CVJ / VOL 52 / DECEMBER 2011
Case Report Rapport de cas
Exophthalmos due to multicentric B-cell lymphoma in a goat
Beth A. Valentine, Susanne Stieger-Vanegas, Steven R. Brown, Susan J. Tornquist, Kyra Young
Abstract — Multicentric B-cell lymphoma with extensive retrobulbar involvement was diagnosed in a 6-year-old
Nubian goat that was presented with conjunctival swelling and exophthalmos. Serologic testing for bovine leukemia
virus (BLV) was negative. Postmortem computed tomography aided in identification of the extent of soft tissue
and bone lesions.
Résumé — Exophtalmie causée par un lymphome B multicentrique chez une chèvre. Un lymphome B
multicentrique avec une vaste atteinte rétrobulbaire a été diagnostiqué chez une chèvre nubienne âgée de 6 ans qui
avait été présentée avec de l’enflure conjonctivale et l’exophtalmie. Des tests sérologiques pour le virus de la leucémie
bovine se sont avérés négatifs. Une tomodensitométrie réalisée à l’autopsie a facilité l’identification de l’étendue
des lésions dans les tissus mous et les os.
(Traduit par Isabelle Vallières)
Can Vet J 2011;52:1350–1352
by peripheral lymphadenomegaly is a common presentation in
cattle with multicentric bovine leukemia virus (BLV)-induced
lymphoma (9,10). A similar syndrome has been reported in
2 goats with lymphoma (4,7), but conjunctival swelling and
exophthalmos as the primary presenting signs without peripheral
lymphadenomegaly or signs of systemic disease has not been
previously reported in goats. The cell type of caprine lymphoma
is poorly studied, and only 1 case report of caprine lymphoma
describes immunophenotyping, which resulted in a diagnosis of
T-cell lymphoma (8). This report describes clinical, computed
tomographic, and pathologic studies including immunopheno-
typing of multicentric lymphoma causing conjunctival swelling
and exophthalmos in a goat.
ymphoma is a sporadic disease in goats and clinical signs
are extremely variable (1–8). Exophthalmos accompanied
A 6-year-old 70-kg castrated male Nubian goat was evaluated for
bilateral conjunctival swelling. A full cranial nerve examination
was not performed, but conjugate eye movements were present
and no visual, motor, or sensory deficits were apparent. There
were no other physical abnormalities and appetite and activity
level were described as normal. A hypersensitivity reaction was
suspected but there was only temporary improvement following
subconjunctival injection of corticosteroids. Progressive con-
junctival swelling and bilateral exophthalmos, more severe on
the left, developed in the next 1.5 mo, and an ulcer developed
in the left cornea (Figure 1). No intraocular abnormalities were
detected. Differential diagnoses at this time were retrobulbar
abscess or neoplasia. Peripheral lymph nodes and mandible were
palpated and abnormalities were not detected. Sinus percussion
was not performed.
Cytologic examination of a conjunctival scraping revealed
inflammation. A biopsy sample of left ventral conjunctiva
contained a dense cellular infiltrate of small, relatively uniform,
round cells with approximately 3 mitoses per high power field.
No germinal centers typical of lymphoid hyperplasia were seen.
Veterinary Diagnostic Laboratory and Department of
Biomedical Sciences (Valentine, Tornquist) and the Department
of Clinical Sciences (Stieger-Vanegas), College of Veterinary
Medicine, Oregon State University, Corvallis, Oregon, USA;
Animal Medical Care of Newport, 162 NE 10th Street,
Newport, Oregon, USA (Brown, Young).
Address all correspondence to Dr. Valentine; e-mail:
Use of this article is limited to a single copy for personal study.
Anyone interested in obtaining reprints should contact the
CVMA office (firstname.lastname@example.org) for additional
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Figure 1. Photograph of a 6-year-old castrated male Nubian
goat with bilateral exophthalmos, more severe on the left side.
Fluorescein dye retention within the left cornea indicates
ulceration due to exposure keratitis.
CVJ / VOL 52 / DECEMBER 2011
The differential diagnoses were atypical reactive lymphoid
hyperplasia and lymphoma. Immunohistochemistry, utilizing
antibodies to CD3 and CD79a (Dako, Carpinteria, California,
USA), appropriately identified B- and T-lymphocyte populations
within a normal goat lymph node (positive control). Cells in the
conjunctival biopsy tissue reacted positively with CD79a. There
were only a small number of scattered CD3-positive T cells. The
diagnosis was B-cell lymphoma.
