Faecal Occult Blood Test

Case of the Month (Emma Scurrell December 2012)

Myeloid leukaemia with lymph node invasion in a dog  

A 2-year-old German Shepherd Dog presented with acute lethargy, splenomegaly and a mild generalised peripheral lymphadenopathy. On routine haematology, there was a leukocytosis of 31.5 x10*9/L (reference range 6.6-18.4 x10*9/L) and 64% of these cells consisted of large neoplastic round cells similar to those described below in figures 1 & 2.



Fig 1. Aspirate of the prescapular lymph node. 60-70% of the nucleated cells consist of large round immature cells (red arrows) that contain moderate amounts of blue-tan ground glass cytoplasm with small pink-orange granules (azurophilic granulation). These cells are not lymphocytes and are instead typical of myeloid lineage.



Fig 2. Aspirate of the prescapular lymph node. Some of these large immature cells contain indented to band-shaped nuclei (red arrows) suggestive of metamyelocyte differentiation. Mitotic figures are common (black arrow). 
 

 







Final Diagnosis

Acute myeloblastic leukaemia (AML) 


Discussion

In contrast to acute lymphoblastic leukaemia, myeloblastic leukaemia arises from the myeloid cell line. The neoplastic process may involve the neutrophil, eosinophil or basophil but the neutrophil type is the most common in dogs. Affected dogs often present in good body condition but the course of disease is typically rapid and death usually results from a combination of haemorrhage and sepsis due to myelophthisis with resultant thrombocytopaenia and neutropaenia respectively.

Previous Monthly Cases

Hypertensive Retinopathy January 2010
FIP in a cat - uncommon presentation February 2010
Phaeohyphomycosis    March 2010 
Scleral Rupture April 2010
Canine and feline epulides May 2010
Erythema multiforme in a labrador retreiver June 2010
Keloidal fibrosarcoma in a labrador retreiver July 2010
Cutaneous epitheliotropic lymphoma  August 2010 
Benign cutaneous histiocytoma  September 2010 
Iridociliary adenoma October 2010
Proliferative thrombovascular necrosis of the pinnae November 2010
Signet-ring cell carcinoma in the stomach of a dog December 2010
Cutaneous infiltrative lipoma in a labrador January 2011

Tonsillar squamous cell carcinoma February 2011
Canine orbital meningioma March 2011
"Lung-digit" syndrome in a cat April 2011
Hepatic amyloidosis in a cat May 2011
Haemophagocytic histiocytic sarcoma June 2011
Alternaria spp. infection in an immunocompromised dog July 2011
Ocular manifestation of lymphoma in a cat  August 2011
Kerion dermatophytosis in a Cocker spaniel September 2011
Subcuticular coenurus in a rabbit  October 2011
Optic nerve glioma in a dog November 2011
Malignant transformation of a viral papilloma in a dog  December 2011
Uveodermatological syndrome in an Akita
January 2012
Cutaneous angiostomatosis in a dog  February 2012
Transitional cell carcinoma in a dog  March 2012
Corneal inclusion cysts in a dog   April 2012
Extraskeletal osteosarcoma in a dog  May 2012
Subungual melanoma in a dog  June 2012
Retrobulbar grass seed in a dog   July 2012
Lungworm infection associated with hypercalcaemia in a dog  August 2012
Conjunctival melanoma in a dog  September 2012
Pneumocystis infection in a Cavalier King Charles Spaniel  October 2012
Fungal keratitis and secondary endophthalmitis in a horse November 2012    



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Faecal Occult Blood Test