Case Study

Lymphoma, eosinophilic lymphadenitis, and eosinophilic enteritis in a 12 year old FS DSH cat

A 12-year-old FS DSH was presented for vomiting for several months, inappetence, and weight loss. On survey radiographs, a possible thickened stomach wall was identified.

A 12-year-old FS DSH was presented for vomiting for several months, inappetence, and weight loss. On survey radiographs, a possible thickened stomach wall was identified.

DX

Lymphoma, eosinophilic lymphadenitis, and eosinophilic enteritis

Sonographic Differential Diagnosis

Infiltrative intestinal neoplasia or inflammatory change is most likely. The lymph nodes may be enlarged due to neoplastic or inflammatory processes as well.

Image Interpretation

Thickened jejunal segment with increased muscularis layer but no loss of layering (image 1). Mild cranial mesenteric root lymphadenopathy (image 2). There is a loss of layering in some segments of the bowel (video 1).

Outcome

The patient was treated with chemotherapy, which resulted in a marked improvement. Recheck ultrasound two months after starting chemotherapy revealed that the mesenteric lymph nodes had enlarged. The prednisone was increased to 5mg BID and the chemotherapy protocol changed to single agent carmustine. On CBC two weeks later, neutrophilia, lymphopenia, and anemia were evident. Mild hypercholesterolemia was present on serum biochemistry. The abdominal mass felt smaller on palpation. Three months after starting chemotherapy, the patient showed loss of appetite, weakness, and labored respiration. The owner elected euthanasia.

Clinical Differential Diagnosis

GI tract disease (neoplasia, partial obstruction, IBD, foreign body, dietary hypersensitivity), pancreatic disease (chronic pancreatitis, neoplasia), liver disease, renal disease.