Epitheliotropic Lymphoma In Dogs

Lymphoma in dogs is unfortunately quite a common cancer. It happens when the white blood cells called lymphocytes start growing and multiplying uncontrollably. They then spread to the lymph nodes, blood or internal organs.

A rare form that targets the skin is epitheliotropic lymphoma (EL), also called mycosis fungoides or cutaneous lymphoma. It has a very different appearance and outlook.

Signs Of Epitheliotropic Lymphoma

Epitheliotropic lymphoma is very difficult to diagnose and is often overlooked for some time. The lesions are not specific and look like any other severe skin disease. Signs may include:

  • Widespread red and scaly skin
  • Areas of raised red nodules and scaling
  • Ulcerated and depigmented patches
  • Severe itch

There is usually a very poor response to the first attempts to treat based on more common conditions. At this point, the diagnosis is usually made via a surgical biopsy.

Treatment of Epitheliotropic Lymphoma

Treatment options include:

  • Surgical removal of solitary lesions (not recommended for multiple sites)
  • Radiotherapy (not available in Adelaide, not always useful)
  • Chemotherapy (see below)
  • Retinoids (isotretinoin, acitretin) daily
  • Safflower oil (3mL/kg daily)
  • Soothing creams (we find Aloveen conditioner works the best)

Chemotherapy for EL has traditionally been the use of lomustine (also called CCNU) every 3 weeks. Recent evidence suggests that combination chemotherapy (called ‘VELCAP-EL’) may produce longer survival times, however side effects are also likely to be more common.

Prognosis Of Epitheliotropic Lymphoma

Current treatment does not provide a very good prognosis. Chemotherapy provides a much lower benefit than we see with other forms of lymphoma, but it does help to reduce signs of illness. Survival times with treatment are only around 6 months.

Chan, C. M., Frimberger, A. E., & Moore, A. S. (2018). Clinical outcome and prognosis of dogs with histopathological features consistent with epitheliotropic lymphoma: a retrospective study of 148 cases (2003–2015). Veterinary dermatology29(2), 154-e59.

Have something to add? Comments are welcome below and will appear within 24 hours of lodging.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These help topics are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story! The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Andrew

7 Replies to “Epitheliotropic Lymphoma In Dogs”

  1. My sweet little dog was just diagnosed. As you indicated, he has been treated for numerous skin lesions, for many months, with no improvement. The results of his biopsy just came in and I am devastated. He is a nearly 10 year old pug and I can’t bear to watch him suffer. He has been given a steroid shot for itching, is taking antibiotics, and is on pain medication. I have opted not to do chemotherapy. I would welcome suggestions on, at what point, is euthanasia recommended? I don’t want him to suffer.

    1. Hi Kim. It’s reasonable to try chemotherapy, as a proportion do very well. However, euthanasia is best when there’s clearly no improvement or at the first signs of relapse. Without chemo, I would not persist for long at all as these poor dogs will inevitably worsen.

  2. My dog has some sort of a bit bloody smooth pink ball on neck. There is 2. It looks very bad..i can’t believe i didn’t notice it. It is outside of his body. Is it something really bad?

  3. Thank you for your info. Our 8.5 years old Border Collie has today been diagnosed with the C E L having had a huge lump removed from under the skin near his nose. He had no signs of this illness apart from the lump which appeared 3 months ago, until his lymph node was swollen. The first biopsy was unclear. Our Vet said we could think about chemo but he didn’t sound hopeful about it. He suggested we do our own research then get back to him.

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