Case Study

Intestinal Lymphocytic Lymphoma in a 16 year old FS DSH cat

This FS 16-year-old DSH presented for anorexia, weight loss and PU/PD. Physical exam revealed a poor body condition, small irregular kidneys and a palpable intestinal thickening. Blood analysis demonstrated moderately elevated BUN and moderately elevated creatinine with a mild amylase elevation. Urinalysis demonstrated evidence of urinary tract infection and isosthenuria. Radiographs demonstrated a mid abdominal density with intestinal displacement.

This FS 16-year-old DSH presented for anorexia, weight loss and PU/PD. Physical exam revealed a poor body condition, small irregular kidneys and a palpable intestinal thickening. Blood analysis demonstrated moderately elevated BUN and moderately elevated creatinine with a mild amylase elevation. Urinalysis demonstrated evidence of urinary tract infection and isosthenuria. Radiographs demonstrated a mid abdominal density with intestinal displacement.

DX

Intestinal lymphocytic lymphoma

Sonographic Differential Diagnosis

Small bowel mural mass compatible with neoplasia such as lymphosarcoma or adenocarcinoma, possible leiomyoma or leiomyosarcoma.

Image Interpretation

The transverse image of a segment of small bowel demonstrates marked, asymmetrical mural thickening with complete loss of normal wall architecture. The peripheral serosal margin is slightly irregular; however, it appears to be intact.

Outcome

The patient responded briefly to aggressive antibiotic therapy with eventual prednisone and chlorambucil. The patient was euthanized after 2 months due to clinical decline.

Clinical Differential Diagnosis

GI pathology – Intestinal thickening differentials include gastroenteritis, IBD, neoplasia, granulomatous inflammation. Renal pathology – chronic renal failure