Acute myeloid leukemia with multilineage dysplasia in an alpaca.

An 18-year-old female alpaca was presented to the Colorado State University Veterinary Teaching Hospital for chronic ill thrift over a 1-year period. Six weeks previously, an infected left mandibular cheek tooth was removed by oral extraction. On physical examination the patient was cachectic, lethargic, and weak. Abnormalities on the CBC included neutropenia, thrombocytosis, and severe nonregenerative, macrocytic, hypochromic anemia. Dysplastic nucleated erythrocytes and micromegakaryocytes were observed on the peripheral blood smear. Neutrophils, bands, and metamyelocytes appeared markedly toxic. Numerous blasts containing variable numbers of fine azurophilic granules were also observed. Based on their morphology, the cells were interpreted to be progranulocytes and myeloblasts, and a presumptive diagnosis of acute myeloid leukemia (AML) was made. The blast cells accounted for 60% of the nucleated cell population on bone marrow aspirates, further supporting a diagnosis of AML with multilineage dysplasia. Post mortem examination showed infiltration of the neoplastic cells into spleen, liver, kidney, and lymph nodes. Based on histologic findings, the morphologic diagnoses were disseminated myeloid neoplasia, chronic regionally extensive tooth root abscess, and membranous glomerulonephritis. The neoplastic cells were CD172a-positive on flow cytometry, chloroacetate esterase-positive by cytochemistry, and myeloperoxidase-positive by immunohistochemistry, confirming myeloid origin. To our knowledge, this is the first case of AML with multilineage dysplasia in an alpaca, with only one other case of myelodysplasia described previously in this species.

What is your diagnosis? Cervical mass in a cat.

An 8-year-old female spayed domestic shorthair cat was presented for several months of weight loss, decreased appetite, and 2 bilateral, ventral cervical masses. Initial cytologic samples were interpreted as reactive lymphoid hyperplasia. Evaluation of subsequent mass aspirates revealed small numbers of large binucleated and multinucleated cells resembling Reed-Sternberg cells admixed with more numerous small and intermediate-sized lymphocytes. In histopathologic sections, the normal architecture of the lymph node was largely effaced by a slightly heterogeneous mass composed of round cells arranged in densely cellular sheets with a minor population of large (25-microm diameter) mononuclear cells and a few very large (30-40-microm diameter) binucleated or multinucleated cells interpreted as Reed-Sternberg-like cells. Immunohistochemically, the large neoplastic (Reed-Sternberg-like) cells were negative for CD18, CD3, CD20, and CD79a while the background population consisted of about 70% T cells and 30% B cells. This pattern of immunohistochemical staining along with cytologic and histopathologic findings supported a diagnosis of Hodgkin's-like lymphoma, specifically, the lymphocyte-rich subtype. Hodgkin's-like lymphoma has been reported previously in cats and should be suspected when Reed-Sternberg-like cells are observed in cytologic preparations of lymph node aspirates. Histopathology and immunohistochemistry are necessary for a definitive diagnosis.

Hematologic and biochemical abnormalities indicating iron deficiency are associated with decreased reticulocyte hemoglobin content (CHr) and reticulocyte volume (rMCV) in dogs.

BACKGROUND: The ADVIA 120 automated hematology system uses low- and high-angle light scatter to determine individual RBC and reticulocyte volume and hemoglobin (Hgb) concentration. Current hematologic and biochemical markers of iron status in the dog are insensitive, and results may be highly variable, especially in the presence of concurrent disease (ie, inflammation, neoplasia). Reticulocyte Hgb content (CHr) has proven useful in detecting early iron deficiency and iron deficiency masked by concurrent disease in human patients. OBJECTIVES: The purpose of this study was to retrospectively investigate the association of low CHr and reticulocyte MCV (rMCV) with hematologic and biochemical abnormalities indicative of iron deficiency in canine patients. METHODS: Reference intervals for CHr and rMCV were established on a population of 362 hematologically-normal dogs using standard methods. CBC and serum biochemical results from 833 dogs at Colorado State University Veterinary Teaching Hospital were retrospectively evaluated. The prevalence of decreased CHr and rMCV values was determined based on the reference intervals. Hematologic (HCT, MCV) and biochemical (serum Fe concentration, percent saturation of transferrin [% sat]) values were compared among dogs with low CHr (n=58), low rMCV (n=50), and control dogs (cohort groups from the initial population) using a Fisher exact test. RESULTS: Reference intervals were 22.3-27.9 pg for CHr and 77.8-100.2 fL for rMCV. Seven percent (n=58) of dogs in the hospital population had low CHr and 6% (n=50) had low rMCV based on the reference values. Dogs with low CHr had significantly lower HCT, MCV, serum Fe, and % sat values than did control dogs. In addition, dogs with low CHr or low rMCV values had a higher frequency of microcytosis, anemia, low serum Fe concentration, and low % sat than did control dogs. CONCLUSION: Low CHr and low rMCV are associated with hematologic and serum biochemical abnormalities indicative of iron deficiency. CHr and rMCV hold promise as noninvasive, cost-effective measures of iron status in the dog.