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Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats

Sarah E. EvansE & M Bobst Hospital and Caspary Research Institute of The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

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Jennifer J. BonczynskiE & M Bobst Hospital and Caspary Research Institute of The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

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John D. BroussardE & M Bobst Hospital and Caspary Research Institute of The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

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Eveline HanE & M Bobst Hospital and Caspary Research Institute of The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

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Keith E. BaerE & M Bobst Hospital and Caspary Research Institute of The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

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Abstract

Objective—To evaluate the accuracy of endoscopic biopsy (EB) specimens for diagnosis of alimentary tract lymphosarcoma in cats.

Design—Prospective study.

Animals—22 cats with inflammatory bowel disease (IBD) or alimentary tract lymphosarcoma.

Procedures—Endoscopic biopsy specimens were obtained during endoscopy of the stomach and duodenum immediately prior to laparotomy or laparoscopic surgery, during which full-thickness biopsy (FTB) specimens were obtained. Accuracy of histopathologic diagnoses was compared between EB and FTB specimens.

Results—Lymphosarcoma was diagnosed in 10 cats on the basis of FTB specimens. Lymphosarcoma was detected in the jejunum and ileum in all 10 cats, in the duodenum in 9 cats, and in the stomach in 4 cats. In the same 10 cats, EB findings indicated a diagnosis of lymphosarcoma in 3 cats and were suggestive but inconclusive for lymphosarcoma in 3 cats. Lymphosarcoma was correctly diagnosed via gastric EB specimens in 3 of the 4 cats with gastric lymphosarcoma but evaluation of EB specimens led to an incorrect diagnosis of IBD in 4 cats with small intestinal lymphosarcoma.

Conclusions and Clinical Relevance—EB specimens were useful for diagnosis of gastric lymphosarcoma but were not adequate for differentiating between IBD and lymphosarcoma in the small intestine. Because the most common sites of alimentary tract lymphosarcoma in cats are the jejunum and ileum, FTB specimens of those sites should be obtained via laparotomy or laparoscopy for accurate diagnosis. Laparoscopy may be a minimally invasive alternative to endoscopy and laparotomy for obtaining diagnostic biopsy specimens.

Abstract

Objective—To evaluate the accuracy of endoscopic biopsy (EB) specimens for diagnosis of alimentary tract lymphosarcoma in cats.

Design—Prospective study.

Animals—22 cats with inflammatory bowel disease (IBD) or alimentary tract lymphosarcoma.

Procedures—Endoscopic biopsy specimens were obtained during endoscopy of the stomach and duodenum immediately prior to laparotomy or laparoscopic surgery, during which full-thickness biopsy (FTB) specimens were obtained. Accuracy of histopathologic diagnoses was compared between EB and FTB specimens.

Results—Lymphosarcoma was diagnosed in 10 cats on the basis of FTB specimens. Lymphosarcoma was detected in the jejunum and ileum in all 10 cats, in the duodenum in 9 cats, and in the stomach in 4 cats. In the same 10 cats, EB findings indicated a diagnosis of lymphosarcoma in 3 cats and were suggestive but inconclusive for lymphosarcoma in 3 cats. Lymphosarcoma was correctly diagnosed via gastric EB specimens in 3 of the 4 cats with gastric lymphosarcoma but evaluation of EB specimens led to an incorrect diagnosis of IBD in 4 cats with small intestinal lymphosarcoma.

Conclusions and Clinical Relevance—EB specimens were useful for diagnosis of gastric lymphosarcoma but were not adequate for differentiating between IBD and lymphosarcoma in the small intestine. Because the most common sites of alimentary tract lymphosarcoma in cats are the jejunum and ileum, FTB specimens of those sites should be obtained via laparotomy or laparoscopy for accurate diagnosis. Laparoscopy may be a minimally invasive alternative to endoscopy and laparotomy for obtaining diagnostic biopsy specimens.

Contributor Notes

Dr. Evans' present address is Hollywood Animal Hospital, 2864 Hollywood Blvd, Hollywood, FL 33020.

Supported in part by a grant from the WINN Feline Foundation.

Presented in part at the 32nd American College of Veterinary, Surgeons Veterinary Symposium, Washington, DC, October 2006.

Address correspondence to Dr. Evans.