8yr old FS DSH with gastrointestinal lymphadenopathy

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8yr old FS DSH with gastrointestinal lymphadenopathy

  • 8 year old FS DSH presented 10d ago for vomiting, anorexia, and lethargy.  This cat will ingest FB’s.
  • Vomiting resolved with Cerenia but lethargy and anorexia persist
  • Bloodwork shows mild lymphopenia (0.84K/mcl), Glu=176 mg/dL, BUN=15mg/dL, Glob-5.6g/dL
    • 8 year old FS DSH presented 10d ago for vomiting, anorexia, and lethargy.  This cat will ingest FB’s.
    • Vomiting resolved with Cerenia but lethargy and anorexia persist
    • Bloodwork shows mild lymphopenia (0.84K/mcl), Glu=176 mg/dL, BUN=15mg/dL, Glob-5.6g/dL
    • Abdominal US shows multiple rounded 0.5-1.0cm reactive mesenteric and colic lymph nodes with adjacent reactive fat, a small amount of free anechoic fluid between the pylorus and liver, decreased hepatic echogenicity, thickened duodenal wall with mild fluid distention, slightly decreased left pancreatic echogenicity, and a stomach mildly distended with ingesta and gas.
    • My differential diagnosis list includes infection (bacterial, mycobacterial, viral-FIP) and neoplasia (LSA, carcinomatosis). Foreign body is on the list, but none were seen and the duodenal fluid distension is mild.
    • Any other thoughts on this case? Exploratory next?  

Comments

rlobetti

Good differential list. FB

Good differential list. FB not obvious and should not give diffuse lymphadenomegaly unless there is perforation with peritonitis. Would do FNA and if possible collect some of the ascitic fluid before laparotomy as lymphoma is an important diagnosis.

Electrocute

Thank you Dr. Lobetti.
 

Thank you Dr. Lobetti.

 

EL

Lookks like chronic GI and

Lookks like chronic GI and lympadenititis with maybe baterial involvement and hair density in the stomach which all go hand in hand. I would fna cyto and culture the LN and tx for the above unless full thickness bx of the GI and ln are an option.

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