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
  • It can also affect the mouth

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. Survival times with treatment average around 6 months. Chemotherapy provides a much lower benefit than we see with other forms of lymphoma, but it does help to reduce signs of illness.

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.

By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These blogs are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story!
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Andrew

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