Peer-reviewed veterinary case report
Comparing upper and lower intestinal biopsies in cats
By Chow, Betty et al.·Published in Journal of veterinary internal medicine·2021·Veterinary Specialty Hospital by Ethos Veterinary Health, United States·View original on PubMed →
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Original publication title: Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy.
- Species:
- cat
Plain-English summary
A study involving 57 cats with chronic gastrointestinal issues found that using advanced testing methods helped better distinguish between inflammatory bowel disease (IBD) and small cell lymphoma (LSA). Initially, many cats were diagnosed with IBD based on standard testing, but after adding immunohistochemistry and clonality testing, a significant number were reclassified as having LSA. The results showed that while both upper and lower intestinal biopsies provided useful information, the lower intestine samples rarely changed the diagnosis. This means that if your cat is diagnosed with IBD, further testing may be needed to rule out LSA, especially if symptoms persist.
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Abstract
BACKGROUND: Integrating immunohistochemistry (IHC) and clonality testing with histopathology may improve the ability to differentiate inflammatory bowel disease (IBD) and alimentary small cell lymphoma (LSA) in cats. HYPOTHESIS/OBJECTIVES: To evaluate the utility of histopathology, IHC, and clonality testing to differentiate between IBD and LSA and agreement of diagnostic results for endoscopic biopsy (EB) samples from the upper (USI) and lower small intestine (LSI). ANIMALS: Fifty-seven cats with IBD or LSA. METHODS: All cases were categorized as definitive IBD (DefIBD), possible LSA (PossLSA), probable LSA (ProbLSA), or definitive LSA (DefLSA) based on histopathology alone. Results from IHC and clonality testing were integrated. RESULTS: Based on histopathology alone, 24/57 (42.1%), 15/57 (26.3%), and 18/57 (31.6%) cats were diagnosed with DefIBD, PossLSA or ProbLSA, and DefLSA, respectively. After integrating IHC and clonality testing, 11/24 cases (45.8%) and 15/15 cases (100%) previously categorized as DefIBD and PossLSA or ProbLSA, respectively, were reclassified as LSA. A final diagnosis of IBD and LSA was reported in 13/57 (22.8%) and 44/57 (77.2%) cats, respectively. Agreement between USI and LSI samples was moderate based on histopathology alone (κ = 0.66) and after integrating IHC and clonality testing (κ = 0.70). However, only 1/44 (2.3%) of the LSA cases was diagnosed based on LSI biopsy alone. CONCLUSIONS AND CLINICAL IMPORTANCE: Integrating IHC and clonality testing increased the number of cases diagnosed with LSA, but the consequence for patient outcome is unclear. There was moderate agreement between USI and LSI samples. Samples from the LSI rarely changed the diagnosis.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33345405/