Classification of 1,198 cases of bovine lymphoma using the National Cancer Institute Working Formulation for human non-Hodgkin's lymphomas

Review of Histological Grading Systems in Veterinary Medicine

Tumor grading is a method to quantify the putative clinical aggressiveness of a neoplasm based on specific histological features. A good grading system should be simple, easy to use, reproducible, and accurately segregate tumors into those with low versus high risk. The aim of this review is to summarize the histological and, when available, cytological grading systems applied in veterinary pathology, providing information regarding their prognostic impact, reproducibility, usefulness, and shortcomings. Most of the grading schemes used in veterinary medicine are developed for common tumor entities. Grading systems exist for soft tissue sarcoma, osteosarcoma, multilobular tumor of bone, mast cell tumor, lymphoma, mammary carcinoma, pulmonary carcinoma, urothelial carcinoma, renal cell carcinoma, prostatic carcinoma, and central nervous system tumors. The prognostic relevance of many grading schemes has been demonstrated, but for some tumor types the usefulness of grading remains controversial. Furthermore, validation studies are available only for a minority of the grading systems. Contrasting data on the prognostic power of some grading systems, lack of detailed instructions in the materials and methods in some studies, and lack of data on reproducibility and validation studies are discussed for the relevant grading systems. Awareness of the limitations of grading is necessary for pathologists and oncologists to use these systems appropriately and to drive initiatives for their improvement.

T-cell lymphoma in the nasal cavity of a Brown Swiss heifer

Background

Tumours of the upper respiratory tract are relatively common in cattle, but to our knowledge, there have been no reports of lymphoma of the nasal cavity. This case report describes the findings in a 22-month-old Brown Swiss heifer with T-cell lymphoma of the nasal cavity.

Case presentation

The main clinical findings were lacrimation and swelling of the head above and below the right eye, mild exophthalmos, third eyelid prolapse, purulent ocular discharge and congestion of scleral blood vessels. An endoscope could only be introduced a few centimetres into the right nasal cavity because of an obstructing mass in the nasal passage. Radiographs showed a mass in the right nasal cavity and maxillary sinus. A tentative diagnosis of neoplasia of the right nasal cavity was made and the heifer was euthanased and necropsied. A firm, tan mass measuring 10 by 13 by 15 cm in the right half of the head occupied the entire right nasal cavity. A final diagnosis of high-grade, malignant, small-sized T-cell lymphoma was made based on histological and immunohistochemical evaluation. A distinction between αβ T-cell or γδ T-cell lymphoma was not made.

Conclusions

This report on T-cell lymphoma in the nasal cavity of a cow suggests that nasal lymphoma should be included in the list of differential diagnosis of conditions associated with dyspnoea and stertorous breathing in cattle.

Cytomorphology and PCNA expression pattern in bivalves Mytilus galloprovincialis and Cerastoderma edule with haemic neoplasia

Haemic neoplasia (HN) is a pathologic condition reported in several bivalve species in different geographic areas. In this study we describe the cytomorphological features and the proliferative behaviour, assessed by the proliferating cell nuclear antigen (PCNA), of HN in common cockle Cerastoderma edule and Mediterranean mussel Mytilus galloprovicialis. In mussels the presence of at least 5 types of atypical haemocytes was detected, including A- and B-type cells, previously described in M. edulis and Mytilus sp., with predominance of A-type cells in early phases of the disease and B-type cells in more advanced stages. PCNA immunostaining was positive for 97 to 100% of the neoplastic cells, with both cytoplasmic (A cells) and nuclear patterns (B cells). Conversely, in C. edule there was no distinctive morphological cell sub-population, and staining atypical haemocytes with PCNA (range 93 to 100%) showed nuclear expression in early phases of disease and cytoplasmic expression in more advanced stages. The above findings suggest distinct histo-pathogenetic pathways for HN in mussels and common cockles.

