Abstract
Dogs with lymphoma are at risk of developing clinical complications due to immunosuppression and side effects of chemotherapy. Clinical reports of concurrent lymphoma and leishmaniasis are rare and confined to single cases of comorbidity at presentation. Herein, we describe a case of lymphoma during maintenance chemotherapy in which bone marrow cytology showed myelodysplasia associated with leishmaniasis. The dog was a seven-year-old intact female Parson Russel Terrier with a two-week history of generalized lymphadenopathy. Diagnosis of multicentric high-grade B-cell lymphoma stage Va was carried out with cytological and cytofluorimetric assays of external lymph nodes, abdominal ultrasound, chest radiology, and lymphoid blasts blood smear examination. The dog lived and had traveled in endemic areas of Leishmania with uninterrupted prevention against sand fly bites by an insecticide-impregnated collar and presented seronegativity to Leishmania at presentation. Chemotherapy for lymphoma was successful and the patient achieved complete remission. Approximately eight months after the diagnosis, a persistent pancytopenia was assessed. Unexpectedly, Leishmania amastigotes were identified in the bone marrow. Combined treatment rounds were administered with antileishmanial and antineoplastic drugs for approximately eight months. Eventually, lymphoma relapsed and became unresponsive to chemotherapy, and the dog was euthanatized. Canine lymphoma overlapping with subsequent Leishmania infection as a complication is rare and lacks specific clinical manifestations. A delayed diagnosis of leishmaniasis may occur. We suggest considering leishmaniasis as part of the differential diagnosis of persistent pancytopenia in dogs with lymphoma, particularly in dogs who reside or travel to endemic areas, when treatment fails or abnormal laboratory findings are present.
Highlights
Lymphomas are a group of blood malignancies originating from lymphocytes that can affect all lymphoid organs, as well as other tissues
The four most common types of lymphoma in dogs are typically characterized by the site of occurrence: (1) Multicentric, which occurs in multiple sites; (2) alimentary, which originates in the digestive system; (3) mediastinal, which arises within the chest; and (4) extranodal, which can involve the kidneys, central nervous system, skin, or other tissues
Our case report shows that the presence of persistent pancytopenia in dogs treated for lymphoma in endemic areas makes it necessary to rule out leishmaniasis
Summary
Lymphomas are a group of blood malignancies originating from lymphocytes that can affect all lymphoid organs, as well as other tissues. Multicentric lymphoma is by far the most common in dogs, accounting for more than 80% of diagnosed canine lymphomas [1,2] In this type of lymphoma, lymph nodes throughout the body are affected, and, in many cases, the most obvious clinical manifestation is their rapid enlargement. We present a case of an association between multicentric large B-cell lymphoma and subsequent CanL that occurred as a clinical complication during chemotherapy for lymphoma with a 252-day follow-up period. The aim of this case report is to improve the current knowledge concerning this medical condition
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