The diagnostic relevance of mesenteric lymph node biopsy in small intestinal lymphoma in cats

IF 2.1 2区农林科学 Q1 VETERINARY SCIENCES Journal of Veterinary Internal Medicine Pub Date : 2024-06-10 DOI:10.1111/jvim.17095

Laura Marconato, Valeria Martini, Barbara Banco, Silvia Benali, Veronica Crocchianti, Selina Iussich, Michele Marino, Maria Massaro, Teresa Bruna Pagano, Luca Aresu

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Abstract

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.

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肠系膜淋巴结活检对猫小肠淋巴瘤的诊断意义。

背景：在怀疑患有肠淋巴瘤的猫中，区域淋巴结经常被取样；然而，它们的诊断价值尚未得到探讨：研究肠系膜淋巴结的组织学和免疫组化分析是否与猫肠淋巴瘤的诊断相关：方法：回顾性研究：回顾性研究。纳入标准要求对小肠进行全厚活检，并同时切除肠系膜淋巴结。对肠活检组织和相应淋巴结进行组织学和免疫分型分析。对诊断为反应性淋巴结的部分结节样本进行了克隆性检测：结果：包括小细胞和大细胞类型在内的跨膜T细胞淋巴瘤占主导地位（64例，62.7%），大B细胞淋巴瘤的跨膜发生率（68.8%）高于粘膜发生率（31.2%）。在所有受检淋巴结中，有 44 个（43.1%；95% CI：33.9%-52.8%）出现肿瘤浸润。在小细胞淋巴瘤病例中，72 例中有 51 例（70.8%；95% CI：59.4%-80.1%）无结节受累。克隆结果正确识别了 19/30 个（63.3%；95% CI：45.5%-78.2%）反应性淋巴结。结论和临床重要性：本研究强调了仅依靠肠系膜淋巴结诊断猫肠道淋巴瘤（尤其是小细胞亚型）的潜在缺点。它强调了全厚活检对评估跨壁浸润的重要性，并建议在使用肠系膜淋巴结对粘膜淋巴瘤进行组织学、免疫组化和克隆性评估时要谨慎。尽管存在局限性，但这项研究强调了对患有肠道淋巴瘤的猫采取综合诊断策略的必要性。

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来源期刊

Journal of Veterinary Internal Medicine 农林科学-兽医学

CiteScore

4.50

自引率

11.50%

发文量

243

审稿时长

22 weeks

期刊介绍： The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.