A 10-year-old MN DSH was presented for vomiting, hematuria, and stranguria. The cat has a history of transient diabetes. Physical exam was unremarkable. Thrombocytopenia and an eosinophilia were present on the CBC. No abnormalities were noted on the serum biochemical profile. In-house urinalysis showed hematuria, bilirubinuria, and proteinuria. The pH and specific gravity were within the normal reference range.
A 10-year-old MN DSH was presented for vomiting, hematuria, and stranguria. The cat has a history of transient diabetes. Physical exam was unremarkable. Thrombocytopenia and an eosinophilia were present on the CBC. No abnormalities were noted on the serum biochemical profile. In-house urinalysis showed hematuria, bilirubinuria, and proteinuria. The pH and specific gravity were within the normal reference range.
Case Study
Emerging Lymphosarcoma in a 10 year old MN DSH Cat
DX
Sonographic Differential Diagnosis
intestinal lymphoma, chronic inflammatory bowel disease, mast cell disease, dry form FIP, intestinal necrosis, and less likely intestinal carcinoma owing to the diffuse and relatively uniform pattern of the lesion.
Image Interpretation
Diffusely thickened, irregularly layered small bowel with echogenic submucosal layer thickening suggestive for fibrosis and hypertrophied muscularis.
Outcome
A chemotherapy protocol of Elspar, vincristine, Cytoxan, doxorubicin and prednisone was initiated. Glucose levels remained manageable and patient was thriving 4 months post lymphoma diagnosis.
Comments
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Clinical Differential Diagnosis
GI pathology – IBD, intestinal neoplasia, concurrent Helicobacter, parasitic disease, chronic foreign body; Urinary pathology -urolithiasis, UTI, idiopathic cystitis, urinary tract neoplasia
Sampling
22g US guided FNA was performed of a mesenteric root lymph node and revealed lymphoid hyperplasia and marked eosinophilic inflammation. Full thickness gastrointestinal biopsies were performed at the time of cystotomy for bladder stones. Histopathology: moderate to severe subacute to chronic eosinophilic-lymphocytic enteritis with reactive lymphoid hyperplasia and eosinophilic lymphadenitis. Full thickness surgical biopsies of the intestine and regional lymph node revealed lymphoma.
Patient Information
Clinical Signs
- Hematuria
- Stranguria
- Vomiting
History
- Diabetes, controlled
Images
CBC
- Eosinophils, High
- Platelet Count, Low
Clinical Signs
- Hematuria
- Stranguria
- Vomiting
Urinalysi
- Bilirubin Present
- Blood Present
- Protein Present