Case Study

Gastric Lymphoma in a 10 year old FS DSH cat

A 10-year-old FS DSH cat was presented for chronic hematemesis. Physical exam was unremarkable. CBC showed anemia (no reticulocyte count performed) neutrophilia, monocytosis and thrombocytopenia. Blood chemistry was within normal limits. Urinalysis had a cloudy appearance, but all results were within normal reference range, as was a T4.

A 10-year-old FS DSH cat was presented for chronic hematemesis. Physical exam was unremarkable. CBC showed anemia (no reticulocyte count performed) neutrophilia, monocytosis and thrombocytopenia. Blood chemistry was within normal limits. Urinalysis had a cloudy appearance, but all results were within normal reference range, as was a T4.

DX

Lymphoblastic lymphoma, liver. Gastric lymphoma.

Sonographic Differential Diagnosis

gastric lymphoma with epigastric lymphadenopathy. Possible complicated IBD, carcinoma, FIP.

Image Interpretation

The stomach demonstrated significant mural detail loss to the pyloric antrum with dramatic hypoechoic thickening in the gastric wall with associated epigastric lymphadenopathy. This did not appear overtly resectable. The pylorus did not appear affected at this time nor did the duodenum. No evidence of metastatic disease was noted.

Outcome

Chemotherapy was started; however, the patient was euthanized within a month due to a progressive decline in her condition.

Clinical Differential Diagnosis

Thrombocytopenia/hematemesis – GI bleeding, paraneoplastic syndrome, DIC, immune-mediated, neoplasia of GI, hepatic or pancreatic origin (lymphoma, adenocarcinoma, leiomyoma, leiomyosarcoma, mast cell tumor, gastrinoma,) severe cholangitis/cholangiohepatitis,severe inflammatory bowel disease, pancreatitis, triaditis.

Sampling

US-guided FNA of gastric wall mass and epigastric lymph node. Cytology results of the stomach aspirate were suggestive of lymphoblastic lymphoma. The patient vomited gastric tissue which was sent for histopathology and a diagnosis of gastric lymphoma was made.