Case Study

Pancreatic lymphoblastic lymphoma in a 12 year old FS DLH cat

This 12-year-old FS DLH was presented for profuse vomiting. The clinical exam revealed a swollen abdomen, mild dehydration and a palpable cranial abdominal mass. The CBC and blood chemistry analysis revealed slight ALT elevation, CPK elevation and moderate calcium elevations, moderately regenerative anemia and leukocytosis with a left shift.

This 12-year-old FS DLH was presented for profuse vomiting. The clinical exam revealed a swollen abdomen, mild dehydration and a palpable cranial abdominal mass. The CBC and blood chemistry analysis revealed slight ALT elevation, CPK elevation and moderate calcium elevations, moderately regenerative anemia and leukocytosis with a left shift.

DX

Pancreatic lymphoblastic lymphoma and high cellularity.

Sonographic Differential Diagnosis

Severe, focal pancreatic enlargement with minimal peripancreatic inflammation highly suggestive of neoplasia. Focal pancreatitis and nodular hyperplasia are considered less likely.

Image Interpretation

Focal, severe enlargement of the pancreas is present. The affected segment is fairly distinct with rounded margination and a moderately, uniformly hypoechoic parenchyma. The tubular structure traversing the center of the affected pancreas could represent a vessel or duct. The bordering tissues are mildly echogenic. Video: US-guided 22 gauge FNA is performed upon the hypoechoic pancreatic tissue. Note that the angle of the needle changes on each jab to obtain a variety of cells in the affected tissue

Outcome

The patient responded well initially to a chemotherapy protocol of vincristine, l-asparaginase, prednisone, and cyclophosphamide. However, due to recurrence of symptoms that did not respond to medical management, the patient was euthanized 6 weeks post diagnosis.