Case Study

CT – Diffuse multi-organ infiltrative process likely lymphoma in a 12 year old MN DSH cat

This 12 year old MN DSH cat presented for chronic melena and mild anemia of 28%

DX

Suggestive of diffuse multi-organ infiltrative process, likely lymphoma

Image Interpretation

Spondylosis deformans is present at T3-4 through T 11. Marked spondylosis with intervertebral disc space narrowing and endplate sclerosis is present at T3-4 and T9-10.

The liver is enlarged with rounded margins. The spleen is mildly enlarged with rounded margins and has several ill-defined nonenhancing nodules within the ventral extremity. These nodules measure 3-6 mm in diameter. Thickness at the hilus equals 1.4 cm.”The kidney margins are irregular and possibly mildly enlarged. Faint mineral opacity is seen within the diverticuli of the left kidney.”The small bowel appears diffusely thickened and surrounding mesentery is ill-defined and hyperattenuating.”Spondylosis deformans is present at L2-3, L 5-6, and marked spondylosis at L7-S1.

Outcome

CT changes suggest a diffuse multi-organ infiltrative process. Lymphoma is a primary differential. CT cannot definitively confirm involvement of all organs as separate from normal physiologic effects of sedation and anesthesia. Hepatobiliary disease is also possible. Pancreatitis cannot be excluded. Further evaluation with abdominal ultrasound is warranted. Specifically, the wall layering and thickness of the small bowel should be assessed for findings consistent with large cell or small cell lymphoma or inflammatory bowel disease. Fine needle aspirates could be considered if the liver, spleen or kidneys appear affected.