Page 498 - Feline diagnostic imaging

510 29 Hemolymphatic System

(a) (c)

(b)

Figure 29.10 Radiographs of a 14-year-old domestic shorthair with acute lymphoblastic leukemia. There is marked enlargement of
the spleen (S) including the distal extremity (arrowheads) which can be seen ventrally and crossing the midline. An opacity (arrows)
ventral to the seventh lumbar vertebra is likely caused by enlargement of one or more medial iliac lymph nodes. (a) Left lateral
projection. (b) Right lateral projection. (c) Ventrodorsal projection.

about two‐thirds of the cats had changes in the liver, and thickening (8–25 mm for the stomach and 5–22 mm for
which were found to be caused by lymphoma in all but the intestine in two studies [13,14]) although in early cases,
one (Figure 29.17). Aspiration can be done to determine there may only be thickening of the wall of the stomach or
if invasion of the spleen and/or liver has occurred. intestines. Multiple sites may be affected. Hypomotility may
Peritoneal effusion and intestinal lymphoma may also be be apparent at affected areas [14]. There is often a change
present [10]. One case of multicentric follicular lymphoma in echogenicity, with decreased echogenicity being more
splenomegaly, hepatomegaly with nodules, and pancre- common than increased echogenicity [13].
atic enlargement appeared to be associated with skin Lymphoma is more likely to cause circumferential
fragility syndrome [11]. lesions than mast cell tumor [12]. Nodular lesions occur
The most common gastrointestinal neoplasms are most commonly in the ileocecocolic region and can result
lymphoma, adenocarcinoma, and mast cell tumor [12]. in obstruction [13]. Examination of mesenteric lymph
Alimentary lymphoma usually affects middle‐aged and nodes frequently shows that these are also abnormal.
older cats. Radiography may be normal but sometimes Affected walls can be aspirated if they are thick enough but
there is a visible radiopaque mass or evidence of intestinal care must be taken to avoid contamination of the perito-
obstruction on survey films (Figure 29.18). Gastric gas in an neal cavity with intestinal or gastric contents [14].
affected stomach may have an irregular shape. If sufficient Mesenteric lymph nodes are frequently affected [14] and
gas is present, it may be possible to recognize thickening of should be aspirated if possible, because some bowel walls
the gastric wall. Barium studies may be helpful in revealing do not exfoliate easily.
partial obstruction if it occurs. On ultrasonography On ultrasonography of kidneys infiltrated with lym-
(Figures 29.19–29.21), the key signs are a loss of wall layering phoma (Figure 29.22), there is usually bilateral smooth