Analyze Diet
BMC veterinary research2022; 18(1); 267; doi: 10.1186/s12917-022-03365-7

Cutaneous epitheliotropic T-cell lymphoma in a donkey – a case report.

Abstract: Cutaneous epitheliotropic T-cell lymphoma is a malignant tumour of the skin already reported in humans, dogs, cats, horses, and other species, but not previously in donkeys. The standard diagnosis is based on clinical, morphological and immunophenotypic data. Differentiation of malignant versus benign proliferation of lymphocytes is crucial; in ambiguous cases T-cell receptor gamma (TRG) molecular clonality should be tested. In the present paper, we report a case of mycosis fungoides diagnosed in a donkey whose diagnosis was based on clinical, histological and immunohistochemical aspects and a positive TRG clonality test. Methods: A twenty-five-year-old donkey gelding was referred with a mildly pruritic, generalised and severe exfoliative dermatosis. Otherwise, the animal was clinically healthy, though mildly underweight. Dermatological examination revealed severe generalised alopecic and exfoliative dermatitis, occasionally eroded, with high number of large, thin, greyish scales. All mucocutaneous junctions except the hoofs were affected. Ectoparasites and dermatophytes were ruled out. The complete blood count and blood smear evaluation revealed mild normocytic normochromic anemia. The biochemistry panel showed mild hyperproteinemia with albumin within the normal range. Protein electrophoresis showed moderate polyclonal hypergammaglobulinemia. Histological findings were characterised by interface dermatitis with massive exocytosis in the epidermis of a homogenous population of lymphoid cells showing atypia. Clusters of neoplastic cells were present within the epidermis forming Pautrier "microabscesses". These findings are consistent with cutaneous epitheliotropic lymphoma. Immunohistochemical staining revealed uniform labelling of the neoplastic cells for CD3, and lack of expression of CD20 (a B cell lineage associated marker). Molecular clonality PCR (PARR) was performed using equine TRG primers; this revealed a clonal rearrangement in a heavy polyclonal background. Transmission electronic microscopy showed multiple lymphocytes with convoluted or cerebriform nuclei. Conclusions: This case report provides the first evidence of clinical, histopathological, immunophenotypic features, electron microscopy findings and molecular analysis of a cutaneous epitheliotropic T-cell lymphoma (mycosis fungoides) in a donkey. Our observations suggest that cutaneous T-cell lymphoma should be included in the differential diagnoses of exfoliative dermatitis, even those progressing in a chronic pattern and/or with few or no pruritus.
Publication Date: 2022-07-11 PubMed ID: 35821128PubMed Central: PMC9275177DOI: 10.1186/s12917-022-03365-7Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Case Reports
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study reports the first-ever case of a donkey contracting cutaneous epitheliotropic T-cell lymphoma, a malignant skin tumor, with diagnosis confirmed through clinical, histological, immunohistochemical aspects, and a positive TRG clonality test.

Research Overview

  • The researchers conducted a case study investigation on a 25-year-old donkey gelding that had displayed signs of cutaneous epitheliotropic T-cell lymphoma. These signs included mildly pruritic (itchy), widespread, severe exfoliative dermatosis (scaling), and alopecia (hair loss) with some skin erosion.
  • The donkey was also mildly underweight, but otherwise clinically healthy. All mucocutaneous junctions, except the hooves, were affected by the condition. Any possibility for the presence of ectoparasites and dermatophytes was eliminated by the study team.

Medical Findings

  • Medical tests carried out on the donkey revealed mild normocytic normochromic anemia and mild hyperproteinemia with normal albumin levels within the donkey’s bloodstream. Protein electrophoresis revealed a moderate polyclonal hypergammaglobulinemia.
  • The presence of several lymphocytes with twisted or cerebriform nuclei was observed under transmission electronic microscopy.

Historical and Immunohistochemical Analysis

  • Deep analysis of the donkey’s skin tissue showed massive exocytosis of lymphoid cells in the epidermis, forming microscopic clusters known as Pautrier microabscesses. These are tissue characteristics of cutaneous epitheliotropic lymphoma.
  • The immunohistochemical staining of these cells revealed a uniform labeling for CD3, a marker associated with T cells, and a lack of expression of CD20, a marker associated with B cells. This implied the cancer was of T-cell lineage.