Two Hundred Three Cases of Equine Lymphoma Classified According to the World Health Organization (WHO) Classification Criteria

Lymphoma is the most common malignant neoplasm in the horse. Single case reports and small retrospective studies of equine lymphomas are reported infrequently in the literature. A wide range of clinical presentations, tumor subtypes, and outcomes have been described, and the diversity of the results demonstrates the need to better define lymphomas in horses. As part of an initiative of the Veterinary Cooperative Oncology Group, 203 cases of equine lymphoma have been gathered from 8 institutions. Hematoxylin and eosin slides from each case were reviewed and 187 cases were immunophenotyped and categorized according to the World Health Organization classification system. Data regarding signalment, clinical presentation, and tumor topography were also examined. Ages ranged from 2 months to 31 years (mean, 10.7 years). Twenty-four breeds were represented; Quarterhorses were the most common breed ( n = 55), followed by Thoroughbreds ( n = 33) and Standardbreds ( n = 30). Lymphomas were categorized into 13 anatomic sites. Multicentric lymphomas were common ( n = 83), as were skin ( n = 38) and gastrointestinal tract ( n = 24). A total of 14 lymphoma subtypes were identified. T-cell–rich large B-cell lymphomas were the most common subtype, diagnosed in 87 horses. Peripheral T-cell lymphomas ( n = 45) and diffuse large B-cell lymphomas ( n = 26) were also frequently diagnosed.

Immunophenotypic and Histologic Classification of 50 Cases of Feline Gastrointestinal Lymphoma

The purpose of this study was to determine the immunophenotype and histologic classification of 50 cases of feline gastrointestinal lymphoma. Classification was determined using the National Cancer Institute Working Formulation and the Revised European and American Lymphoma/ World Health Organization classification system. Tissue sections were stained with HE, phosphotungstic acid hematoxylin, anti-CD3, anti-CD79a, and anti-BLA.36. Overall, B-cell tumors predominated at 54% (27/50), including 16 diffuse large with immunoblastic nuclear type, 2 diffuse large with centroblastic nuclear type, 3 small lymphocytic, 4 lymphocytic intermediate type, and 2 T-cell-rich large B-cell lymphomas. T-cell tumors comprised 38% (19/50), including 15 epitheliotropic small lymphocytic and 4 lymphoblastic. Three tumors (6%) were nonreactive for B- and T-cell markers and had eosinophilic cytoplasmic granules when stained with HE. Gastric tumors were diagnosed in 24% (12/50) of cats, and 18% (9/50) were present only in the stomach. All gastric lymphomas were of B-cell lineage. Small intestinal lymphoma predominated, with 74% (37/50) of cats affected: T-cell tumors comprised 52% (19/37); 38% (14/37) were B-cell tumors; 8% (3/37) were nonreactive for B- and T-cell markers; and 2% (1/37) expressed both CD3 and BLA.36. Of the 8 cats (16%) that had lymphoma of the large intestine, 88% (7/8) had B-cell tumors and 12% (1/8) had T-cell tumors. The strongest association between gastrointestinal lymphoma immunophenotype, histologic classification, and location occurred in the stomach, where there was a predominance of diffuse large B-cell lymphoma of immunoblastic nuclear type.

Evolution of classic Hodgkin lymphoma in correlation to changes in the lymphoid organ structure of vertebrates

In order to integrate evolutionary concepts into lymphoma research we mapped features of classic Hodgkin lymphoma (a disease which has been recently described to be derived from germinal center B-cells) onto a phylogenetic tree of vertebrates. Secondly, we matched the phylogenetic occurrence of classic Hodgkin lymphoma to the changes in the lymphoid organ structure during vertebrate evolution. According to our analysis, classic Hodgkin lymphoma evolved exclusively at the developmental stage of mammals. Interestingly the appearance of Hodgkin lymphoma is correlated to the evolution of germinal centers in mammals. This lends some credit to the hypothesis that genes specific to the germinal center reaction are involved in the pathogenesis of Hodgkin lymphoma. However, as evolution did not stop at the developmental stage of the mammalian stem-species, to a certain extent species with specific differences of classic Hodgkin lymphoma can be expected. One such difference is that classic Hodgkin lymphoma occurs with a significantly higher frequency in humans than in all other mammals. This could be partially due to Epstein-Barr virus (EBV) infection in approximately 40%-50% of Hodgkin disease cases, that is associated with an expression of the EBV-encoded oncogen LMP-1. In conclusion we propose that the mapping of lymphoma related characteristics onto a phylogenetic tree is a valuable new tool in lymphoma research.

