ACVIM guidelines on diagnosing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats
Lymphoplasmacytic enteritis (LPE) and low-grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging. The objective of this consensus statement was to summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats, providing guidance on the differentiation between LPE and LGITL in cats.
A panel of six experts in the field (two internists, one radiologist, one anatomic pathologist, one clonality expert, one oncologist) with the support of a human medical immunologist, assessed and summarized evidence in the peer-reviewed literature. The team complemented the search with a review of consensus recommendations.
Despite increasing interest in the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature was challenging because of the heterogeneity of the cases. Most recommendations by the panel were supported by a moderate or low level of evidence. Several understudied areas were identified, including cellular markers using immunohistochemistry, genomics and transcriptomic studies.
The team concluded that, to date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats. A diagnosis is established by integrating all available clinical and diagnostic data. Histopathology remains the mainstay to better differentiate LPE from LGITL in cats with chronic enteropathy.
Sina Marsilio et al. “ACVIM consensus statement guidelines on diagnosing and distinguishing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats.” J Vet Intern Med. 2 May 2023. doi: 10.1111/jvim.16690.
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