Conclusions

  • The case was then confirmed to be that of cutaneous epitheliotropic T-cell lymphoma, also known as mycosis fungoides, after a molecular clonality PCR (PARR) was conducted using equine TRG primers – revealing a clonal rearrangement indicative of cancer amongst much normal cell-growth.
  • The findings of this study make it the first to document clinical, histopathological, immunophenotypic features, electron microscopy findings, and molecular analyses of such a case in a donkey. It also suggested that cutaneous T-cell lymphoma should be included in differential diagnoses of exfoliative dermatitis, even those progressing in a chronic pattern and/or with few or no pruritus.

Cite This Article

APA
Kondratjeva J, Julien F, Coutelier C, Humeau L, Moog F, Combarros D, Fourquaux I, Pressanti C, Delverdier M, Moore PF, Cadiergues MC. (2022). Cutaneous epitheliotropic T-cell lymphoma in a donkey – a case report. BMC Vet Res, 18(1), 267. https://doi.org/10.1186/s12917-022-03365-7

Publication

ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 18
Issue: 1
Pages: 267

Researcher Affiliations

Kondratjeva, Jevgenija
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
Julien, Florie
  • Selarl Hippovet Aude, Laure Minervois, France.
Coutelier, Céline
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
Humeau, Louis
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
Moog, Fabien
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
Combarros, Daniel
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
  • INFINITy, Université de Toulouse, CNRS, UPS, InsermToulouse, France.
Fourquaux, Isabelle
  • Centre de Microscopie Electronique Appliquée À La Biologie, Université de Toulouse, Toulouse, France.
Pressanti, Charline
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France.
  • INFINITy, Université de Toulouse, CNRS, UPS, InsermToulouse, France.
Delverdier, Maxence
  • Basic Sciences Department, Université de Toulouse, ENVT, Toulouse, France.
  • IHAP, Université de Toulouse, INRAE, ENVT, Toulouse, France.
Moore, Peter F
  • Leukocyte Antigen Biology Laboratory, UC Davis, VM PMI, Davis, CA, USA.
Cadiergues, Marie Christine
  • Small Animal and Equine Hospital, ENVT, Université de Toulouse, Toulouse, France. marie-christine.cadiergues@envt.fr.
  • INFINITy, Université de Toulouse, CNRS, UPS, InsermToulouse, France. marie-christine.cadiergues@envt.fr.

MeSH Terms

  • Animals
  • Dermatitis, Exfoliative / veterinary
  • Equidae
  • Lymphoma, T-Cell, Cutaneous / diagnosis
  • Lymphoma, T-Cell, Cutaneous / pathology
  • Lymphoma, T-Cell, Cutaneous / veterinary
  • Male
  • Mycosis Fungoides / diagnosis
  • Mycosis Fungoides / pathology
  • Mycosis Fungoides / veterinary
  • Receptors, Antigen, T-Cell, gamma-delta
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology
  • Skin Neoplasms / veterinary

Conflict of Interest Statement

The authors declare that they have no competing interests.

