Page 8 - Clinical Connections- Summer 2021
P. 8

RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
         Oncology

        FELINE LYMPHOMA

        Irina Gramer, Lecturer in Veterinary Oncology, and Alexandra Guillen Martinez, Lecturer in Veterinary
        Oncology
             ymphoma is the most frequently diagnosed among all types   leukaemia virus infection (FeLV) and feline immunodeficiency virus
             of feline cancer and due to its systemic distribution often   (FIV), they are seen less frequently today. This would appear to be
        L affects a wide range of organs. Disease found primarily in   due to effective testing, isolation of infected cats and vaccines that
        the peripheral lymph nodes as is the case with the multicentric   protect against FeLV. These days feline lymphoma is more likely to
        form is diagnosed less commonly in cats than in dogs. In cats,   be found in the gastrointestinal tract.
        lymphoma is more likely to be found in the gastrointestinal tract   Cats of any age can develop lymphoma, although are most
        (alimentary lymphoma), chest cavity (mediastinal lymphoma),   commonly diagnosed after the age of 6-10.  Feline mediastinal
        spleen, liver, kidneys, nasal cavity, and eyes.       lymphoma commonly occurs in young cats with a median age at
          Historically, lymphoma in the chest cavity (mediastinal   diagnosis of three years and has commonly been associated with
        lymphoma) or the multicentric form were the most commonly   a positive FeLV status. The most common presenting clinical signs
        diagnosed presentations of the disease. However, as these   include dyspnoea, tachypnoea, inappetence and cough, with half
        have been demonstrated to be commonly associated with feline   of the cats presenting with pleural effusion at diagnosis.
        BILBO’S CASE















                                                                                 Figure 2. Sagittal post-contrast CT scan
         Figure 1. Sagittal (left) and dorsal (right) post-contrast CT scan images of Bilbo´s thorax. A   image of the abdomen. A hypoattenuating
         multilobulated, homogeneous, soft tissue attenuating cranial mediastinal mass is present (arrows)   funnel-shaped angular structure is present
         consistent with high-grade lymphoma.                                    within the proximal jejunum.

        A three-year-old, neutered Siberian   intestinal obstruction (Fig. 2). This finding   therefore elected to start treatment with
        cross was presented to his local vet for   was considered to be the most likely cause   L-asparaginase during his postoperative
        investigations into intermittent vomiting,   for Bilbo´s vomiting.      recovery at the hospital. L-asparaginase
        anorexia, weight loss and lethargy.   Following discussion with our Soft Tissue   would provide anticancer effects while
        Thoracic and abdominal radiographs   Surgery Service, it was agreed to proceed   avoiding any myelosuppression or
        revealed a cranial mediastinal mass. No   with surgical removal of the intestinal   gastrointestinal toxicity, which could
        obvious abnormalities were detected in   foreign body via enterotomy before   have increased the risk of postoperative
        the abdomen. Bilbo was then referred   considering chemotherapy treatment for   complications, especially intestinal
        to the RVC Oncology service for further   Bilbo´s mediastinal lymphoma.   dehiscence.
        investigations and treatment.        Even though Bilbo was not presenting   Bilbo made a complete recovery from
          Despite the radiographic findings,   any respiratory signs from his mediastinal   his intestinal surgery and the episodes
        the owners had not noticed any signs   lymphoma, a treatment delay could have   of vomiting completely resolved. He was
        of tachypnoea, dyspnoea or exercise   been detrimental in his case and it was   then continued on chemotherapy for his
        intolerance at home. On clinical                                        mediastinal lymphoma with a high dose
        examination, Bilbo´s respiratory rate and                               L-COP protocol combining vincristine,
        pattern were within the normal range.                                   cyclophosphamide and prednisolone,
        Blood work on admission was largely                                     in addition to the previously given
        unremarkable and FIV, FeLV virus SNAP                                   L-asparaginase.
        test were negative. CT scan of the thorax                                Bilbo achieved a complete response to
        and abdomen revealed a multilobulated                                   chemotherapy with no visible mediastinal
        cranioventral mediastinal mass (8.4cm in                                mass present on follow-up thoracic
        maximum diameter) associated with mild                                  ultrasound one month after starting
        pleural effusion (Fig.1).                                               treatment (Fig. 3). He recently completed
          Fine needle aspirates were obtained                                   his high dose L-COP protocol and remains
        from the mediastinal mass and pleural                                   in complete remission to date.
        fluid and those confirmed a high-grade
        mediastinal lymphoma. Within the proximal                                     For small animal referrals, please call:
                                                                                     01707 666399
        jejunum a funnel-shaped foreign body   Fig 3. Bilbo during one of his chemotherapy     Email:
        was found, which was causing a partial   sessions                            qmhreception@rvc.ac.uk

        8   Summer 2021
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