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Generalized symmetric alopecia and hyperoestrogenism associated with concurrent lymphoma, sertoli cell tumour ...111Figure 4: Lymphoblasts in the spleen (×1000)Figure 5: Dog three months after surgeryFigure 6: Dog three months after surgeryTreatment was initiated using anthelminticspraziquantel 5 mg/kg and fenbendazole 50 mg/kg(Zantel, CAM) PO q24h for 5 days, ketoconazole 14 mg/kg PO q24h (Oronazol, Krka) and topical ophthalmicgentamicin (Garamycin, Krka) ointment bilaterallyq12h. After one month, there was no improvementand total serum T4 and TSH analyses were repeated(30.6 nmol/l and 0.47 ng/ml, respectively). A hypoallergenicdiet (Eucanuba FP dermatosis and homemadediet (horse meat, rabbit meat, fish) and an oralomega 3 and omega-6 fatty acids preparation (Dermanorm,Vetoquinol, 2 capsules/dog PO q24h) wereprescribed for three weeks, when an improvement ingeneral health and growth of hair was seen (Figure3). The same therapy was continued for 2 additionalmonths. At that time, the dog was rechecked due todeterioration in the condition of the skin. It had pruritus,alopecia, erythema, ventral hyper- and hypopigmentationand dorsal hypotrichia, seborrhoea andcrusts. An abdominal ultrasound revealed nonhomogeneoussplenomegally and nonhomogenous masses:two cranio-dorsal to right and two cranio-dorsalto the left kidney. These masses were interpreted aslymph nodes by the radiologist. The testicle presentwithin the scrotum had a hypoechoic discrete noduleof 8 mm diameter. A nonhomogeneous 3×4 cm massin the right inguinal area was observed. Other abdominalorgans were ultrasonografically normal. Afine needle aspiration of the inguinal mass (probablytesticle) and the spleen was performed. The first wasnon-diagnostic while the latter revealed a populationof large lymphoid cells with large nuclei, scant deeplyblue cytoplasm, some of which had a pronouncedperinuclear reactive zone and 1-3 prominent nucleoliof different size and shape (Figure 4).According to these findings we planned to castratethe dog and take samples of the spleen, enlargedlymph nodes and skin.A preoperative CBC showed a mild normochromicnormocytic nonregenerative anaemia (RBC5.02 × 10 12 /l, reference range 5.5-8.5 × 10 12 /l; haemoglobin115 g/l, reference range 120-180 g/l; haematocrit0.32 l/l, reference range 0.37-0.55 l/l) and mildthrombocytopenia (platelets 141 × 10 9 /l, referencerange 200-500 × 10 9 /l)(14). Serum biochemistrywas unremarkable. Under general anaesthesia, thedog was castrated and the right inguinal mass wasexcised. This mass was 5 cm in diameter and hadan appearance of a testicle. Then, a midline exploratorylaparotomy was performed. The spleen as wellas the gastric lymph node were enlarged and wereremoved. The mesenteric lymph nodes were also