Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia

Abstract

Background: Gastrointestinal eosinophilic sclerosing fibroplasia (GESF) in cats presents as mass(es) associated with the gastrointestinal tract, mesentery, and abdominal lymph nodes.

Hypothesis/objectives: To report the clinicopathological findings, treatment, and outcome of cats with GESF.

Animals: Sixty client-owned cats diagnosed with GESF.

Methods: Retrospective review of medical records of cats with histopathologically confirmed GESF.

Results: The median age was 5.4 years (interquartile range [IQR], 3.3-8.9.); 30% were Domestic Shorthairs and 12% were Domestic Longhair cats, with the most prevalent pedigree breeds being Ragdolls (25%), Exotic Shorthair (10%) and Persian (8%) cats. The median duration of clinical signs was 90 days (IQR, 17.5-247.0); the most common clinical signs were weight loss (60%), hyporexia/anorexia (55%), chronic vomiting (37%), lethargy (35%) and chronic diarrhea (27%). Masses were located in the small intestine (32%), stomach (27%), ileocolic junction (15%), colon (10%), lymph node (8%) and mesentery (8%) and 15% of cats had >1 mass. Eosinophilia was present in 50% and hypoalbuminemia in 28% of cats. The mass was removed surgically in 37% of cases. Most cats (98%) were treated with corticosteroids. Survival was not statistically different between cats treated with surgical resection and cats treated with medical therapy alone, 88% of the cats were still alive at the time of writing.

Conclusions and clinical importance: GESF is an important differential diagnosis for abdominal masses in cats, and has a much better prognosis than previously reported.

Keywords: eosinophilia; gastrointestinal mass; mesenteric mass; ragdoll.

FIGURE 1

Ultrasonographic image of a mass at the level of the ileocolic junction (white arrow). The mass shows loss of layering, circumferential thickening and eccentric growth. The wall is heterogeneously mixed in echogenicity because of hyperechoic areas. The surrounding peritoneum is hyperechoic (asterisk).

FIGURE 2

Common locations of the masses found in cats with gastrointestinal sclerosing fibroplasia in this study. Y‐axis represents the % of masses in the location.

FIGURE 3

Histological findings of the duodenal mass—the muscularis and submucosa are expanded by a discrete, sparsely cellular mass (*). Hematoxylin & eosin, 20× magnification. Scale bar = 500 μm. Photo credit: Dr Allison Watson from Colorado State University.

FIGURE 4

Histological findings of the duodenal mass—the mass is composed of anastomosing trabeculae of sclerotic collagen separated by fibroblasts, macrophages, and small numbers of eosinophils and mast cells. Hematoxylin & eosin, 200× magnification. Scale bar = 50 μm. Photo credit: Dr Allison Watson from Colorado State University.

FIGURE 5

Kaplan‐Meier plot of survival of cats that had a surgical resection of the mass and cats where the mass was biopsied only (P = .19). Tick marks represent censored cats. Green line is cats where mass was surgically removed, and blue line is cats where mass was not removed.