References

This article includes 30 references
  1. Gross TL, Ihrke PJ, Walder E, Affolter VK. Lymphocytic tumors. 2005;pp. 866–893.
  2. Scott DW, Miller WH. Neoplasms, Cysts, Hamartomas, and Keratoses. 2011;pp. 468–516.
  3. Specht L, Skov L. Cutaneous Lymphomas. Clin Oncol (R Coll Radiol) 2019;31(11):797–807.
    doi: 10.1016/j.clon.2019.07.018pubmed: 31405542google scholar: lookup
  4. Fontaine J, Bovens C, Bettenay S, Mueller RS. Canine cutaneous epitheliotropic T-cell lymphoma: a review. Vet Comp Oncol 2009;7(1):1–14.
  5. Fontaine J, Heimann M, Day MJ. Cutaneous epitheliotropic T-cell lymphoma in the cat: a review of the literature and five new cases. Vet Dermatol 2011;22(5):454–461.
  6. Peleteiro M, Pinto C, Correia J, Silva J, Branco S. Two cases of cutaneous T cell lymphoma in Friesian cows in the Azores. Vet Dermatol 2000;11:299–304.
  7. Mineshige T, Kawarai S, Yauchi T, Segawa K, Neo S, Sugahara G, Kamiie J, Hisasue M, Shirota K. Cutaneous epitheliotropic T-cell lymphoma with systemic dissemination in a dog. J Vet Diagn Invest 2016;28(3):327–331.
    doi: 10.1177/1040638716637642pubmed: 26951331google scholar: lookup
  8. Moore PF, Affolter VK, Graham PS, Hirt B. Canine epitheliotropic cutaneous T-cell lymphoma: an investigation of T-cell receptor immunophenotype, lesion topography and molecular clonality. Vet Dermatol 2009;20(5–6):569–576.
  9. Durham AC, Pillitteri CA, San Myint M, Valli VE. Two hundred three cases of equine lymphoma classified according to the World Health Organization (WHO) classification criteria. Vet Pathol 2013;50(1):86–93.
    doi: 10.1177/0300985812451603pubmed: 22700849google scholar: lookup
  10. Miller CA, Durham AC, Schaffer PA, Ehrhart EJ, Powers BE, Duncan CG. Classification and clinical features in 88 cases of equine cutaneous lymphoma. J Vet Diagn Invest 2015;27(1):86–91.
    doi: 10.1177/1040638714561653pubmed: 25525142google scholar: lookup
  11. Knottenbelt DC. Skin Disorders of the Donkey and Mule. Vet Clin North Am Equine Pract 2019;35(3):493–514.
    doi: 10.1016/j.cveq.2019.08.006pubmed: 31672201google scholar: lookup
  12. Lima TS, Silva RAF, Pereira RMF, Soares KL, Santos NTA, Sousa MS, Mendonca FS, Lucena RB. Skin Diseases in Donkeys and Mules-An Update. Animals (Basel) 2020;11(1):65.
    doi: 10.3390/ani11010065pmc: PMC7824245pubmed: 33396381google scholar: lookup
  13. Davis CR, Valentine BA, Gordon E, McDonough SP, Schaffer PA, Allen AL, Pesavento P. Neoplasia in 125 donkeys (Equus asinus): literature review and a survey of five veterinary schools in the United States and Canada. J Vet Diagn Invest 2016;28(6):662–670.
    doi: 10.1177/1040638716665659pubmed: 27698162google scholar: lookup
  14. Tesfaye A, Tekle Y, Taddele H, Gezahagn K, Yihdego H. Survey of common skin problem of working equines in and around Mekelle, North Ethiopia. Acad J Animal Dis 2015;4:30–38.
  15. White SD, Bourdeau PJ, Brement T, Vandenabeele SI, Haspeslagh M, Bruet V, Sloet van Oldruitenborgh-Oosterbaan MM. Skin disease in donkeys (Equus asinus): a retrospective study from four veterinary schools. Vet Dermatol 2019;30(3):247–e276.
    doi: 10.1111/vde.12733pubmed: 30828915google scholar: lookup
  16. Burden F, Hazell-Smith E, Mulugeta G, Patrick V, Trawford R, Brooks Brownlie H. Reference intervals for biochemical and haematological parameters in mature domestic donkeys (Equus asinus) in the UK. Equine vet Educ 2016;28(3):134–139.
    doi: 10.1111/eve.12512google scholar: lookup
  17. van Doorn R, Van Haselen CW, van Voorst Vader PC, Geerts ML, Heule F, de Rie M, Steijlen PM, Dekker SK, van Vloten WA, Willemze R. Mycosis fungoides: disease evolution and prognosis of 309 Dutch patients. Arch Dermatol 2000;136(4):504–510.
    pubmed: 10768649
