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Updated: Nov 24, 2025
Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy
Betty Chow1,2, Steve L Hill1,3, Keith P Richter1
1Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.
Insights
Integrating immunohistochemistry (IHC) and clonality testing with histopathology improves feline lymphoma diagnosis. This study found that these methods significantly increased lymphoma diagnoses compared to histopathology alone, though lower small intestine samples were less informative.
Area of Science:
- Veterinary Pathology
- Oncology
- Gastroenterology
Background:
- Differentiating feline inflammatory bowel disease (IBD) from alimentary small cell lymphoma (LSA) is challenging.
- Histopathology alone has limitations in definitively diagnosing these conditions.
Purpose of the Study:
- To assess the combined utility of histopathology, immunohistochemistry (IHC), and clonality testing for diagnosing feline IBD and LSA.
- To evaluate diagnostic agreement between upper (USI) and lower small intestine (LSI) endoscopic biopsy samples.
Main Methods:
- Histopathology, IHC, and clonality testing were applied to biopsy samples from 57 cats with suspected IBD or LSA.
- Cases were initially classified by histopathology, then re-evaluated after integrating IHC and clonality results.
- Diagnostic agreement between USI and LSI samples was analyzed.
Main Results:
- Histopathology alone diagnosed 42.1% as IBD and 31.6% as LSA.
- Integrating IHC and clonality testing reclassified significant numbers of cases, increasing the final LSA diagnosis rate to 77.2%.
- Moderate agreement (κ = 0.66–0.70) was observed between USI and LSI samples, with LSI rarely providing a definitive LSA diagnosis alone.
Conclusions:
- Combined IHC and clonality testing enhance the diagnosis of feline alimentary small cell lymphoma.
- While diagnostic agreement between upper and lower small intestine samples is moderate, lower small intestine biopsies are less likely to yield a definitive diagnosis.
- The clinical impact of these diagnostic improvements on patient outcomes requires further investigation.
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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