Cutaneous lymphoma development during therapy of intestinal T-cell lymphoma in a dog

Abstract

A 13-year-old intact male Shih-Tzu presented with a 2-month history of gastrointestinal signs. A mechanical ileus developed due to an obstruction from an intramural tumor in the small intestine that was surgically resected. The tumor was diagnosed as a high-grade intestinal T-cell lymphoma with incomplete margins and serosal and mesentery extension. CHOP chemotherapy (vincristine, cyclophosphamide, doxorubicin, and prednisolone) was applied, but during the CHOP protocol, the dog developed a nodule on the skin in the scapular area. Histopathological examination of a punch biopsy revealed a high-grade cutaneous T-cell lymphoma. Lomustine was administered and the cutaneous T-cell lymphoma was surgically resected and histologically diagnosed to have complete margins. However, the dog experienced progressive disease. With adjuvant chemotherapy including dexamethasone, melphalan, actinomycin D, and cytosine arabinoside (DMAC), and chlorambucil, methotrexate, and prednisolone (LMP), the patient lived for 571 days in relatively good health condition. No evidence of recurrence nor metastasis was revealed at necropsy. This case suggests the benefit of surgical resection for both intestinal and cutaneous T-cell lymphoma lesions. However, further studies are required to investigate the effect of chemotherapy, remission rate, survival time, and impact on the quality of life.