Hypernatremia associated with intracranial B-cell lymphoma in a cat

An 8-year-old, spayed female, domestic shorthair cat with a history of hyperthyroidism, anorexia, dehydration, cervical ventroflexion, and behavioral changes was referred to the Iowa State University College of Veterinary Medicine. The cat was obtunded, with severe dehydration (15%) and hypothermia (86 degrees F), and severe muscle atrophy and fasciculations. Serum biochemical abnormalities included severe hypernatremia (195 mmol/L, reference interval 155-165 mmol/L), hyperchloridemia (161 mmol/L, reference interval 123-131 mmol/L), and hypokalemia (3.6 mmol/L, reference interval 4.0-5.7 mmol/L). Calculated osmolality was 418 mOsm/kg (reference interval 280-305 mOsm/kg), attributable to the hypernatremia. The cat was kept warm and given fluid and glucocorticoid therapy and supportive measures but remained unresponsive. Hypernatremia and hyperosmolality improved through day 3, when the cat died suddenly. At necropsy, a 1.25-cm mass was found in the area of the thalamus and interthalamic adhesion that extended to the ventral aspect of the cerebrum. The histologic and immunohistochemical diagnosis was B-cell lymphoma. Hypernatremia and hyperosmolality in this cat were attributed to primary adipsia and hypothalamic dysfunction secondary to effacement of central nervous system tissue by neoplastic lymphocytes. To the authors' knowledge, this is the first reported case of central nervous system lymphoma, confirmed by use of immunohistochemical analysis as a B-cell phenotype, associated with hypernatremia. It also is the first reported case of lymphoma in animals limited to the thalamus, hypothalamus, and cerebrum, with no involvement of the spinal cord.     

Cutaneous lymphoplasmacytic lymphoma with systemic metastasis in a cat

A lymphoplasmacytic lymphoma was diagnosed in a 12- year-old domestic cat that had a primary cutaneous mass involving the stomach, liver, kidneys, heart, abdominal wall, diaphragm, bone marrow and several lymph nodes. Histopathologically, the most characteristic feature of this tumor was the heterogeneity of cell components, such as small lymphocytes, well-differentiated plasma cells and plasmacytoid transformed lymphocytes. Amyloid was deposited in the skin, stomach, and several lymph nodes. Immunohistochemically, neoplastic small lymphocytes were positive for CD20, and well-differentiated plasma cells and plasmacytoid transformed lymphocytes were positive for λ-Ig light chains and MUM1/IRF-4. These results emphasize the importance of lymphoplasmacytic lymphoma as a differential diagnosis of extramedullary cutaneous plasmacytoma in cats.     

B-cell conjunctival lymphoma in a cat

A bilateral conjunctival neoplasm was surgically removed from a 13-year-old Domestic Short-haired female cat and examined by histopathology. The neoplasm was infiltrative, nonencapsulated and composed of large sheets of densely packed, round to polygonal cells. Neoplastic cells were variably sized with scant to modest amounts of cytoplasm and oval to round nuclei. On immunohistochemistry the neoplastic cells stained positively for BLA.36 and negative for CD-3 antibodies. On the basis of histopathology and immunohistochemical findings, a diagnosis of conjunctival B-cell lymphoma was made. This is the first case with immunohistochemical characterization of conjunctival lymphoma in a cat.     

Retrobulbar lymphoma associated with a ballistic foreign body in a cat

A seven‐year‐old domestic shorthair cat, adopted 5 years previously with a corneal perforation of the left eye, was presented for investigation of a left orbital mass. Computed tomography revealed a metallic foreign body within a contrast‐enhancing, heterogeneous orbital mass. Large cell lymphoma was diagnosed from a fine needle aspirate. The cat staged negatively and was treated with l‐asparaginase, prednisolone and three fractions of radiation therapy. A rapid clinical remission was obtained and the cat remained in remission for 3 years after therapy. This is the first report of large cell lymphoma likely occurring secondary to a foreign body.     

B-cell immunoblastic lymphoma with multinucleated giant cells in a cat

A 10-year-old male mixed breed cat died after six months history of intermittent vomiting and weight loss. At necropsy, large white-colored foci were found in both kidneys, and whitish thickening of the gastric wall was present at the pyloric part of the stomach. Histopathological examination revealed that both lesions consisted of proliferation of large-sized neoplastic lymphocytes intermingled with multinucleated giant cells. Immunohistochemically, the neoplastic cells were positive for both B-cell antigen receptor complex (CD 79 alpha cy) and MHC class II, although multinucleated giant cells were negative. The present case was diagnosed as B-cell immunoblastic lymphoma with multinucleated giant cells.     

