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2 HISTORY 6 yr old intact female Rottweiler found dead Christmas morning One of eight Rottweilers Fully vaccinated Access to 14 acres and a lake One of the older dogs had died the day before Since the previous afternoon, this Rottweiler had been quiet and lethargic Was seen foaming from the mouth on one occasion Photograph courtesy of Dr WL Castleman Permission granted only for viewing on SEVPAC website
3 Good body condition GROSS FINDINGS Firm multifocal white masses predominantly within the caudal and middle lung lobes that coalesced to diffusely efface the right middle lung lobe Diffuse enlargement of the cranial mediastinal, tracheobronchial and pancreatoduodenal lymph nodes Pulmonary thrombosis Chronic renal infarction Splenic nodule Cystic endometrial hyperplasia Permission granted only for viewing on SEVPAC website
4 GROSS FINDINGS Permission granted only for viewing on SEVPAC website Photographs courtesy of Dr W.L Castleman
5 Permission granted only for viewing on SEVPAC website GROSS FINDINGS
6 Permission granted only for viewing on SEVPAC website GROSS FINDINGS
7 Permission granted only for viewing on SEVPAC website HISTOPATHOLOGY
8 Permission granted only for viewing on SEVPAC website HISTOPATHOLOGY
9 Permission granted only for viewing on SEVPAC website HISTOPATHOLOGY
10 Permission granted only for viewing on SEVPAC website HISTOPATHOLOGY
11 Permission granted only for viewing on SEVPAC website HISTOPATHOLOGY
12 Immunohistochemistry Permission granted only for viewing on SEVPAC website CD79a (x60)
13 Immunohistochemistry Permission granted only for viewing on SEVPAC website CD3 (x60)
14 Immunohistochemistry Permission granted only for viewing on SEVPAC website CD11d (x60)
15 Immunohistochemistry Permission granted only for viewing on SEVPAC website SMA (x40)
16 SUMMARY Lungs were the main organ system affected Mixed round cell population of which 40 70% of cells stained positively for a T cell immunohistochemical marker (CD3). Negative staining for CD79a and CD11d Bronchioles and pulmonary blood vessels multifocally infiltrated and sometimes effaced by neoplastic cells Spindle cells surrounding granulomas stained positively for SMA Granulomas did not stain with GMS, B&B, Giemsa, acidfast or Fites stains Metastasis to tracheobronchial, cranial mediastinal lymph nodes and pancreatoduodenal lymph nodes Permission granted only for viewing on SEVPAC website
17 Final Anatomic Diagnosis Lymphomatoid granulomatosis, multifocal to coalescing, lungs, cranial mediastinal, tracheobronchial and pancreatoduodenal lymph nodes Permission granted only for viewing on SEVPAC website
18 Differential Diagnoses Histiocytic sarcoma Permission granted only for viewing on SEVPAC website
19 Discussion The granulomas resemble rheumatoid granulomas or palisading granulomas (also necrobiotic granulomas) found in autoimmune, immune mediated and lymphoproliferative diseases of man Permission granted only for viewing on SEVPAC website
20 Discussion Canine LG Human LG Angiocentric, lymphoreticular proliferative disease involving predominantly the lungs Mixed lymphoreticular and plasmacytoid cells admixed with fewer mature eosinophils and lymphocytes T-cell, or mixed T- and B-cell lineage. No known associations with a virus Frequent metastasis to hilar lymph nodes Angiocentric, angiodestructive lymphoreticular proliferative disease involving predominantly the lungs Atypical lymphoid cells mixed in varied proportions with plasma cells, histiocytes and mature lymphocytes Atypical lymphoid cells are usually B-cell linage and contain the Epstein-Barr virus Hilar lymphadenopathy is infrequent Other organs affected often include heart, kidneys, spleen, pancreas and adrenal glands Positive for CD3, variable for CD79a Large cells positive for CD15 and CD30 Other organs affected often include skin, nervous system and kidneys Positive for CD3, CD20cy and CD79a Negative for CD15 and CD30 Permission granted only for viewing on SEVPAC website
21 Permission granted only for viewing on SEVPAC website Questions?
22 Bibliography 1. Berry C.R, Moore P.F, Thomas W.P, Sisson D and Koblik P.D Pulmonary lymphomatoid granulomatosis in seven dogs ( ). Journal of Veterinary Internal Medicine 4: (1990) 2. Fitzgerald S.D, Wolf D.C and Carlton W.W Eight cases of canine lymphomatoid granulomatosis Veterinary Pathology 28: (1991). 3. Jubb, K.V.F., Kennedy, P.C. & Palmer, N.C. Pathology of Domestic Animals, 5 th Edition, Volume 3. Saunders p Jaffe E.S and Wilson W.H Lymphomatoid granulomatosis: pathogenesis, pathology and clinical implications. Cancer Surveys 30: (1997). 5. Park H. M, Hwang D. N, Kang B.T, Jung D. I, Song G. S, Lee S. J, Yhee J. Y, Yu C. H, Doster A.R and Sur J. H Pulmonary lymphomatoid granulomatosis in a dog: evidence of immunophenotypic diversity and relationship to human pulmonary lymphomatoid granulomatosis and pulmonary Hodgkin s disease. Veterinary Pathology 44: (2007) 6. Katzenstein A.A, Carrington C.B, & Liebow A.A Lymphomatoid granulomatosis: a clinicopathologic study of 152 cases Cancer 43: (1979)
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