphomatosis) is rarely reported in veterinary species. We report a case of a dog with multicentric B-cell lymphoma involving the left femoral nerve and compare its gross, histologic, and immunohistochemical features to those of previous canine and human cases. Case HistoryA 10-year-old spayed female English Cocker Spaniel was presented to the Colorado State University Veterinary Teaching Hospital for evaluation of left pelvic limb lameness. Prior history included protein-losing nephropathy, hypertension, and intermittent spinal pain with medically managed episodes of spinal hyperpathia and moderate paraparesis in the past 6 years. The dog had been treated surgically for intervertebral disk disease by L3-L4 hemilaminectomy and rhizotomy of the right L3 nerve root 3 months before presentation. Upon examination, the dog had severe weight-bearing lameness and muscle atrophy in the left pelvic limb. Evidence of pain could not be elicited on manipulation of the stifle and tarsal joints nor the long bones, but inconsistent pain was elicited upon extension of the left hip. Consistent painful response was elicited by palpation of the left mid to caudal lumbar epaxial muscles. The lameness progressed insidiously for several months despite institution of prednisone, increasing doses of tramadol and gabapentin, and incorporation of methocarbamol and amantadine. Eventually, the dog lost the patellar reflex in the affected limb. A left femoral neuropathy or...

Sciatic T‐cell neurolymphomatosis in a dog

“…Samples of lesions and routine organs were fixed in 10 per cent neutral buffered formalin, processed routinely, sectioned at 3 μm and stained with H&E. On select slides, automated dewaxing, rehydration, heat-induced epitope retrieval (PT link, Pre-Treatment Module for Tissue Specimens) and automated incubation (Dako Autostainer Universal Staining System) with anti-human CD3, anti-human CD79a (both Dako Denmark A/S, Glostrup, Denmark) and anti-human CD56 (Clone 123C3, Invitrogen, Paisley, UK) were carried out similar to described in previous investigations (O'Connor and others 2012, Schaffer and others 2012, Ota-Kuroki and others 2013, Sakamoto and others 2013, Ueno and others 2014, Wiggans and others 2014). …”

“…To date only one report describes the infiltration of a canine peripheral nerve distal to the plexus, namely, the femoral nerve, with neoplastic B-cells (Schaffer and others 2012). …”

Canine Nervous System Lymphoma Subtypes Display Characteristic Neuroanatomical Patterns

“…13,36 This adapted classification includes emerging syndromes such as neurolymphomatosis, which is often systemic but targets peripheral nerves and is mostly of B-cell lineage. 15,20,27,34 The goals of this study were primarily to determine both histologically and immunophenotypically the subtypes of canine nervous system lymphoma using this scheme 36 and to establish the prevalence of primary versus secondary nervous system lymphomas in this population, and second, among the various subtypes of nervous system lymphoma, it is necessary to identify any characteristic patterns of microscopic lesions with respect to their neuroanatomical sites and cerebrospinal fluid (CSF) cytological findings.…”

Extranodal Lymphoma with Peripheral Nervous System Involvement in a Dog

“…Canine neurolymphomatosis is uncommon, and only two reports have been published [9, 11]. A comparison of three cases including this case is shown in Table 2…”