Two Cases of Feline Hepatosplenic Cytotoxic T‐Cell Lymphoma With Hemophagocytosis

Vollständiger Abstract

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ABSTRACT This report describes the clinical courses of two cats with hepatosplenic cytotoxic T‐cell lymphoma (TCL) with tumor‐cell hemophagocytosis (THP). Both cats presented with pancytopenia and marked splenomegaly with a honeycomb pattern on ultrasonography. Cytology of splenic aspirates revealed large atypical lymphocytes with phagocytosis of erythrocytes and leukocytes. Immunohistochemical analysis revealed positive staining for CD3 and granzyme B. Bone marrow analysis revealed preserved trilineage hematopoiesis without apparent evidence of neoplastic infiltration. In Case 1, the cat was treated with prednisolone, L‐asparaginase, and a CHOP‐based chemotherapy protocol, resulting in temporary improvement. However, the cat died suddenly on day 88, with necropsy revealing pulmonary fibrosis. In Case 2, early splenectomy followed by CHOP chemotherapy led to sustained clinical improvement and longer‐term disease control. Despite relapse on day 65, the cat responded to rescue therapy with L‐asparaginase and ACNU and survived until day 278. These cases highlight the clinical and pathological features of 2 cases of feline hepatosplenic cytotoxic TCL with THP and suggest that splenectomy may play a role in improving clinical stability by suppressing hemophagocytic activity. A multimodal approach incorporating surgery and chemotherapy may be considered as a therapeutic option for hepatosplenic cytotoxic TCL with THP.