Intestinal Lymphoma in Cats

Lingard AE, Briscoe K, Beatty JA, et al. Low-grade alimentary lymphoma: clinicopathological findings and response to treatment in 17 cases. J Feline Med Surg 2009; 11: 692-700.

Alimentary lymphoma is the most common anatomic form of lymphoma in the cats. Seventeen cats in this study were diagnosed with low-grade alimentary lymphoma (LGAL) by immunological and immunohistochemical evaluation of full-thickness biopsies collected from multiple gastrointestinal sites during exploratory laparotomy. The most common clinical signs were weight loss, inappetence, vomiting or diarrhea, vomiting and diarrhea, lethargy, and polyphagia. Vomiting and/or diarrhea were considered chronic in 11 of 15 cats. Abdominal palpation was abnormal in 12 cats. Mature neutrophilia and anemia were the most common hematological abnormalities. Serum albumin was normal in all cats tested. The most common ultrasonographic finding was normal or increased intestinal wall thickness with preservation of layering. LGAL is typically a diffuse or multifocal disease and the ileum and jejenum were most commonly affected. The cats were put on three chemotherapeutic protocols, the majority being given the oral chemotherapeutic regimen of prednisolone and high-dose pulse chlorambucil. Thirteen of the 17 cats (76%) had complete clinical remission with a median remission time of 18.9 months. Cats that were lethargic were less likely to achieve complete remission. The prognosis for cats with LGAL treated with oral prednisolone in combination with high-dose pulse chlorambucil is good to excellent. [VT]
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Wilson HM. Feline alimentary lymphoma: demystifying the enigma. Top Companion Anim Med 2008; 23: 177-84.
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Waly NE, Gruffydd-Jones TJ, Stokes CR, Day MJ. Immunohistochemical diagnosis of alimentary lymphomas and severe intestinal inflammation in cats. J Comp Pathol 2005; 133: 253-60.
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Nasal Lymphoma in Cats

Haney, S. M., L. Beaver, et al. (2009). "Survival analysis of 97 cats with nasal lymphoma: a multi-institutional retrospective study (1986-2006)." J Vet Intern Med 23(2): 287-294.

While lymphoma is one of the most common cancer types affecting cats, nasal lymphoma is relatively rare. This retrospective study examined survival times in cats given different therapies, and evaluated response to treatment, duration of response, and prognostic factors. Records of 97 cats from various veterinary centers in the United States diagnosed with nasal lymphoma were analyzed. Two methods of survival analysis were used. In the first method, only deaths caused by progressive lymphoma were counted. The median survival time for these cats, regardless of treatment modality, was 536 days. In the second method, all deaths regardless of cause were counted. The median survival time for these cats was 172 days. There were no statistical differences in survival times based on treatment modality (radiation therapy alone, chemotherapy alone, radiation therapy plus chemotherapy). The results must be interpreted with caution, as many confounding variables were present. The investigators did note that inclusion of radiation therapy was critical to controlling the disease at the site (nasal cavity), and a higher dose of radiation may increase survival time. Anemia appeared to be an indicator of poor prognosis. [MK]
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Related articles:
Little, L., R. Patel, et al. (2007). "Nasal and nasopharyngeal lymphoma in cats: 50 cases (1989-2005)." Vet Pathol 44(6): 885-92.
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Sfiligoi, G., A. P. Theon, et al. (2007). "Response of nineteen cats with nasal lymphoma to radiation therapy and chemotherapy." Vet Radiol Ultrasound 48(4): 388-93.
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Endoscopy for Diagnosis of Gastrointestinal Disease in Cats

Willard, M. D., J. Mansell, et al. (2008). "Effect of sample quality on the sensitivity of endoscopic biopsy for detecting gastric and duodenal lesions in dogs and cats." Journal of Veterinary Internal Medicine 22(5): 1084-1089.

A common diagnostic procedure for assessment of chronic gastrointestinal disease in cats is endoscopy with biopsies of gastrointestinal mucosa. Previous studies have highlighted the difficulty in obtaining quality biopsy samples via endoscopy. In this study, the researchers attempted to address two issues: whether the ability to demonstrate a histologic lesion in the stomach or duodenum is affected by sample quality, and whether more samples are needed to find a lesion when tissue specimens are of poor quality. The researchers evaluated tissues obtained via endoscopy from 51 cats (and 99 dogs) that were examined as clinical cases at 8 veterinary institutions or practices in 5 different countries. The results showed that the quality of endoscopically obtained tissue samples has a profound effect on their sensitivity for identifying certain lesions, and there are differences between biopsies of canine and feline tissues. Multiple samples need to be taken to ensure that a sufficient number of adequate tissue samples are obtained during endoscopic procedures. The old assumption that a single adequate biopsy sample is sufficient for diagnosis was shown to be incorrect. The study suggests that a goal of obtaining 6 marginal or adequate feline duodenal or gastric samples will be sufficient to give 99% confidence of finding any lesions present.
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Related articles:
Day, M. J., T. Bilzer, et al. (2008). "Histopathological standards for the diagnosis of gastrointestinal inflammation in endoscopic biopsy samples from the dog and cat: a report from the World Small Animal Veterinary Association Gastrointestinal Standardization Group." J Comp Pathol 138 Suppl 1: S1-43.
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Evans, S. E., J. J. Bonczynski, et al. (2006). "Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats." J Am Vet Med Assoc 229(9): 1447-50.
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Pulmonary Fibrosis in a Cat Receiving Lomustine

Skorupski, K. A., A. C. Durham, et al. (2008). "Pulmonary fibrosis after high cumulative dose nitrosourea chemotherapy in a cat." Veterinary and Comparative Oncology 6(2): 120-125.