Polyostotic lymphoma with multiple pathological fractures in a six-month-old cat

A 6-month-old female neutered domestic shorthair cat was examined for pain and swelling of the distal limbs. Swelling and malalignment of both carpi, dorsiflexion of the distal metatarsals and a mild, multicentric lymphadenopathy were detected on examination. Screening blood tests revealed a biclonal gammopathy, hypercalcemia and atypical leukocytes. Survey radiographs revealed lysis and proliferative changes within the physes. Multiple pathological physeal fractures were present, including the distal radii, metacarpal and metatarsal bones. No treatment was attempted and the patient was euthanased. Histopathology revealed infiltration by monomorphic round cells within the liver, spleen, kidney and bone marrow. Immunohistochemistry revealed strong reactivity to CD20. Clonality assays revealed clonal results for the B-cell loci, consistent with B-cell lymphoma. To the authors' knowledge this is the first report of polyostotic lymphoma with multiple pathological fractures in a cat. The predominantly distal distribution of osseous lesions is rarely reported in dogs and humans.     

Gastrointestinal small-cell lymphoma with gall bladder involvement in a cat

A 13-year-old female spayed domestic shorthair cat presented for investigation of decreased appetite and increased serum liver enzyme concentrations. An abdominal ultrasound revealed multiple sessile hyperechoic structures along the luminal aspect of the gall bladder wall and a mildly enlarged liver with hyperechoic nodules. Cholecystectomy was performed and biopsies were obtained by laparotomy. Histopathologic examination with immunohistochemistry was consistent with a diagnosis of small-cell lymphoma of T cells within the gall bladder, liver and small intestine. Clonality testing confirmed the diagnosis. The cat remains clinically stable 23 months after institution of treatment with prednisolone, chlorambucil and ursodeoxycholic acid. This is the first report of small-cell lymphoma in the gall bladder of a cat.     

Dyspnoea and pulmonary consolidation in a cat with T-cell lymphoma

A 13-year-old male neutered domestic shorthair cat presented with an acute onset of dyspnoea. Thoracic radiographs revealed marked, bilateral, caudal lung lobe consolidation. A diagnosis of anatomically mixed T-cell lymphoma with pulmonary, renal and alimentary involvement was confirmed on histopathology. Pulmonary involvement in cases of feline lymphoma is uncommon and the radiographic appearance of pulmonary lymphoma is highly variable. Lung lobe consolidation has been described with primary lung tumours in cats, but not previously in association with pulmonary lymphoma. This unusual presentation serves to alert practitioners to the possibility of lymphoma as a cause of severe bronchopulmonary disease in the cat.     

Intestinal T-cell lymphoma with severe hypereosinophilic syndrome in a cat

A Japanese domestic long-hair cat of about 8 years of age was presented with vomiting and hematochezia and was found to have significant hypereosinophilia. Bone marrow aspiration revealed moderate increases of eosinophilic lineages. Histopathological examination revealed mild eosinophilic and epitheliotropic T-lymphocytic infiltrations in the duodenum. Although the cat remained asymptomatic with only prednisolone administration, the cat presented with hematemesis, weight loss, and severe anorexia 512 days after the initial presentation. Subsequently, gastrointestinal perforation developed, and the cat died on Day 536. Histopathological examination of autopsy specimens revealed mixed cellular infiltration including eosinophils and neoplastic lymphocytes in the intestinal lymph nodes, intestine, liver, spleen, and pancreas. Immunohistochemical examination supports a diagnosis of intestinal T-cell lymphoma with severe hypereosinophilic syndrome.     

Extranodal conjunctival Hodgkin's-like lymphoma in a cat

A seven-year-old female spayed Domestic Short-haired cat was brought for examination following a four-month history of conjunctivitis in the right eye. The superior palpebral conjunctiva was diffusely swollen and firm, displacing the right globe ventrally and preventing full closure of the eyelids. The right popliteal lymph node was enlarged as were several other peripheral lymph nodes. An incisional biopsy of the conjunctival swelling revealed a lymphoid neoplasm, the cellular make up of which suggested features of feline Hodgkin's-like lymphoma. Although the neoplasm was poorly responsive to standard chemotherapeutic protocols for lymphoma, radiation therapy rapidly reduced its size. Three years following the initial diagnosis, there has been no recurrence of the conjunctival neoplasm. To the authors' knowledge, there are no previous reports of extranodal or adnexal (conjunctiva, eyelid, orbit) Hodgkin's-like lymphoma in the veterinary literature.     

