Case Study

Lymphoma, liver and spleen in a 9 year old MN DSH cat

A 9 year old MN DSH cat was presented for weight loss. Physical exam revealed an elevated temperature of 105.0 degrees F; the rest of the physical exam did not yield any abnormalities. A serum biochemical profile revealed hyperbilirubinemia, elevations of the serum alkaline phosphatase, elevated ALT and elevated AST enzyme activities and an elevated magnesium. A urinalysis was not performed.

A 9 year old MN DSH cat was presented for weight loss. Physical exam revealed an elevated temperature of 105.0 degrees F; the rest of the physical exam did not yield any abnormalities. A serum biochemical profile revealed hyperbilirubinemia, elevations of the serum alkaline phosphatase, elevated ALT and elevated AST enzyme activities and an elevated magnesium. A urinalysis was not performed.

Sonographic Differential Diagnosis

Chronic inflammatory hepatopathy and mesenteric root lymphadenopathy. Suspect cholangiohepatitis or lymphoma owing to lymphatic involvement. Other neoplasia such as mast cell disease less likely.

Image Interpretation

The liver is coarse with increased portal markings suggestive for chronic inflammatory hepatopathy and potential emerging lymphoma or similar neoplasia. Echogenic omentum is present associated with the caudal border of the liver capsule suggestive for leakage of inflammatory mediators through the hepatic capsule. The spleen was uniformly enlarged. Mesenteric root lymph nodes are enlarged encompassing the ileocecal region

DX

Lymphoma, liver and spleen

Outcome

The patient was lost to follow-up. No video is available on this patient.

Clinical Differential Diagnosis

Multi-system pathology – Cholangitis/cholangiohepatitis,pancreatitis with secondary cholestasis and/or cholangiohepatitis, Triaditis with an ascending bacterial infection, neoplasia (primary vs. metastatic; lymphoma, adenocarcinoma, leiomyoma, leiomyosarcoma, mast cell tumor,) feline infectious peritonitis, toxoplasmosis, leptospirosis (uncommon in cats, but original reports in the literature documented hepatic involvement.)