Splenic mast cell disease diagnosed on FNA in a 15 year old MN DSH cat

Case Study

Case Study

Splenic mast cell disease diagnosed on FNA in a 15 year old MN DSH cat

A 15-year-old MN DSH cat with a history of hyperglycemia and cardiomyopathy was presented for polyuria/polydipsia. The cat was bright, alert and responsive on physical exam. A grade II/VI systolic murmur was present on auscultation, but no abnormalities were noted within the lungs. The cat’s abdomen was found to be slightly pot-bellied. Blood chemistry revealed hyperglobulinemia. No abnormalities were noted on the CBC or urinalysis. The urine culture did not yield any bacterial growth. A protein electrophoresis was performed, and findings were consistent with a monoclonal gammopathy.

A 15-year-old MN DSH cat with a history of hyperglycemia and cardiomyopathy was presented for polyuria/polydipsia. The cat was bright, alert and responsive on physical exam. A grade II/VI systolic murmur was present on auscultation, but no abnormalities were noted within the lungs. The cat’s abdomen was found to be slightly pot-bellied. Blood chemistry revealed hyperglobulinemia. No abnormalities were noted on the CBC or urinalysis. The urine culture did not yield any bacterial growth. A protein electrophoresis was performed, and findings were consistent with a monoclonal gammopathy. Radiographs of the axial skeleton were recommended, and no visible lesions were seen on radiographs.

DX

Splenic mast cell tumor

Sonographic Differential Diagnosis

Reactive hypersplenism due to infectious or immune mediated disease versus emerging neoplasia such as lymphoma or mast cell disease.

Image Interpretation

The spleen was enlarged with irregular contour and prominent mid spleen at the hilus.

Outcome

Results of the splenic aspirate were consistent with mast cell disease. The cat was referred to an oncologist, and a splenectomy was performed. A mild regenerative anemia was identified on a CBC performed 2 weeks postoperatively. A chemotherapy protocol consisting of steroids and chlorambucil (LeukeranВ®) was initiated. Approximately 2 months later, the owner reported that the patient was experiencing polyuria/polydipsia, which was attributed to the administration of steroids. However, he was considered to be doing well overall. A re-evaluation was performed 3 months postoperatively, and the cat was bright, alert and responsive. The intensity of the heart murmur was stable. The intestines were subjectively thicker than usual. The CBC showed a slightly decreased RBC count, decreased HCT, elevated numbers of NRBC, mild polychromasia, moderate anisocytosis, neutrophilia, lymphopenia, eosinopenia and thrombocytopenia. No further follow up is available.

Clinical Differential Diagnosis

Hypergammaglobulinemia – lymphoma, multiple myeloma, Erhlichia, other round cell neoplasia. Pot-bellied appearance – ascites and/or organomegaly.

Sampling

US-guided FNA were consistent with mast cell disease.

Video

Patient Information

Patient Name : Sam L
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 08_00014

Clinical Signs

  • PU-PD

History

  • Hyperglycemia

Exam Finding

  • Heart Murmur
  • Pot belly

Images

08_00014_samlord_felmctspleen_06242011113712_07052011113920

Blood Chemistry

  • Globulin, High

Clinical Signs

  • PU-PD

Special Testing

  • Monoclonal gammopathy

Urinalysi

  • Culture negative
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