The histologic classification of 602 cases of feline lymphoproliferative disease using the National Cancer Institute working formulation

Case information and histologic slides for 688 admissions of feline tissues from 12 veterinary institutions were assembled and reviewed to determine tissues obtained by biopsy or necropsy, age and sex of cat, tumor topography, feline leukemia viral antigen status, histologic frequency of mitoses, diagnosis, presence of necrosis, and presence and degree of sclerosis. Histologic sections were examined to place the lesions in one of the diagnostic categories of the National Cancer Institute working formulation (NCI WF) for lymphomas or lymphoid leukemia. Correlations between the various factors determined were tested using contingency tables and chi-square analysis to provide a statistical comparison between the levels of observations determined by case examination with the numbers expected from chance alone. Significant correlations (P < or = 0.05) were found between diagnosis and tumor topography, the frequency of mitoses, necrosis, sclerosis, and age, between mitoses and necrosis, topography, age, and feline leukemia viral infection status, between topography and necrosis and age, and between leukemia viral status and age. Significant correlations between diagnosis and tumor topography included a greater than expected number of cases of acute and chronic lymphoid leukemia and multicentric distribution of tumor. Small cell lymphomas were more frequent than expected in enteric and cutaneous areas and less frequent than expected in mediastinal, renal, and multicentric areas. In contrast, the high-grade small noncleaved type of lymphomas was found significantly more frequently than expected in the mediastinum and less frequently than expected in enteric tissues. In comparing diagnosis and frequency of mitoses, the lymphomas classified as low grade by the NCI WF were significantly more frequent than expected in the lower categories (0-2/100x) of mitoses, and those classified as high-grade lymphomas were more frequent than expected in the higher categories (4-8/1OOx) of mitoses. In comparing diagnosis and sclerosis, diffuse sclerosis was more frequent than expected for the intermediate grade lymphomas of mixed cell type and for the high-grade lymphomas of the immunoblastic polymorphous type. In comparing diagnosis and locally extensive necrosis, this feature was more frequently observed than expected for cases of intermediate grade lymphoma of the small-cleaved cell category and for the high-grade lymphoma of the immunoblastic cell type. In comparing mitoses and necrosis, the lower grade lymphomas were, in general, characterized by a lower frequency of mitoses and a lower incidence of necrosis then would be expected from chance alone. In contrast, the higher grade lymphomas were characterized by more frequent mitoses and a higher incidence of necrosis. In tests comparing mitoses and tumor topography, lymphomas of the alimentary tract were more frequently observed than expected in the category with the lowest level of mitoses (0-1/100x), whereas lymphomas of the mediastinum and kidney were more frequently observed than expected in the categories with a higher level (4-20/ 100x) of mitoses.

Distribution of T-lymphocyte subpopulation in blood and spleen of normal cattle and cattle with enzootic bovine leukosis

Immunocytochemical and flow cytometry techniques were used to examine T-lymphocyte subpopulations in peripheral blood lymphocytes (PBLs) and spleen from cases of enzootic bovine leukosis (EBL) in adult cattle, and from normal cattle (adult and young), with a panel of monoclonal antibodies against bovine leucocyte differentiation molecules. Both in PBLs and spleen, the percentages of T-lymphocyte subpopulations (CD3+, CD4+, CD8+, and WC1 + gamma delta T lymphocytes) of EBL-affected and normal adult cattle were significantly lower than those of normal young cattle. The percentages of these T-lymphocyte subpopulations in the PBLs of adult cattle with EBL were lower than those of normal adult cattle, but the converse was true in the spleen. It is suggested that tumour immunity occurred in the spleen. Histological examination revealed no follicular hyperplasia in the spleen, and the proliferation of neoplastic cells began in the red pulp. It is concluded that the spleen is not the organ initially responsible for the transformation of EBL lymphoma and that neoplastic cells migrating from peripheral blood are metastatic.

Equine malignant lymphomas: morphologic and immunohistochemical classification

Gross lesions, microscopic appearance, and immunophenotyping are reported in a retrospective study of 31 cases of equine malignant lymphoma. Immunohistochemical studies were performed on archived formalin-fixed, paraffin-embedded tissues. Monoclonal antibodies to surface glycoprotein BLA.36 and intracytoplasmic domains of mb-1 and B29 were used to document the presence of B lymphocytes in the equine tumors. Polyclonal antibody to CD3 and monoclonal antibodies to T-lymphocyte markers CD3 and CD5 revealed the presence of variable numbers of T cells within the equine lymphomas. The neoplastic component of the equine lymphomas was determined through morphologic evaluation, immunophenotyping, and the use of proliferation markers Ki-67 and proliferating cell nuclear antigen. Equine malignant lymphomas were composed of a heterogeneous cell population. Most tumors contained B and T lymphocytes. Twenty-four horses had diffuse lymphomas derived from B lymphocytes. Thirteen of these lymphomas contained primarily neoplastic B lymphocytes. Eleven additional cases of diffuse large B-cell lymphoma contained from 40% to 80% nonneoplastic T lymphocytes and were classified as T-cell-rich, large B-cell lymphomas. This is the first description of T-cell-rich, B-cell lymphoma in the horse. Six tumors with a diffuse architecture were derived from T lymphocytes. Four T-cell tumors were large-cell tumors, 1 was a small-cell tumor, and in 1 tumor the size of the cells could not be determined accurately because of autolytic change in the tissues. One diffuse large-cell lymphoma did not react with either B- or T-cell markers.