A retrobulbar lymphoma extending into the conjunctiva and
causing exophthalmos was suspected. Ultrasonographic studies
of the eyes were planned but the goat died 2 wk later, before
antemortem imaging studies could be performed. Postmortem
computed tomography of the head, thorax, and abdomen was
performed using a 64-slice computed tomography scanner
(Toshiba America, Tustin, California, USA) with slices acquired
at 2 mm. Axial images and coronal and sagittal reconstructed
images were evaluated in a soft tissue, bone and lung window.
Multiple lesions were present in the head (Figure 2), thorax,
and abdomen. An approximately 3.0 3 1.7 3 2.9 cm large soft
tissue mass was present in the right frontal sinus adjacent to
the ethmoid bone. The mass extended caudally into the rostral
aspect of the right olfactory bulb, cranially into the right caudal
maxillary sinus displacing the dorsal conchae of the right nasal
cavity, and disrupted the overlying frontal bone. A smaller,
inhomogeneous, hyperdense soft tissue mass was present in the
ventral left frontal sinus, extending through the ethmoid into
the rostral left olfactory bulb. A soft tissue mass was present
in the medial aspect of the right and left retrobulbar spaces.
Soft tissue masses were more prominent on the left side than
the right and caused lateral displacement and compression of
the left eye. An inhomogeneous soft tissue mass was present in
the right caudo-lateral maxillary sinus that extended caudally
to the last molar, disrupted the maxillary bone, and involved
the tooth root of the second right maxillary premolar. Another
large soft tissue mass was present adjacent to the caudo-lateral
border of the right mandible and extended into the right parotid
Mandibular, retropharyngeal, and cervical lymph nodes were
enlarged. Findings in the body were severe pleural effusion,
marked enlargement of all lymph nodes of the thoracic cavity,
marked thickening of the right atrial wall, multiple variably sized
soft tissue masses within lung parenchyma, a large subcutaneous
soft tissue mass within the right thoracic wall and invading the
right abdominal cavity, irregular thickening of the abomasum
wall, and peritoneal effusion. Computed tomography findings
were consistent with multicentric lymphoma.
Necropsy findings mirrored those of computed tomography.
Thoracic and abdominal effusions were serosanguinous. No
tumor cells were found in the thoracic fluid examined cytologi-
cally. Infiltrating neoplastic tissue was soft, pale tan, and fleshy.
Histologic evaluation confirmed the diagnosis of multicentric
lymphoma, with tumor cell morphology and mitotic activity
as seen in the conjunctival biopsy. Serologic testing of thoracic
fluid and heart blood was negative for bovine leukemia virus
A prior survey study found that lymphoma represented 2.2% of
all goat submissions and approximately 50% of all neoplasia in
goats (2). Multicentric lymphoma is the most common form of
caprine lymphoma (2–4,6–7). Age of affected goats has ranged
from 2 to 18 y, and no gender or breed predisposition has
been detected (2). Loss of body condition is described in 11 of
19 reported goats with lymphoma; in others, body condition is
described as normal to increased (1–8). Generalized peripheral
lymphadenomegaly is not consistent, and was detected in only
8 of 19 reported cases (1–8). It has been suggested that lym-
phoma should be considered as a differential diagnosis in any
goat over 2 y of age with any clinical disease (2). Findings in the
goat in this report, in which the clinical signs of multicentric
lymphoma were progressive chemosis and exophthalmos, sup-
port this suggestion.
Involvement of structures of the head, especially maxilla,
mandible, and mandibular lymph nodes, is common in goats
with lymphoma, and was described in 11 of 19 cases (1–8).
Results of this study support that conclusion and indicate that
lymphoma should be considered in goats with conjunctival
swelling or exophthalmos as well as with mandibular or maxil-
lary bone swelling (1–3,5). Commercial antibodies can deter-
mine tumor cell type by immunohistochemistry. The diagnosis
Figure 2. Postmortem transverse (a), sagittal (b), and dorsal (c) computed tomography bone window images of the head. A soft tissue
mass is present invading the ethmoid bone and dorsal aspect of the right nasal cavity and right frontal sinus. Another soft tissue mass is
present in the right maxillary sinus causing loss of the bony structures around the second, right maxillary premolar.
CVJ / VOL 52 / DECEMBER 2011
RAPPORT DE CAS
of B-cell lymphoma in this case and of T-cell lymphoma in a
previous case (8) indicates that lymphoma in goats can be of
variable cell origin. Imaging procedures such as ocular ultraso-
nography can detect retrobulbar neoplasia in farm animals with
exophthalmos (11). In this case, computed tomography proved
to be a valuable imaging technique for identification of tumor
infiltrates in both soft tissue and bone.
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