ACVIMconsensus statement guidelines on diagnosing and distinguishing low‐grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats

Veterinary medicine 610 cat lymphoma Cat Diseases histology T-cell SDG 3 - Good Health and Well-being inflammatory bowel disease Clinical Research 616 SF600-1100 Humans Animals Veterinary Sciences Prospective Studies Lymphocytes alimentary endoscopy lymphoplasmacytic enteritis screening and diagnosis lymphoproliferative disorders Consensus Statement Inflammatory Bowel Diseases gastrointestinal Enteritis 3. Good health 4.1 Discovery and preclinical testing of markers and technologies Detection immunohistochemistry Cats chronic diarrhea Digestive Diseases
DOI: 10.1111/jvim.16690 Publication Date: 2023-05-02T16:40:14Z
ABSTRACT
AbstractBackgroundLymphoplasmacytic enteritis (LPE) and low‐grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging.ObjectivesTo summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats and provide guidance on the differentiation between LPE and LGITL in cats. To provide statements established using evidence‐based approaches or where such evidence is lacking, statements based on consensus of experts in the field.AnimalsNone.MethodsA panel of 6 experts in the field (2 internists, 1 radiologist, 1 anatomic pathologist, 1 clonality expert, 1 oncologist) with the support of a human medical immunologist, was formed to assess and summarize evidence in the peer‐reviewed literature and complement it with consensus recommendations.ResultsDespite increasing interest on the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature often 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.Conclusions and Clinical ImportanceTo date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats and a diagnosis currently 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.
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