Morphometric analysis of bovine lymphomas classified according to the National Cancer Institute Working Formulation

The National Cancer Institute Working Formulation (NCI-WF) for the subjective classification of human non-Hodgkin's lymphoma is readily applicable to the classification of bovine lymphomas. Forty-nine cases of bovine lymphoma were analysed morphometrically to see if nuclear size and cleavage were distributed continuously or discretely between different NCI-WF tumour cell types. The mean nuclear area (+/- standard error of the mean, SE) was significantly greater (P < 10(-6)) in cells from the different types of diffuse large-cell lymphoma than in cells from the different types of small-cell lymphoma (42.91 +/- 1.21 micron 2 vs 19.33 +/- 1.08 micron 2, respectively); there was no overlap between the two groups. The mean nuclear are (+/- SE) of cells from diffuse large-cell lymphomas was significantly greater (P < 10(-4)) than that of cells from small non-cleaved lymphomas (42.74 +/- 1.72 micron 2 vs 27.54 +/- 1.08 micron 2, respectively), and there was again no overlap between the two groups; these two cell types are difficult to distinguish by any criteria other than size. Additionally, the cell-to-cell variability in nuclear area within a given tumour was significantly greater (P < 0.001) for the diffuse large-cell type than for the small non-cleaved cell type. The mean nuclear form factor (+/- SE) and mean nuclear contour indices (+/- SE) of the diffuse large cleaved cell type (0.53 +/- 0.02 and 5.08 +/- 0.11, respectively) were significantly different (P < 0.01 to 10(-6)) from the same parameters in the diffuse large-cell type (0.82 +/- 0.01 and 3.94 +/- 0.04, respectively). Some of the major criteria of the NCI-WF used subjectively to discriminate between bovine lymphoma cell types were supported by morphometric measurements. The magnitude of the differences in nuclear morphological characteristics between bovine lymphoma cell types was such that there was no overlap.

The immunophenotypic characterization of bovine lymphomas

A prospective analysis of 38 cases of bovine lymphoma was performed. Thirty-five of the lymphomas were considered enzootic because of serologic or molecular biologic association with the bovine leukemia virus (BLV). The three remaining cases were in cattle < 1 year of age and were not associated with BLV and hence were considered sporadic lymphomas. Utilizing the national cancer Institute Working Formulation for the morphologic classification of human non-Hodgkin's lymphoma, 54.3% (19/35) of the enzootic lymphomas were classified as the diffuse large cleaved cell type. The cells of the 35 enzootic lymphomas expressed a consistent immunophenotype represented by MHCII+, gamma-heavy chain+, and lambda-light chain+; this constellation of markers indicated a mature B-cell phenotype. The three sporadic lymphomas failed to express MHCII antigen despite the presence of other B-cell antigens. There was no correlation between morphologic cell type and immunophenotype in these bovine lymphomas.

Further analysis of the phenotype and distribution of tumor cells in sporadic B-cell and T-cell lymphomas in the lymph node and spleen of cattle

Immunohistologic studies were performed to identify the phenotype and distribution of neoplastic lymphocytes in the spleens of BLV-negative animals examined by PCR and diagnosed as having sporadic bovine leukosis. Tumor cells from three cases of sporadic bovine leukosis were identified as of B-cell lineage. Tumor cells from three additional cattle were identified as CD3+ CD4- CD8+, CD3+ CD4- CD8-, and CD3+ CD4- WC1+, respectively. The last case was diagnosed as a gamma/delta T-cell lymphoma. Differences in morphology proliferative characteristics were recognized between B- and T-cell type lymphomas. The tumor cells in B-cell type lymphoma were characterized as follows: medium or large in size, round or polymorphic nucleus with rough chromatin with some tumor cells containing a convoluted nucleus. These tumor cells of B-cell type lymphoma were present in the red pulp and periarteriolar lymphoid sheath. Tumor cells of the T-cell type lymphoma were uniformly smaller than B-cell type and present around arteries or replaced red pulp of the spleen.

