SUSPECTED PARANEOPLASTIC ERYTHEMA MULTIFORME MAJOR IN A DOG WITH SMALL-CELL T-CELL INTESTINAL LYMPHOMA

Type:
Case Report
Topic:
Oncology
Companies:
(1) Department of Small Animal Clinical Sciences, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, Neston, United Kingdom
(2) Department of Molecular & Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool
(3) Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
Authors:
Malgorzata Ossowska (1)
Vanessa Schmid (1)
Petra Bizikova (3)
Jean Benoit Tanis (1,2)
RESUMEN CORTO - SHORT SUMMARY:
 
Erythema multiforme (EM) is a cutaneous T-cell mediated hypersensitivity reaction that can be secondary to triggers such as drugs, food, infections, or idiopathic. A paraneoplastic origin is also described in humans1,2 but paraneoplastic EM is exceedingly rare in dogs, with only a single case described in association with thymoma3. Here, we describe a dog with an intestinal small-cell T-cell lymphoma and suspected paraneoplastic EM major. 

 
A 9 year-old cross-breed dog was referred for severe, progressive, generalised, non-pruritic, cutaneous and mucocutaneous lesions, pyrexia, vomiting and weight loss. Dermatohistopathology of skin biopsies interface dermatitis, single cell apoptosis and lymphocyte satellitosis at all levels of the epidermis. Clinical and histopathological findings were consistent with EM major. Computed tomography revealed a small-intestinal mass associated with a mesenteric lymphadenomegaly. Excision of the intestinal mass and mesenteric lymph node biopsy were performed. Histopathology and immunohistochemistry confirmed small-cell T-cell lymphoma with mesenteric nodal involvement. Methylprednisolone and chlorambucil were initiated. Cutaneous and systemic signs gradually resolved. No recurrence of the small-intestinal lymphoma was noted upon restaging and treatment was eventually discontinued. 

Nine months after discontinuing treatment, cutaneous lesions recurred. Restaging was declined. Methylprednisolone/chlorambucil were re-started, leading to partial, transient improvement. Cutaneous lesions then deteriorated with development of severe systemic signs, leading to euthanasia 26 months following initial diagnosis. 
 
This case is the first report of suspected paraneoplastic EM associated with small-cell intestinal T-cell lymphoma in a dog. This case would suggest that a paraneoplastic origin should be considered when a diagnosis of EM is made. 
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