Cutaneous Epitheliotropic T-Cell Lymphoma in a Dog: Clinical Responses to Lomustine and Gemcitabine

개에서 발생한 피부 상피친화성 T-세포 림프종: Lomustine 및 Gemcitabine에 대한 임상적 반응

  • Kang, Byeong-Teck (Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National University) ;
  • Kim, Dae Young (Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri) ;
  • Kang, Ji-Houn (Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National University) ;
  • Chang, Dong-Woo (Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National University) ;
  • Jung, Dong-In (Research Institute of Life Sciences, Gyeongsang National University) ;
  • Cho, Kyu-Woan (Research Institute of Life Sciences, Gyeongsang National University) ;
  • Yang, Mhan-Pyo (Veterinary Teaching Hospital, College of Veterinary Medicine, Chungbuk National University)
  • 강병택 (충북대학교 수의과대학) ;
  • 김대영 (미국 미주리 수의과대학) ;
  • 강지훈 (충북대학교 수의과대학) ;
  • 장동우 (충북대학교 수의과대학) ;
  • 정동인 (경상대학교 생명과학연구원) ;
  • 조규완 (경상대학교 생명과학연구원) ;
  • 양만표 (충북대학교 수의과대학)
  • Accepted : 2013.08.06
  • Published : 2013.08.31

Abstract

A 5-year-old, spayed female Maltese dog presented with generalized multifocal pruritic erythema and alopecia for a month. Initial skin biopsy suggested cutaneious histiocytosis. The dog had been treated with the immunosuppressive therapy for a month, but multifocal erythematous patches and plaques were newly observed. Direct imprint smear of cutaneous lesions suggested a lymphoma and rebiopsy was performed. Microscopic examination demonstrated a round cell tumor with epitheliotrophism to the epidermis and adnexal structures. The neoplastic round cells were strongly positive for CD3 yet negative for CD79a, indicting the tumor was cutaneous epitheliotropic T-cell lymphoma. After 2 cycles of oral administration of lomustine ($70mg/m^2$, once every 2-3 weeks), only partial response was observed. Alternative chemotherapy with gemcitabine ($500mg/m^2$, 30-minute IV infusion, once every week) was initiated. A total 3 cycles of gemcitabine failed to control the progression of disease, and the dog was euthanized on Day 69 after the 1st lomustine treatment.

5년령의 중성화된 암컷 말티즈가 1개월 동안 지속된 전신적 발적, 탈모 및 소양감으로 내원하였다. 피부조직구증으로 진단되어 면역억제치료를 1개월 간 지속하였지만 다발성의 발적된 반 및 판 병변들이 새롭게 발생하였다. 피부병변에 대한 압박도말검사에서 림프종을 지시하는 원형세포들이 관찰되었다. 조직학적 검사에서는 종양세포들의 외피 및 부속구조물에 대한 친화성이 나타났다. 면역염색결과 종양세포들은 CD3에 대하여 양성, CD79a에 대해서는 음성반응을 나타내어 피부 상피친화성 T-세포 림프종으로 확진하였다. $70mg/m^2$의 lomustine을 2-3주 간격으로 총 2회 투여하였으며 부분적인 치료반응이 관찰되었다. 피부병변의 악화와 lomustine의 이용제한으로 gemcitabine ($500mg/m^2$, 1주일당 1회 30분간 혈관주입)을 이용한 화학치료를 시작하였다. 총 3회 치료가 실시되었으나 질병의 진행을 억제하지 못하였으며, 최초 lomustine 치료 69일 후 안락사 되었다.

Keywords

References

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