Lomustine (CCNU) is an alkylating nitrosourea chemotherapy drug. In feline medicine, it has been used for cutaneous lymphoma and mast cell tumors. Neutropenia and thrombocytopenia are known complications, so close monitoring of blood cell parameters is necessary during treatment. In this case report, a cat diagnosed with alimentary lymphoma did poorly on several chemotherapeutic regimes. However, a long-term remission was achieved with lomustine and corticosteroid therapy. After 12 months of therapy, the cat died after an acute episode of respiratory distress. On post mortem examination, severe diffuse pulmonary fibrosis was identified. The cat had no previous history of pulmonary disease. This is the first report of pulmonary fibrosis following high cumulative dose nitrosourea chemotherapy in a cat.
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Blog post: Lomustine for mast cell tumors in cats

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Feline Large Granular Lymphocyte Lymphoma

Krick, E. L., L. Little, et al. (2008). "Description of clinical and pathological findings, treatment and outcome of feline large granular lymphocyte lymphoma (1996-2004)." Veterinary and Comparative Oncology 6(2): 102-110.

Large granular lymphocytes (LGL) can be found in the blood of healthy animals and usually constitute 10% or less of total circulating lymphocytes. Large granular lymphosarcoma/leukemia is a neoplastic disease of lymphocytes rarely seen in cats and dogs and is a distinct variation of lymphoma. Limited information exists regarding pathological and immunohistochemical descriptions, clinical findings, treatment and survival times in cats. Medical records of 45 cats with LGL lymphoma were retrospectively evaluated. The most common clinical signs were decreased appetite, anorexia, weight loss, lethargy, and vomiting. The mesenteric lymph nodes and small intestine were the most commonly affected organs. One complete response and six partial responses were noted in the 23 cats that received chemotherapy as their initial treatment. Median survival time for cats that were treated was 57 days. Based on these results, feline LGL lymphoma appears to be minimally responsive to chemotherapy and is associated with a grave prognosis.
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Related articles:
Roccabianca, P., W. Vernau, et al. (2006). "Feline large granular lymphocyte (LGL) lymphoma with secondary leukemia: primary intestinal origin with predominance of a CD3/CD8(alpha)(alpha) phenotype." Vet Pathol 43(1): 15-28.
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Helicobacter and Lymphoma in Cats

Bridgeford, E. C., R. P. Marini, et al. (2008). "Gastric Helicobacter species as a cause of feline gastric lymphoma: A viable hypothesis." Vet Immunol Immunopathol 123(1-2): 106-13.

In humans and other animals, gastric Helicobacter spp. bacteria are associated with chronic inflammation. In this study, the relationship between Helicobacter heilmannii and gastric lymphoma in cats was examined. Gastric specimens were collected via biopsy or at necropsy from 47 pet cats with clinical signs of gastrointestinal disease, such as vomiting and anorexia. The specimens were characterized as gastritis (14/47), lymphoma (31/47), or normal (2/47). Staining for Helicobacter organisms was positive in 29 of the specimens. These tissues were then further examined to determine the Helicobacter species involved. Of the cats characterized as having lymphoblastic lymphoma, 13/17 were positive for H. heilmannii. The association between gastric lymphoma in cats and H. heilmannii infection requires further investigation, especially to evaluate the frequency and strain distribution of H. heilmanni in both well cats and those with gastric lymphoma using prospective studies.
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Related articles:
Priestnall, S. L., B. Wiinberg, et al. (2004). "Evaluation of "Helicobacter heilmannii" subtypes in the gastric mucosas of cats and dogs." J Clin Microbiol 42(5): 2144-51.
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Quality of Life for Cats Receiving Chemotherapy

Tzannes, S., M. F. Hammond, et al. (2008). "Owners 'perception of their cats' quality of life during COP chemotherapy for lymphoma." J Feline Med Surg 10(1): 73-81.


Lymphoma is one of the most common feline cancers and many owners opt for chemotherapy as a treatment option. Most owners are concerned about quality of life for feline cancer patients, both with and without chemotherapy. Questionnaires on quality of life (QOL) were completed by the owners of 31 cats undergoing treatment for lymphoma between 2002 and 2006. All cats were treated with cyclophosphamide, vincristine, and prednisolone (COP). QOL scores were significantly higher in cats before the onset of cancer than after, but before the start of chemotherapy. During chemotherapy, QOL scores were also lower than before the onset of cancer, but were significantly higher than prior to starting treatment. The majority of cats (87%) experienced adverse effects during treatment. Most pet owners (83%) were happy they treated their cats and most (87%) would treat another cat. The results of this questionnaire survey indicate that COP chemotherapy is well tolerated by cats according to owner perceptions of QOL.
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Related articles:
Teske, E., G. van Straten, et al. (2002). "Chemotherapy with cyclophosphamide, vincristine, and prednisone (COP) in cats with malignant lymphoma: new results with an old protocol." J Vet Intern Med 16(2): 179-186.
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