Case Study

Lymphoblastic Lymphoma in a 6 year old MN DSH cat

This 6-year-old MN DSH was presented for anorexia, weight loss, and vomiting. The clinical exam revealed thickened bowel loops. The CBC was normal with blood chemistry revealing only mildly elevated bilirubin, mildly elevated ALT, and mildly elevated SAP. Blood analysis 2 days prior was normal except for a slightly elevated bilirubin.

This 6-year-old MN DSH was presented for anorexia, weight loss, and vomiting. The clinical exam revealed thickened bowel loops. The CBC was normal with blood chemistry revealing only mildly elevated bilirubin, mildly elevated ALT, and mildly elevated SAP. Blood analysis 2 days prior was normal except for a slightly elevated bilirubin.

Sonographic Differential Diagnosis

neoplasia, most likely round cell in origin. Marked inflammatory disease is considered much less likely.

Image Interpretation

Severe, circumferential duodenal wall thickening with complete loss of wall layering is present infiltrating through the pyloric outflow with regional lymphadenopathy (Video 1). The affected duodenal wall is markedly hypoechoic.

DX

Lymphoblastic lymphoma

Outcome

The owner elected euthanasia given that an aggressive chemotherapy protocol would have been necessary to treat this lymphoblastic form of lymphoma.

Clinical Differential Diagnosis

GI pathology – IBD. Neoplasia (LSA, adenocarcinoma, mast cell disease); Pancreatic pathology – pancreatitis/triaditis, Liver pathology – concurrent hepatic disease; trichobezoar, FIP.