Thieme Maureen E, Olsen Anastasia M, Woolcock Andrew D, Miller Margaret A, Simons Micha C
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.
JFMS Open Rep. 2019 Aug 16;5(2):2055116919867178. doi: 10.1177/2055116919867178. eCollection 2019 Jul-Dec.
A 4-year-old neutered male cat was presented with a 2-month history of intermittent constipation that progressed to obstipation. Primary clinical findings included a large, multi lobulated mass in the caudodorsal abdomen, peripheral eosinophilia and hyperglobulinemia. Abdominal imaging revealed a multilobulated, cavitated mass in the sublumbar region. Exploratory celiotomy revealed multiple firm masses in the sublumbar retroperitoneal space causing ventral displacement and compression of the descending colon with extension of the masses into the pelvic canal. Histopathology was consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). Aerobic culture was positive for . The cat was treated with prednisolone (2 mg/kg PO q24h), lactulose (0.5 g/kg PO q8h), amoxicillin/clavulanic acid (62.5 mg/cat PO q12h for 1 month) and fenbendazole (50 mg/kg PO q24h for 5 days). Six months postoperatively, the cat had no recurrence of clinical signs. Repeat evaluation and imaging at day 732 postoperatively revealed marked improvement of the abdominal mass, resolution of peripheral eosinophilia and no clinical signs with continued prednisolone therapy (0.5 mg/kg PO q24h).
This is a report of a primary extramural FGESF lesion, and the first description of characteristics of FGESF on CT. Previous evidence suggests that the most favorable outcomes require immunosuppressive therapy and complete surgical excision; however, this case demonstrates a favorable outcome with medical management alone.
一只4岁已绝育雄性猫，出现间歇性便秘2个月，后发展为完全性便秘。主要临床发现包括在尾背部腹部有一个大的、多叶状肿块，外周嗜酸性粒细胞增多和球蛋白血症。腹部影像学检查显示腰下部区域有一个多叶状、有空洞的肿块。剖腹探查显示腰下部腹膜后间隙有多个坚实肿块，导致降结肠腹侧移位和受压，肿块延伸至盆腔。组织病理学与猫胃肠道嗜酸性硬化性纤维增生症（FGESF）一致。需氧培养结果为阳性。该猫接受泼尼松龙（2mg/kg口服，每24小时一次）、乳果糖（0.5g/kg口服，每8小时一次）、阿莫西林/克拉维酸（62.5mg/猫口服，每12小时一次，共1个月）和芬苯达唑（50mg/kg口服，每24小时一次，共5天）治疗。术后6个月，该猫无临床症状复发。术后第732天的重复评估和影像学检查显示腹部肿块明显改善，外周嗜酸性粒细胞增多症消退，继续使用泼尼松龙治疗（0.5mg/kg口服，每24小时一次）无临床症状。
这是一篇关于原发性壁外FGESF病变的报告，也是首次对FGESF在CT上的特征进行描述。先前的证据表明，最有利的结果需要免疫抑制治疗和完全手术切除；然而，本病例表明仅通过药物治疗也能取得良好效果。