T-cell-rich B-cell lymphoma in a cat

T-cell-rich B-cell lymphoma is a neoplasm recognized in humans in which a neoplastic proliferation of large B lymphocytes is present amid a background of reactive T lymphocytes. A 13-year-old Domestic Shorthair cat developed a mass in the region of the left parotid gland. Histologically, the mass was composed of scattered large atypical cells within a dense background of uniform small lymphoid cells. Immunohistochemically, the large cells were uniformly labeled using antiserum directed against the B-lymphocyte marker BLA.36, whereas labeling of nearly all of the small cells was limited to the T-lymphocyte marker CD3. The histomorphologic and immunohistochemical features of this unique feline neoplasm are characteristic of T-cell-rich B-cell lymphoma of humans.

Changes in the distribution of cells expressing tumour-associated antigen in lymph nodes during the progression of enzootic bovine leukosis

A monoclonal antibody (MAb), c143, that recognizes a tumour-associated antigen that is "upregulated" on neoplastic B cells in cattle with enzootic bovine leukosis (EBL), was used as a marker to study disease progression. An immunohistochemical examination of neoplastic tissue and superficial cervical lymph nodes from 14 animals with EBL revealed three morphologically definable stages of change in the structure of lymph nodes, associated with the distribution of c143-positive cells: (1) the presence of c143-positive cells at the marginal sinus with no apparent changes in lymph node structure; (2) the presence of positive cells extending into and distorting the architecture of the lymph node, with clear evidence of proliferation before overt changes (enlargement of lymph nodes) were evident; and (3) the presence of positive cells throughout the lymph node with total disruption of lymph node structure when clinical signs of lymph node enlargement were evident. The results indicated that the bovine leukaemia virus-transformed lymphocytes or neoplastic cells in peripheral blood accumulate in the marginal sinus area at the earliest stages, and subsequently proliferate and infiltrate into follicles, leading to the development of clinical signs of lymphosarcoma.

Phenotypic analysis of neoplastic cells from calf, thymic, and intermediate forms of bovine leukosis

Immunohistochemistry and flow cytometric analysis were used with monoclonal antibodies to examine the phenotype of neoplastic cells from cattle with sporadic bovine leukosis (three cases of calf form, two cases of thymic form, and three cases of intermediate form). Three cases of calf form and two cases of intermediate form were positive for B cell lineage in immunohistologic examination and in flow cytometric analysis for B-B2+, sIgM+, and major histocompatibility class II+. Two cases of thymic form and one case of intermediate form were CD2+, CD5+, CD6+, and CD8+ in immunohistologic examination and in flow cytometric analysis. The results show that neoplastic cells develop from B and T cell lineages in sporadic bovine leukosis.

Multicentric lymphoma involving large granular lymphocytes in a cow

This case report describes for the first time in the literature a bovine multicentric lymphoma involving large granular lymphocytes (LGL). Clinically, the cow had typical manifestations of multicentric lymphoma with nonspecific signs. Most lymphocytes in cytological specimens from blood and lymph nodes had an LGL-morphology. Histopathologically malignant LGLs were found in the liver, kidneys, and lungs. The azurophilic granules were clearly seen with May-Grünwald-Giemsa stain. The granules were slightly eosinophilic as shown with hematoxylin-eosin stain, and most stained intensively dark with phosphotungstic acid hematoxylin.

An immunohistochemical study of an equine B-cell lymphoma

The tissues of an 8-year-old thoroughbred castrated male horse with equine lymphoma were examined immunohistochemically. Neoplastic masses were observed in the mediastinum, mesenteric lymph nodes, gastric mucosa and serosa, liver capsule, and spleen capsule with associated lymph nodes. Histopathologically, the neoplastic cells were seen to consist predominantly of a mixture of well differentiated small and large types. Immunohistochemically, the small lymphoid cells were MHC class IIlow+ and PanT- and the large lymphoid cells were MHC class IIhigh+ and PanT-. These findings revealed that the neoplastic cells were of B-lymphocyte lineage.