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The diagnostic relevance of mesenteric lymph node biopsy in small intestinal lymphoma in cats
Laura Marconato1, Valeria Martini2, Barbara Banco3
1Department of Veterinary Medical Sciences, University of Bologna, BO, Italy.
Insights
Mesenteric lymph nodes are unreliable for diagnosing feline intestinal lymphoma, especially small cell types. Full-thickness biopsies are crucial for accurate diagnosis and treatment planning in cats.
Area of Science:
- Veterinary Medicine
- Oncology
- Gastroenterology
Background:
- Intestinal lymphoma is common in cats.
- Mesenteric lymph node sampling is a frequent diagnostic step.
- The diagnostic utility of these lymph nodes remains under-explored.
Purpose of the Study:
- To evaluate the correlation between mesenteric lymph node analysis and feline intestinal lymphoma diagnosis.
- To assess the accuracy of histologic and immunohistochemical methods in lymph node evaluation.
Main Methods:
- Retrospective analysis of 102 cats with intestinal lymphoma.
- Inclusion of full-thickness intestinal biopsies and concurrent mesenteric lymph node excision.
- Histologic, immunophenotypic, and clonality analyses of both tissues.
Main Results:
- Neoplastic infiltration was found in 43.1% of lymph nodes.
- Small cell lymphoma cases frequently lacked nodal involvement (70.8%).
- Clonality testing showed limitations in identifying reactive lymph nodes accurately.
Conclusions:
- Sole reliance on mesenteric lymph nodes can be misleading for feline intestinal lymphoma diagnosis.
- Full-thickness biopsies are essential for assessing transmural infiltration.
- Caution is advised for lymph node evaluation in mucosal lymphomas, emphasizing comprehensive diagnostic approaches.
Background:
Regional lymph nodes are frequently sampled in cats with suspected intestinal lymphoma; however, their diagnostic value has not been explored.
Objectives:
To investigate whether histologic and immunohistochemical analysis of mesenteric lymph nodes correlates with the diagnosis of intestinal lymphoma in cats.
Animals:
One hundred 2 client-owned cats diagnosed with intestinal lymphoma.
Methods:
Retrospective study. The inclusion criteria required a full-thickness biopsy of the small intestine and concurrent excision of mesenteric lymph nodes. Histologic and immunophenotypic analyses were performed on intestinal biopsies and corresponding lymph nodes. Selected nodal samples diagnosed with reactive lymph nodes underwent clonality testing.
Results:
Transmural T-cell lymphomas, encompassing small and large cell types, were predominant (64 cases, 62.7%), with large B-cell lymphomas being more frequently transmural (68.8%) than mucosal (31.2%). Among all lymph nodes examined, 44 (43.1%; 95% CI: 33.9%-52.8%) exhibited neoplastic infiltration. Among cases of small cell lymphoma, 51 out of 72 (70.8%; 95% CI: 59.4%-80.1%) showed no nodal involvement. Clonality results correctly identified 19/30 (63.3%; 95% CI: 45.5%-78.2%) reactive lymph nodes. Concerns were raised regarding clonal identification in the remaining cases and potential misdiagnoses based on phenotypic characteristics.
Conclusion And Clinical Importance:
The study underscores the potential drawbacks of relying solely on mesenteric lymph nodes for diagnosing intestinal lymphomas in cats, particularly small cell subtypes. It emphasizes the importance of full-thickness biopsies for assessing transmural infiltration and recommends caution when utilizing mesenteric lymph nodes for histologic, immunohistochemical and clonality evaluations in mucosal lymphomas. Despite limitations, this research highlights the need for comprehensive diagnostic strategies in cats with intestinal lymphoma.
