Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

CNS Relapsed T-cell Lymphoma in a Young Cat

어린 고양이에서 발생한 중추신경계로 재발한 T세포 림프종

  • Seo, Kyoung-Won (College of Veterinary Medicine, Chungnam National University) ;
  • Oh, Ye-In (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Han, Sei-Myoung (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Go, Du-Min (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Lee, Jeong-Ha (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Youn, Hwa-Young (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
  • 서경원 (충남대학교 수의과대학) ;
  • 오예인 (서울대학교 수의과대학) ;
  • 한세명 (서울대학교 수의과대학) ;
  • 고두민 (서울대학교 수의과대학) ;
  • 이정하 (서울대학교 수의과대학) ;
  • 윤화영 (서울대학교 수의과대학)
  • Accepted : 2014.03.27
  • Published : 2014.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

An 8-month-old domestic shorthair cat presented with decreased activity and anorexia. Diagnostic imaging revealed cranial mediastinal mass and enlarged mesenteric lymph nodes. Fine needle aspirates showed a marked increase in malignant lymphocytes. Multicentric lymphoma (stage V-b) was diagnosed. The cat treated with COP protocol chemotherapy, and complete remission was induced. CNS relapse developed 314 days after the initiation of chemotherapy. Treatment with rescue protocol greatly reduced the clinical signs for a short period. The cat was in partial remission for 33 days and overall survival time was 383 days. Multicentric T-cell lymphoma with brain involvement was confirmed after necropsy by histopathology and immunohistochemistry.

8개월령의 단모종 집고양이가 감소된 식욕과 활력 저하로 내원하였다. 진단을 위한 영상 검사에서 종격동의 종괴와 종격동 림프절의 비대 소견을 확인할 수 있었다. 이어서 진행한 세침흡인술 검사로, 악성 림프구를 다수 확인할 수 있었으며, 이 고양이는 다발성 림프종 (병기 V-b)로 진단되었다. 치료는 COP 프로토콜을 사용하였으며, 완전 완화를 확인할 수 있었지만, 항암 치료를 시작한 후 314일 째 재발과 함께 중추신경계로 전이된 소견을 확인할 수 있었다. 구조화학 요법을 실시하여, 단기적으로는 임상증상의 큰 개선을 확인할 수 있었지만, 부분완화만이 관찰되었으며, 처음 내원 부터 약 383일 정도 생존하였다. 부검과 조직병리학적 검사를 통해, 다발성의 T 세포 림프종으로 확인하였으며, 뇌에서도 병변을 확인할 수 있었다.

Keywords

References

  1. Bashir RM, Bierman PJ, Vose JM, Weisenburger DD, Armitage JO. Central nervous system involvement in patients with diffuse aggressive non-Hodgkin's lymphoma. Am J Clin Oncol 1991; 14: 478-482. https://doi.org/10.1097/00000421-199112000-00004
  2. Boehme V, Zeynalova S, Kloess M, Loeffler M, Kaiser U, Pfreundschuh M, Schmitz N. Incidence and risk factors of central nervous system recurrence in aggressive lymphoma-a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Annal Oncol 2007; 18: 149-157.
  3. Chamberlain MC, Nolan C, Abrey LE. Leukemic and lymphomatous meningitis: incidence, prognosis and treatment. J Neurooncol 2005; 75: 71-83. https://doi.org/10.1007/s11060-004-8100-y
  4. Chowdhary S, Chamberlain M. Leptomeningeal metastases: current concepts and management guidelines. J Natl Compr Canc Netw 2005; 3: 693-703. https://doi.org/10.6004/jnccn.2005.0039
  5. Hollender A, Kvaloy S, Nome O, Skovlund E, Lote K, Holte H. Central nervous system involvement following diagnosis of non-Hodgkin's lymphoma: a risk model. Annal Oncol 2002; 13: 1099-1107. https://doi.org/10.1093/annonc/mdf175
  6. Malik R, Gabor LJ, Foster SF, McCorkell BE, Canfield PJ. Therapy for Australian cats with lymphosarcoma. Aust Vet J 2001; 79: 808-817. https://doi.org/10.1111/j.1751-0813.2001.tb10923.x
  7. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H. Pathology with clinical correlations of primary central nervous system non-Hodgkin's lymphoma. The massachusetts general hospital experience 1958-1989. Cancer 1994; 74: 1383-1397. https://doi.org/10.1002/1097-0142(19940815)74:4<1383::AID-CNCR2820740432>3.0.CO;2-1
  8. Moore AS, Cotter SM, Frimberger AE, Wood CA, Rand WM, L'Heureux DA. A comparison of doxorubicin and COP for maintenance of remission in cats with lymphoma. J Vet Int Med 1996; 10: 372-375. https://doi.org/10.1111/j.1939-1676.1996.tb02083.x
  9. Seo KW, Choi US, Lee JB, Kim MI, Oh YI, Chung JY, Lee SK, Hwang CY, Youn HY. Central nervous system relapses in 3 dogs with B-cell lymphoma. Can Vet J 2011; 52: 778-783.
  10. Snyder JM, Lipitz L, Skorupski KA, Shofer FS, Van Winkle TJ. Secondary intracranial neoplasia in the dog: 177 cases (1986-2003). J Vet Int Med 2008; 22: 172-177. https://doi.org/10.1111/j.1939-1676.2007.0002.x
  11. Tomita N, Kodama F, Kanamori H, Motomura S, Ishigatsubo Y. Secondary central nervous system lymphoma. Int J Hematol 2006; 84: 128-135. https://doi.org/10.1532/IJH97.06091
  12. Troxel MT, Vite CH, Massicotte C, McLear RC, Van Winkle TJ, Glass EN, Tiches D, Dayrell-Hart B. Magnetic resonance imaging features of feline intracranial neoplasia: retrospective analysis of 46 cats. J Vet Int Med 2004; 18: 176-189. https://doi.org/10.1111/j.1939-1676.2004.tb00158.x
  13. Troxel MT, Vite CH, Winkle TJ, Newton AL, Tiches D, Dayrell-Hart B, et al. Feline intracranial neoplasia: retrospective review of 160 cases (1985-2001). J Vet Int Med 2003; 17: 850-859.
  14. van Besien K, Ha CS, Murphy S, McLaughlin P, Rodriguez A, Amin K, Forman A, Romaguera J, Hagemeister F, Younes A, Bachier C, Sarris A, Sobocinski KS, Cox JD, Cabaillas F. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 1998; 91: 1178-1184.
  15. Withrow S, Vail DM, Page RL. Feline Lymphoma and Leukemia. In:Withrow and MacEwen's Small animal clinical oncology. 5th ed. St. Louis: Elsevier Health Sciences 2013; 638-653.
  16. Zaki FA, Hurvitz AI. Spontaneous neoplasms of the central nervous system of the cat. J Small Anim Pract 1976; 17: 773-782. https://doi.org/10.1111/j.1748-5827.1976.tb06943.x