A challenging case: Conjunctival lymphoma in a cat - Veterinary Medicine
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A challenging case: Conjunctival lymphoma in a cat
The owner's schedule and financial constraints made the cause of this cat's protruding nictitating membrane a challenge to diagnose and treat.


VETERINARY MEDICINE


Non-Hodgkin vs. Hodgkin-like lymphoma

Another possible prognostic indictor is the classification of the initial tumor as either non-Hodgkin or Hodgkin-like lymphoma.1 In cats, both Hodgkin-like9 and non-Hodgkin lymphomas have been reported in the conjunctiva, but to our knowledge, only one report of each disease has been published.9,12 The tumor in the cat reported here appears to be most similar to conjunctival B-cell lymphoma (non-Hodgkin lymphoma)8 because it consisted primarily of B cells and lacked Reed-Sternberg cells.19 Non-Hodgkin lymphoma arises from monoclonal expansion of either T or B lymphocytes, and in people, most are B cell in origin.1 In people, a diagnosis of Hodgkin lymphoma generally carries a better prognosis for long-term survival than does a diagnosis of non-Hodgkin lymphoma.1 This better prognosis appears to be the same in cats19; however, there are so few known cases of conjunctival lymphoma in cats that such a conclusion cannot be made.

Treatment

Treatment protocols for feline lymphoma are determined after disease staging. Staging involves performing a CBC, a serum chemistry profile, a urinalysis, FeLV and FIV testing, a lymph node or organ biopsy, bone marrow aspiration, and thoracic and abdominal radiography.13,20 Additional tests might include thoracic and abdominal ultrasonography and computed tomography.

Chemotherapy is the treatment of choice for most forms of systemic lymphoma. Effective chemotherapeutic agents include cyclophosphamide, vincristine sulfate, and prednisolone. Cytosine arabinoside and lomustine have also been used with some success.13,20 Lymphoma cells are radiation-sensitive, and radiation therapy, which was recommended in this case, can be an effective treatment for the localized forms of lymphoma.

Juliet R. Gionfriddo, DVM, MS
Fiona Tancredi-Ballugera, DVM
Department of Clinical Sciences
College of Veterinary Medicine & Biomedical Sciences
Colorado State University
Fort Collins, CO 80538.

David Gardiner, DVM
E.J. Ehrhart, DVM, PhD
Department of Microbiology Immunology and Pathology
College of Veterinary Medicine & Biomedical Sciences
Colorado State University
Fort Collins, CO 80538.

REFERENCES

1. Cockerham GC, Jakobiec FA. Lymphoproliferative disorders of the ocular adnexa. Int Ophthalmol Clin 1997;37(4):39-59.

2. Hardy JWD. Hematopoietic tumors of cats. J Am Anim Hosp Assoc 1981;17:921-940.

3. Valli, VEO. The hematopoietic system. In: Jubb KVF, Kennedy PC, Palmer N, eds. Pathology of domestic animals. Vol 3. 4th ed. San Diego, Calif.: Academic Press, 1993;101-265.

4. Mahony OM, Moore AS, Cotter SM, et al. Alimentary lymphoma in cats: 28 cases (1988-1993). J Am Vet Med Assoc 1995;207(12):1593-1598.

5. Gabor LJ, Malik R, Canfield PJ. Clinical and anatomical features of lymphosarcoma in 118 cats. Aust Vet J 1998;76(11):725-732.

6. Twomey LN, Alleman AR. Cytodiagnosis of feline lymphoma. Compend Contin Educ Pract Vet 2005;27:17-31.

7. Gilger BC, McLaughlin SA, Whitley RD, et al. Orbital neoplasms in cats: 21 cases (1974-1990). J Am Vet Med Assoc 1992;201(7):1083-1086.

8. Radi ZA, Miller DL, Hines ME. B-cell conjunctival lymphoma in a cat. Vet Ophthalmol 2004;7(6):413-415.

9. Holt E, Goldschmidt MH, Skorupski K. Extranodal conjunctival Hodgkin's-like lymphoma in a cat. Vet Ophthalmol 2006;9(3):141-144.


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