Multisystemic, Eosinophilic, Epitheliotropic Disease with Intestinal Lymphosarcoma in a Horse

Multisystemic, eosinophilic, epitheliotropic disease and intestinal lymphosarcoma were diagnosed in a Paso Fino mare that presented with anorexia and weight loss. The stomach, ileum, cecum, colon, pancreas, and lungs were infiltrated by large numbers of eosinophils forming prominent eosinophilic granulomas, as well as lymphocytes and plasma cells. Two jejunal masses composed of solid sheets of neoplastic lymphocytes were present. In contrast to the regions of inflammation, the infiltrates in these masses did not contain plasma cells, eosinophils, and eosinophilic granulomas. Immunohistochemically, the neoplastic lymphocytes expressed CD3 but not CD20 or kappa and lambda light chains, supporting a diagnosis of T-cell lymphosarcoma. Concurrent diagnoses of hypereosinophilic syndrome and lymphosarcoma in this horse and several humans suggest that the multisystemic eosinophilic and lymphoplasmacytic infiltrates were caused by the clonal proliferation of T-lymphocytes that secreted interleukin-5 triggering differentiation and activation of eosinophils.

[1]  G. Bubley,et al.  The idiopathic hypereosinophilic syndrome. , 1994, Blood.

[2]  M. Goldman,et al.  Brief report: clonal proliferation of type 2 helper T cells in a man with the hypereosinophilic syndrome. , 1994, The New England journal of medicine.

[3]  J. Yager.  CHAPTER 5 – The Skin and Appendages , 1993 .

[4]  M. Hendrick.  A Spectrum of Hypereosinophilic Syndromes Exemplified by Six Cats with Eosinophilic Enteritis , 1981, Veterinary pathology.

[5]  D. Pass,et al.  Chronic Eosinophilic Gastroenteritis in the Horse , 1982, Veterinary pathology.

[6]  H. Simon,et al.  Long-term outcome of idiopathic hypereosinophilic syndrome--transition to eosinophilic gastroenteritis and clonal expansion of T-cells. , 1996, European Journal of Gastroenterology and Hepathology.

[7]  T. Mair,et al.  Multisystemic eosinophilic epitheliotropic disease in a horse: attempted treatment with hydroxyurea and dexamethasone , 1992, Veterinary Record.

[8]  H. Simon,et al.  A case of hypereosinophilic syndrome is associated with the expansion of a CD3-CD4+ T-cell population able to secrete large amounts of interleukin-5. , 1996, Blood.

[9]  H. Townsend,et al.  Chronic Eosinophilic Dermatitis: A Manifestation of a Multisystemic, Eosinophilic, Epitheliotropic Disease in Five Horses , 1985, Veterinary pathology.

[10]  J. Fox,et al.  Eosinophilic Gastroenteritis with Splendore-Hoeppli Material in the Ferret (Mustela putorius furo) , 1992, Veterinary pathology.

[11]  P. Quigley,et al.  Eosinophilic enteritis in the dog: a case report with a brief review of the literature. , 1981, Journal of comparative pathology.

[12]  M. Li,et al.  Interleukin-5 mRNA levels in blood and bone marrow mononuclear cells from patients with the idiopathic hypereosinophilic syndrome. , 1994, Immunology.

[13]  H. Simon,et al.  Expansion of cytokine-producing CD4-CD8- T cells associated with abnormal Fas expression and hypereosinophilia , 1996, The Journal of experimental medicine.

[14]  J. Edwards,et al.  Chronic eosinophilic pancreatitis and ulcerative colitis in a horse. , 1985, Journal of the American Veterinary Medical Association.

[15]  H. Schrezenmeier,et al.  Interleukin-5 is the predominant eosinophilopoietin produced by cloned T lymphocytes in hypereosinophilic syndrome. , 1993, Experimental hematology.