Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis
Abstract Background Differentiation of low‐grade intestinal T‐cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. Objective Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. Animals Forty‐four client‐ow...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16231 |
| _version_ | 1798026691432415232 |
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| author | Valérie Freiche Mathieu V. Paulin Nathalie Cordonnier Hélène Huet Maria‐Elena Turba Elizabeth Macintyre Thierry‐Jo Molina Olivier Hermine Lucile Couronné Julie Bruneau |
| author_facet | Valérie Freiche Mathieu V. Paulin Nathalie Cordonnier Hélène Huet Maria‐Elena Turba Elizabeth Macintyre Thierry‐Jo Molina Olivier Hermine Lucile Couronné Julie Bruneau |
| author_sort | Valérie Freiche |
| collection | DOAJ |
| description | Abstract Background Differentiation of low‐grade intestinal T‐cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. Objective Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. Animals Forty‐four client‐owned cats, 22 diagnosed with LGITL and 22 with LPE. Methods Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full‐thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. Results A monomorphic lymphocytic population (22/22, 100%) and in‐depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical‐to‐basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki‐67 20%‐ and 30%‐thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3− and pSTAT5+. T‐cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). Conclusions and Clinical Importance We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE. |
| first_indexed | 2024-04-11T18:40:29Z |
| format | Article |
| id | doaj.art-31c16660d2194a4da90537a390c9e89a |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-11T18:40:29Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-31c16660d2194a4da90537a390c9e89a2022-12-22T04:09:02ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762021-11-013562673268410.1111/jvim.16231Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritisValérie Freiche0Mathieu V. Paulin1Nathalie Cordonnier2Hélène Huet3Maria‐Elena Turba4Elizabeth Macintyre5Thierry‐Jo Molina6Olivier Hermine7Lucile Couronné8Julie Bruneau9Ecole Nationale Vétérinaire d'Alfort CHUVA, Unité de Médecine Interne Maisons‐Alfort F‐94700 FranceDepartment of Small Animal Clinical Sciences Western College of Veterinary Medicine, University of Saskatchewan Saskatoon SK CanadaPathology Department Ecole Nationale Vétérinaire d'Alfort, Biopôle Maisons‐Alfort F‐94700 FrancePathology Department Ecole Nationale Vétérinaire d'Alfort, Biopôle Maisons‐Alfort F‐94700 FranceLaboratorio Genefast Forli ItalyLaboratory of Onco‐Hematology, Hôpital Necker‐Enfants Malades, Assistance Publique des Hôpitaux de Paris University of Paris Paris FranceCentre National Expert des Lymphomes Associés à la Maladie Cœliaque University of Paris Paris FranceCentre National Expert des Lymphomes Associés à la Maladie Cœliaque University of Paris Paris FranceLaboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163 Imagine Institute, University of Paris Paris FranceCentre National Expert des Lymphomes Associés à la Maladie Cœliaque University of Paris Paris FranceAbstract Background Differentiation of low‐grade intestinal T‐cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. Objective Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. Animals Forty‐four client‐owned cats, 22 diagnosed with LGITL and 22 with LPE. Methods Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full‐thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. Results A monomorphic lymphocytic population (22/22, 100%) and in‐depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical‐to‐basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki‐67 20%‐ and 30%‐thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3− and pSTAT5+. T‐cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). Conclusions and Clinical Importance We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE.https://doi.org/10.1111/jvim.16231alimentary lymphomaCD20CD3clonalityepitheliumfibrosis |
| spellingShingle | Valérie Freiche Mathieu V. Paulin Nathalie Cordonnier Hélène Huet Maria‐Elena Turba Elizabeth Macintyre Thierry‐Jo Molina Olivier Hermine Lucile Couronné Julie Bruneau Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis Journal of Veterinary Internal Medicine alimentary lymphoma CD20 CD3 clonality epithelium fibrosis |
| title | Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis |
| title_full | Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis |
| title_fullStr | Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis |
| title_full_unstemmed | Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis |
| title_short | Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis |
| title_sort | histopathologic phenotypic and molecular criteria to discriminate low grade intestinal t cell lymphoma in cats from lymphoplasmacytic enteritis |
| topic | alimentary lymphoma CD20 CD3 clonality epithelium fibrosis |
| url | https://doi.org/10.1111/jvim.16231 |
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