  18. Moore PF, Olivry T, Naydan D. Canine cutaneous epitheliotropic lymphoma (mycosis fungoides) is a proliferative disorder of CD8+ T cells. Am J Pathol 1994;144(2):421–429.
    pmc: PMC1887150pubmed: 7906096
  19. Wong HK, Mishra A, Hake T, Porcu P. Evolving insights in the pathogenesis and therapy of cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome). Br J Haematol 2011;155(2):150–166.
  20. Meyer J, Delay J, Bienzle D. Clinical, laboratory, and histopathologic features of equine lymphoma. Vet Pathol 2006;43(6):914–924.
    doi: 10.1354/vp.43-6-914pubmed: 17099148google scholar: lookup
  21. Hollis A. PCR for antigen receptor rearrangement (PARR) in equine veterinary medicine. Equine vet Educ 2019;31:419–420.
    doi: 10.1111/eve.12857google scholar: lookup
  22. Keller SM, Vernau W, Moore PF. Clonality Testing in Veterinary Medicine: A Review With Diagnostic Guidelines. Vet Pathol 2016;53(4):711–725.
    doi: 10.1177/0300985815626576pubmed: 26933096google scholar: lookup
  23. Collar E, Parker J, Gorman E, Russell D, Valentine B. PCR for antigen receptor rearrangement (PARR) clonality testing in a horse with a solitary retropharyngeal lymphoma. Equine vet Educ 2019;31:413–418.
    doi: 10.1111/eve.12821google scholar: lookup
  24. de Bruijn CM, Veenman JN, Rutten VP, Teske E, van Nieuwstadt RA, van den Ingh TS. Clinical, histopathological and immunophenotypical findings in five horses with cutaneous malignant lymphoma. Res Vet Sci 2007;83(1):63–72.
    doi: 10.1016/j.rvsc.2006.10.015pubmed: 17174365google scholar: lookup
  25. Luethy D, Frimberger AE, Bedenice D, Byrne BS, Groover ES, Gardner RB, Lewis T, MacDonald VS, Proctor-Brown L, Tomlinson JE. Retrospective evaluation of clinical outcome after chemotherapy for lymphoma in 15 equids (1991–2017). J Vet Intern Med 2019;33(2):953–960.
    doi: 10.1111/jvim.15411pmc: PMC6430950pubmed: 30636061google scholar: lookup
  26. Risbon RE, de Lorimier LP, Skorupski K, Burgess KE, Bergman PJ, Carreras J, Hahn K, Leblanc A, Turek M, Impellizeri J. Response of canine cutaneous epitheliotropic lymphoma to lomustine (CCNU): a retrospective study of 46 cases (1999–2004). J Vet Intern Med 2006;20(6):1389–1397.
    pubmed: 17186855
  27. Beck W, Folster-Holst R. Tropical rat mites (Ornithonyssus bacoti) - serious ectoparasites. J Dtsch Dermatol Ges 2009;7(8):667–670.
    pubmed: 19508683
  28. Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome): part II. Prognosis, management, and future directions. J Am Acad Dermatol 2014;70(2):223.
    doi: 10.1016/j.jaad.2013.08.033pubmed: 24438970google scholar: lookup
  29. Photiou L, van der Weyden C, McCormack C, Miles Prince H. Systemic Treatment Options for Advanced-Stage Mycosis Fungoides and Sezary Syndrome. Curr Oncol Rep 2018;20(4):32.
    doi: 10.1007/s11912-018-0678-xpubmed: 29572582google scholar: lookup
  30. Littlewood JD, Whitwell KE, Day MJ. Equine Cutaneous Lymphoma: A Case Report. Vet Dermatol 1995;6(2):105–111.

Citations

This article has been cited 3 times.
  1. Paraschou G, Xue C, Egan R, Bolfa P. Multicentric lymphoma in a donkey with intestinal and bone marrow involvement. BMC Vet Res 2024 Feb 15;20(1):57.
    doi: 10.1186/s12917-024-03903-5pubmed: 38360691google scholar: lookup
  2. Dumitrache MO, Györke A, Julien F, Kondratjeva J, Cadiergues MC. Case report: Identification of the tropical rat mite (Ornithonyssus bacoti) on a domestic donkey in France. Front Vet Sci 2023;10:1141290.
    doi: 10.3389/fvets.2023.1141290pubmed: 37303734google scholar: lookup
  3. Rissi DR, Avery AC, Burnett RC. T-cell-rich, large B-cell lymphoma in the brain of a horse. J Vet Diagn Invest 2023 May;35(3):327-331.
    doi: 10.1177/10406387231164368pubmed: 36946511google scholar: lookup