Post-chemotherapy perforation in cats with discrete intermediate- or large-cell gastrointestinal lymphoma

Abstract

Objectives Gastrointestinal (GI) perforation is a well described complication of GI lymphoma in people, commonly occurring within days of initiation of chemotherapy. There are no studies documenting the prevalence of GI perforation in cats with intermediate- or large-cell GI lymphoma or whether it is associated with induction of chemotherapy. The objectives of this study were to document the prevalence and timing of post-chemotherapy perforation in cats with discrete GI masses caused by intermediate- or large-cell lymphoma. Methods Cats with a diagnosis of intermediate- or large-cell lymphoma based on cytologic or histopathologic examination of a mass lesion of the GI tract and treated with chemotherapy were identified by searching the patient record database of three large specialty referral hospitals. Cats undergoing surgical resection of a GI mass prior to chemotherapy were excluded from the study. A clinical diagnosis of GI perforation was made using ultrasound findings and analysis of abdominal fluid. Results Twenty-three cats with intermediate- (n = 3) or large-cell (n = 20) lymphoma were included in the study. GI perforation was confirmed in 4/23 cats (17%), and occurred at 23, 56, 59 and 87 days after induction. There was no association between tumor size, the presence of hypoproteinemia or suppurative inflammation within the mass at the time of diagnosis and subsequent perforation. Post-hoc analysis revealed that the magnitude of weight loss within 15-28 days of diagnosis was greater in cats with perforation. Conclusions and relevance In this pilot study, we found that post-chemotherapy GI perforation in cats with intermediate- or large-cell GI lymphoma occurs. Acute perforation after induction of chemotherapy was not documented. Larger prospective studies are needed to determine risk factors associated with perforation and whether surgical excision would reduce the risk of subsequent GI perforation in these patients.

Gastrointestinal tract perforation during endoscopy in three cats: A retrospective case series

“…In veterinary medicine, one study suggested cats were at higher risk of perforation during endoscopy compared to dogs, while others have shown a lower incidence. [7][8][9]16 At this institution, a total of 254 endoscopies were performed in cats during the study period, while 1110 endoscopies were performed in dogs over the same timeframe. Furthermore, in the dogs, only one case of rupture post-ballooning a colonic stricture was reported, that is, a perforation rate of 0.09%.…”

“…Lymphoma is the most common neoplasm of the cat, with the GIT being the most common location, accounting for up to 72% of newly diagnosed cases. 16 With surgical biopsies, the risk of intestinal wound dehiscence reported in cats was 3.5%. 17 Comparing with the reported endoscopic risk of 1.2%, then endoscopy remains the safer option for biopsy.…”

Application Value of Multi-Slice Spiral CT Multiplanar Reconstruction Technique in the Diagnosis and Clinicopathological Analysis of Gastrointestinal Lymphoma

“…With the deepening of clinical research, the causes of GIL have become increasingly clear, including human immunodeficiency virus infection, immunosuppression, celiac disease, etc. As the clinical stage of the disease develops, patients will be accompanied by nausea, vomiting, hematemesis, abdominal pain and other uncomfortable conditions that are similar with those of other gastrointestinal diseases, easily causing misdiagnosis [17][18][19][20]. GIL originates from lymphoid tissue of the mucosa lamina propria or submucosa.…”

Bcl-2 Immunoexpression in Feline Epitheliotropic Intestinal T-Cell Lymphomas

“…If present, these are often subtle, and include a progressive lack of appetite, lethargy, chronic diarrhea with or without melena, vomiting, and weight loss, leading to a poor general condition [8,9,11]. Sudden death may occur secondary to intestinal perforation and peritonitis [12].…”