Ultrasonographic and clinicopathological features of feline gastrointestinal eosinophilic sclerosing fibroplasia in four cats

Abstract

Four cats with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) are described. Clinical signs included decreased appetite, weight loss, vomiting and diarrhea. Bloodwork abnormalities included mild neutrophilia (n = 2) and hyperglobulinemia with concurrent hyperproteinemia (n = 2). Ultrasonographically, a total of five solitary masses with mural thickening and loss of layering were identified in the stomach, duodenum, jejunum and colon. In one cat a second, separate lesion was diagnosed 3 weeks following surgical resection of one mass. Histopathologically, lesions were characterized by collagen trabeculae and mixed inflammatory cell infiltrates, predominantly eosinophils. Multiple areas of necrosis were also noted, which contained bacteria in 2/4 cats. In two cats, changes consistent with FGESF were also noted in the liver. All cats had surgical resection of their lesions. Two cats are still living at time of publication (43 and 24 months post-surgery). FGESF should be considered as a differential for intestinal masses in cats.

Figure 1

Panoramic ultrasonographic image (cat 2). In the longitudinal plane, a mixed echogenic mass (calipers) is present within the proximal descending colon. Several ill-defined hyperechoic and hypoechoic regions are identified within the left aspect of the mass. The right aspect of the mass has a well-defined circular region with well-defined regions of hyper- and hypoechogenicity. The adjacent ventral colonic wall is outlined by arrowheads and is irregularly thickened

Figure 2

Gross pathologic cut-section of colonic mass which correlates to the ultrasound image in Figure 1 (cat 2). A focal, well-encapsulated, eccentric mural mass is present within the colon. The well-defined cavitation in the right side of the mass correlates with the circular region containing well-defined areas of hyper- and hypoechogenicity in the ultrasound image (Figure 1), and histologically represents an area of necrosis. There is focal narrowing of the colonic lumen secondary to the mass and there is thickening of the adjacent colonic wall

Figure 3

Ultrasonographic image (cat 4). Transverse sonogram of a thickened jejunal segment with an eccentric, inhomogeneous mural mass measuring 1 cm in thickness. Note the marked muscular layer thickening of the affected intestinal segment, as well as the adjacent intestinal loop (to the right of the calipers)

Figure 4

Subgross photomicrograph of a surgical biopsy of a jejunal mass (cat 4). The poorly demarcated, dense, basophilic mass (at left) regionally disrupts and effaces the intestinal wall (asterisk)

Figure 5

Photomicrograph of a surgical biopsy of a jejunal mass (cat 4) (10×). The mass infiltrates intestinal smooth muscle at left. The mass is densely cellular and basophilic, and contains thick, sclerotic collagen trabeculae (asterisk)