Page 8 - Clinical Connections- Summer 2021

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