Peer-reviewed veterinary case report
Cat with breathing trouble diagnosed early with rare lung disease
By Mau, Alex et al.·Published in Veterinary clinical pathology·2023·William R. Pritchard Veterinary Medical Teaching Hospital, United States·View original on PubMed →
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Original publication title: Antemortem cytologic diagnosis of pulmonary Langerhans cell histiocytosis in a cat.
- Species:
- cat
Plain-English summary
A 9-year-old British shorthair mix cat was brought in for breathing problems that had lasted three months and didn't improve with steroids or antibiotics. X-rays showed significant lung changes, and tests of lung fluid revealed inflammation and an unusual type of cell that indicated a rare lung disease called pulmonary Langerhans cell histiocytosis. Unfortunately, due to the poor prognosis, the cat was humanely euthanized. The diagnosis was confirmed through further examination after death.
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Abstract
Feline pulmonary Langerhans cell histiocytosis (FPLCH) is a rare histiocytic proliferative disease of middle-aged to older domestic cats. Langerhans cells in the terminal airways proliferate and infiltrate the interstitium and the airways to a lesser degree, widely effacing normal parenchyma. Historically, definitive diagnosis has required postmortem evaluation where pulmonary lesions have a classic gross and histologic morphology. Here, we present the first documented antemortem diagnosis of FPLCH using bronchoalveolar lavage (BAL) cytology and immunocytochemistry (ICC) in a 9-year-old British shorthair mix. The cat had a 3-month history of respiratory difficulty that was refractory to steroids and antimicrobials. Pulmonary radiographs had marked diffuse changes with a complex bronchointerstitial and micronodular pattern. BAL cytology revealed neutrophilic inflammation and markedly increased histiocytes with morphology distinct from typical pulmonary macrophages. ICC characterized histiocytes as CD1a/E-cadherin/CD11b/PanCK, consistent with a Langerhans cell phenotype. The cat was humanely euthanized due to poor prognosis and presented for necropsy. Gross, histopathologic, immunophenotypic, and ultrastructural findings confirmed a diagnosis of FPLCH. Proliferative cells were E-cadherin/Iba-1/CD18/CD1a/CD5/MHCII/CD204/CD4; transmission electron microscopy identified the presence of Birbeck granules in the proliferating histiocytes, consistent with previous reports of FPLCH.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37914537/