A 15- year-old MN DSH cat was presented with a history of vomiting hairballs and weight loss in three years before this visit. Physical exam at that time was unremarkable. Blood chemistry found hyperphosphatemia, hypercholesterolemia, hypercalcemia, hypernatremia, hyperchloremia, hyperamylasemia, hypermagnesemia, and a high calculated osmolality. CBC revealed leukopenia, neutropenia, lymphopenia, and thrombocytopenia. The urinalysis, and urine microalbumin were all within normal reference range. The T4 was high and methimazole treatment was initiated.
A 15- year-old MN DSH cat was presented with a history of vomiting hairballs and weight loss in three years before this visit. Physical exam at that time was unremarkable. Blood chemistry found hyperphosphatemia, hypercholesterolemia, hypercalcemia, hypernatremia, hyperchloremia, hyperamylasemia, hypermagnesemia, and a high calculated osmolality. CBC revealed leukopenia, neutropenia, lymphopenia, and thrombocytopenia. The urinalysis, and urine microalbumin were all within normal reference range. The T4 was high and methimazole treatment was initiated. However, the weight loss continued over the next 2 years despite treatment with methimazole. Recheck blood chemistry revealed hypoglycemia, and an elevated urea. CBC found thrombocytopenia and lymphopenia. The cat developed an infection of the upper respiratory tract a few months later and radiographs of the thorax (three views) were performed, which did not reveal any obvious masses.
Case Study
Lymphoma in a 15 year old MN DSH cat
Sonographic Differential Diagnosis
Mesenteric lymphadenopathy or mass. Lymphoma, round cell neoplasia or granulomatous disease. Dry form FIP
Image Interpretation
A dramatically hypoechoic lymph node mass is evident in the mesenteric root. Complete loss of detail is evident with reactive hyperechoic surrounding fat. Mesenteric vasculature is evident on power Doppler assessment. A slight amount of free fluid is noted adjacent to the lymph node consistent with inflammatory fluid or potential transudate owing to lymphatic strangulation.
DX
Outcome
Cytology results were consistent with lymphoblastic (high grade) lymphoma, likely alimentary in origin. The patient was referred to an oncologist and chemotherapy was initiated. A re-evaluation was performed by the rDVM at which time a firm abdominal mass was palpated. A second course of chemotherapy was started. However, the patient did not improve and was humanely euthanized.
Clinical Differential Diagnosis
Gastrointestinal, hepatic or pancreatic neoplasia (lymphoma, adenocarcinoma, leiomyoma, leiomyosarcoma, mast cell tumor); severe inflammatory bowel disease which progressed to lymphoma.
Sampling
US-guided FNA of lymphnode results were consistent with lymphoblastic (high grade) lymphoma, likely alimentary in origin.
Video
Patient Information
Clinical Signs
- Signs of URI
- Vomiting
- Weight loss
History
- Vomiting
- Weight Loss
Images
Blood Chemistry
- Amylase, High
- BUN high
- Calcium, High
- Chloride, High
- Cholesterol, High
- Glucose, Low
- Hyperthyroidism
- Phosphorus, High
- Sodium, High
CBC
- Lymphocytes, Low
- Neutrophils, Low
- Platelet Count, Low
- WBC, Low
Clinical Signs
- Signs of URI
- Vomiting
- Weight loss