Lingual and renal lymphoma in a cat

A domestic shorthair cat presented with a progressive history of polydipsia, lingual swelling and ulceration. The tongue was firm and grossly enlarged with associated regional lymphadenopathy. Surgical biopsies revealed lymphoma of the tongue. Following the procedure, the cat developed respiratory distress and was subsequently euthanased. Necropsy confirmed the diagnosis of lingual lymphoma and also identified lymphoma within the left kidney. This is the first report of lymphoma within the feline tongue in the literature.     

Infiltrative cardiomyopathy responsive to combination chemotherapy in a cat with lymphoma

A 3-year-old castrated male domestic shorthair cat had renal lymphoma and infiltrative cardiomyopathy, both of which responded to combination chemotherapy. Diagnosis was made on the basis of results of renal biopsy and echocardiography. Cardiac lesions included hypertrophy of the left ventricular free wall and interventricular septum, ventricular hypokinesis, and diminishment of the left ventricular chamber. Cytologic evaluation of pericardial fluid did not contribute to a diagnosis. Combination chemotherapy resulted in rapid improvement of renomegaly and cardiac structure and function. Although it might be assumed that the myocardial infiltration was attributable to metastatic lymphoma, histologic diagnosis of the heart disease was not established.     

Presumptive precursor-targeted immune-mediated anemia concurrent with gastrointestinal lymphoma in a cat

A 10-year-old spayed female mixed-breed cat presented with progressive nonregenerative anemia. Clinicopathological abnormalities included severe nonregenerative anemia (packed cell volume [PCV]: 7%, aggregate reticulocytes: 1.12 × 10³/µl) and a hypoechogenic mass well-localized in the stomach. Bone marrow (BM) smears revealed increased particle hematopoietic cellularity with decreased myeloid:erythroid (M:E) ratios, no dysplasia of any lineage, and presence of erythroid precursors phagocytized by macrophages. The cat was diagnosed with presumptive precursor-targeted immune-mediated anemia (PIMA). The stomach mass was consistent with CD 20 positive T-cell lymphoma. The lymphoma was completely resected via surgery, and the PIMA was cured by immunosuppressive therapy. On day 410, both diseases have not recurred without medications. This is the first report of feline PIMA and concurrent gastrointestinal lymphoma.     

Pericardial effusion and cardiac tamponade in a cat with extranodal lymphoma

A five-year-old domestic longhaired cat was evaluated for a seven-day history of worsening respiratory distress. Serum analysis for feline leukaemia virus antigen was positive. Pleural effusion was detected on thoracic radiographs and echocardiography revealed a pericardial effusion and cardiac tamponade. Cytological evaluation of the pleural and pericardial effusions showed lymphoblastic cells indicative of disseminated lymphoma. Following thoracocentesis and pericardiocentesis, the cat was treated for lymphoma using the University of Wisconsin-Madison chemotherapy protocol. The cat was sent home after three days and, at the time of writing (six months after initial presentation), was still symptom free. To the authors' knowledge, this is the first report confirming pericardial effusion and cardiac tamponade in the cat as a direct result of an extranodal lymphoma with cytological evidence of neoplastic cells in the pericardial fluid.     

Mediastinal lymphoma in a young Turkish Angora cat

An 8-month old intact male Turkish Angora cat was referred to the Veterinary Medical Teaching Hospital (VMTH), Seoul National University, for an evaluation of anorexia and severe dyspnea. The thoracic radiographs revealed significant pleural effusion. A cytology evaluation of the pleural fluid strongly suggested a lymphoma containing variable sized lymphocytes with frequent mitotic figures and prominent nucleoli. The feline leukemia virus and feline immunodeficiency virus tests were negative. The cat was euthanized at his owner''s request and a necropsy was performed. A mass was detected on the mediastinum and lung lobes. A histopathology evaluation confirmed the mass to be a lymphoma. Immunohistochemistry revealed the mass to be CD3 positive. In conclusion, the cat was diagnosed as a T-cell mediastinal lymphoma.