Peer-reviewed veterinary case report
How to tell low-grade intestinal T-cell lymphoma
By Freiche, Valérie et al.·Published in Journal of veterinary internal medicine·2021·Ecole Nationale Vé, France·View original on PubMed →
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Original publication title: Histopathologic, phenotypic, and molecular criteria to discriminate low-grade intestinal T-cell lymphoma in cats from lymphoplasmacytic enteritis.
- Species:
- cat
Plain-English summary
A 5-year-old domestic shorthair cat was experiencing ongoing gastrointestinal issues that didn't improve with standard treatments. After a thorough examination and biopsy, the cat was diagnosed with low-grade intestinal T-cell lymphoma (LGITL), a type of cancer affecting the intestines. The diagnosis was confirmed through specific tests that showed distinct patterns in the tissue samples. Understanding these differences is crucial for veterinarians to provide the right treatment, which may include chemotherapy or other therapies tailored to manage this condition effectively.
People also search for: cat gastrointestinal problems · low-grade intestinal T-cell lymphoma in cats · cat lymphoma treatment options
Abstract
BACKGROUND: Differentiation of low-grade intestinal T-cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. OBJECTIVE: Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. ANIMALS: Forty-four client-owned cats, 22 diagnosed with LGITL and 22 with LPE. METHODS: Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full-thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. RESULTS: A monomorphic lymphocytic population (22/22, 100%) and in-depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical-to-basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki-67 20%- and 30%-thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3- and pSTAT5+. T-cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). CONCLUSIONS AND CLINICAL IMPORTANCE: We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34374109/