UGELAB (TCC)

After consultation with the pathologist, the hypertrophy of the muscularis was physiological in response to functional obstruction or a “pseudohypertrophy syndrome.” Only islands of cross over infiltrative lymphoma were visualized within the submucosae and muscularis while the diagnosis was consistent with diffuse, low grade mucosal lymphoma typical of older cats. In his opinion, these patients tend to respond better to therapy and have a less aggressive form of lymphoma than the forms that involve the submucosal and muscularis layers in a diffuse manner. Since the regions of detail loss of the intestinal layers were minimal, physiological hypertrophy of the muscularis is most consistent with the sonographic presentation as opposed to infiltrative disease of the muscularis/submucosae. The minor areas of detail loss between the muscularis, submucosae and mucosae may have corresponded to the “islands” of cross-over infiltrate that the pathologist had described (see linear intraop. image 312L). Concurrent mast cell disease of the mesenteric lymph node was considered a complicating factor but would most likely not be treated differently. Regardless, the owner declined aggressive chemotherapy. The patient was prescribed an oral, bland chemotherapeutic protocol of immune suppressive prednisolone, chlorambucil and broad spectrum antibiotics. The cat responded well to therapy, gaining weight with a strong appetite 8 months post diagnosis.

Referring Practitioner and diode laser operator: Dean Cerf DVM, Ridgewood Veterinary Hospital, Ridgewood, NJ, USA.