Crouse Zachary, Phillips Brenda, Flory Andi, Mahoney Jennifer, Richter Keith, Kidd Linda
1 Angell Animal Medical Center, Boston, MA, USA.
2 Veterinary Specialty Hospital, San Diego, CA, USA.
J Feline Med Surg. 2018 Aug;20(8):696-703. doi: 10.1177/1098612X17723773. Epub 2017 Aug 15.
Objectives Gastrointestinal (GI) perforation is a well described complication of GI lymphoma in people, commonly occurring within days of initiation of chemotherapy. There are no studies documenting the prevalence of GI perforation in cats with intermediate- or large-cell GI lymphoma or whether it is associated with induction of chemotherapy. The objectives of this study were to document the prevalence and timing of post-chemotherapy perforation in cats with discrete GI masses caused by intermediate- or large-cell lymphoma. Methods Cats with a diagnosis of intermediate- or large-cell lymphoma based on cytologic or histopathologic examination of a mass lesion of the GI tract and treated with chemotherapy were identified by searching the patient record database of three large specialty referral hospitals. Cats undergoing surgical resection of a GI mass prior to chemotherapy were excluded from the study. A clinical diagnosis of GI perforation was made using ultrasound findings and analysis of abdominal fluid. Results Twenty-three cats with intermediate- (n = 3) or large-cell (n = 20) lymphoma were included in the study. GI perforation was confirmed in 4/23 cats (17%), and occurred at 23, 56, 59 and 87 days after induction. There was no association between tumor size, the presence of hypoproteinemia or suppurative inflammation within the mass at the time of diagnosis and subsequent perforation. Post-hoc analysis revealed that the magnitude of weight loss within 15-28 days of diagnosis was greater in cats with perforation. Conclusions and relevance In this pilot study, we found that post-chemotherapy GI perforation in cats with intermediate- or large-cell GI lymphoma occurs. Acute perforation after induction of chemotherapy was not documented. Larger prospective studies are needed to determine risk factors associated with perforation and whether surgical excision would reduce the risk of subsequent GI perforation in these patients.
目的 胃肠道穿孔是人类胃肠道淋巴瘤一种已被充分描述的并发症，通常在化疗开始数天内发生。尚无研究记录中、大细胞性胃肠道淋巴瘤猫胃肠道穿孔的发生率，也未研究其是否与化疗诱导有关。本研究的目的是记录由中、大细胞淋巴瘤引起的有离散性胃肠道肿块的猫化疗后穿孔的发生率和时间。方法 通过检索三家大型专科转诊医院的患者记录数据库，确定那些根据胃肠道肿块病变的细胞学或组织病理学检查诊断为中、大细胞淋巴瘤并接受化疗的猫。化疗前接受胃肠道肿块手术切除的猫被排除在研究之外。根据超声检查结果和腹腔积液分析做出胃肠道穿孔的临床诊断。结果 23只患有中（n = 3）或大细胞（n = 20）淋巴瘤的猫被纳入研究。4/23只猫（17%）确诊为胃肠道穿孔，发生在诱导化疗后23、56、59和87天。肿瘤大小、诊断时肿块内低蛋白血症或化脓性炎症的存在与随后的穿孔之间无关联。事后分析显示，穿孔猫在诊断后15 - 28天内体重减轻的幅度更大。结论及相关性 在这项初步研究中，我们发现中、大细胞性胃肠道淋巴瘤猫化疗后会发生胃肠道穿孔。未记录到诱导化疗后的急性穿孔。需要更大规模的前瞻性研究来确定与穿孔相关的危险因素，以及手术切除是否会降低这些患者随后发生胃肠道穿孔的风险。
