Case Study

Intestinal lymphoma in ileocecal mass in a 10-year-old FS DSH cat

A 10-year-old FS DSH cat was presented for weight loss and a possible abdominal mass. Abnormalities on blood chemistry were hypoalbuminemia and elevated ALP.

A 10-year-old FS DSH cat was presented for weight loss and a possible abdominal mass. Abnormalities on blood chemistry were hypoalbuminemia and elevated ALP.

DX

Large cell, lymphoblastic lymphosarcoma.

Sonographic Differential Diagnosis

Ileocecocolic mass with possible splenic involvement. Likely lymphoma or adenocarcinoma, leiomyosarcoma, and minor possibility of complicated inflammatory bowel disease.

Image Interpretation

The gastrointestinal tract revealed a mural ileocecocolic mass with deviation of the lumen. The mass measured 2 x 3 cm. This mass by itself appears resectable. It was localized in the ileocecocolic area. However, associated lymphadenopathy that measured 1.6 x 0.7 cm was also noted as well as other small lymph nodes in the area.

Outcome

The owners were considering oncology referral vs. euthanasia at last communication.

Comments

The mass appears resectable.Fine-needle aspirates of the spleen and mass would be warranted for a definitive diagnosis,

Clinical Differential Diagnosis

Multiple organ pathology -GI tract/spleen/liver/renal (neoplasia, granuloma, abscess). Splenic pathology (infarction/torsion). Renal pathology (hydronephrosis)

Sampling

Microscopic Interpretation: LYMPHOSARCOMA, LARGE CELL/LYMPHOBLASTIC FORM Comment: This is a diagnosis that warrants a cautious prognosis. Large cell lymphosarcoma that involves the G.I. tract typically responds poorly to chemotherapy while cases that do not have G.I. involvement will often respond with 6-18 month disease free intervals with chemotherapy.It is suspected that the ileocecal lymph node was aspirated, and if the tumor is confined to the node only chemotherapy will likely prove beneficial. Unfortunately there is a high probability of concurrent G.I. involvement as this is a common region for G.I. lymphosarcoma to originate.