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Enteropatias Crónicas Em Gatos: Abordagem Diagnóstica Na Diferenciação Entre Enterite Linfoplasmocitária E Linfoma De Baixo Grau
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Abstract(s)
A enterite linfoplasmocitária e o linfoma intestinal de baixo grau são doenças frequentemente encontradas na população felina, apresentando várias semelhanças clínicas, analíticas e imagiológicas. No entanto, o tratamento e o prognóstico podem, em alguns casos, diferir. Nesse sentido, um diagnóstico definitivo destas doenças é essencial. Para isso, é necessária uma análise histopatológica, com amostras recolhidas por biópsias intestinais transparietais (envolvendo toda a espessura da parede), mais fiáveis em comparação com as amostras recolhidas por endoscopia. A análise histopatológica convencional pode ser complementada com exames adicionais, incluindo imunocitoquímica, imunohistoquímica e testes de clonalidade, para um diagnóstico mais preciso.
Estudos mais recentes descobriram outras abordagens no diagnóstico, como a utilidade da espectrometria de massa guiada por histologia ou ainda a identificação de um biomarcador do linfoma, que se revelaram promissoras. Uma terapia nutricional envolvendo dietas de fácil assimilação, monoprotéicas ou com alimentos hidrolisados pode melhorar os sinais clínicos das enterites linfoplasmocitárias, mas em muitos casos é necessário recorrer à corticoterapia para manter o paciente em remissão. No caso de linfoma, de acordo com as suas características, a quimioterapia é o tratamento de eleição, embora possam ocorrer recidivas.
Lymphoplasmacytic enteritis and low-grade intestinal lymphoma are diseases frequently found in the feline population, presenting various clinical, analytical, and imaging similarities. However, the treatment and prognosis can, in some cases, differ. In this regard, a definitive diagnosis of these diseases is essential. For this purpose, histopathological analysis is necessary, with samples collected through full- thickness intestinal biopsies, which are more reliable compared to samples collected by endoscopy. Conventional histopathological analysis can be complemented with additional tests, including immunocytochemistry, immunohistochemistry, and clonality testing, for a more accurate diagnosis. Recent studies have discovered other diagnostic approaches, such as the utility of histology-guided mass spectrometry or the identification of a lymphoma biomarker, which have proven to be promising. Nutritional therapy involving easily digestible diets, single-protein diets, or hydrolyzed foods can improve the clinical signs of lymphoplasmacytic enteritis, but in many cases, corticosteroid therapy is necessary to maintain the patient in remission. In the case of lymphoma, depending on its characteristics, chemotherapy is the treatment of choice, although relapses may occur.
Lymphoplasmacytic enteritis and low-grade intestinal lymphoma are diseases frequently found in the feline population, presenting various clinical, analytical, and imaging similarities. However, the treatment and prognosis can, in some cases, differ. In this regard, a definitive diagnosis of these diseases is essential. For this purpose, histopathological analysis is necessary, with samples collected through full- thickness intestinal biopsies, which are more reliable compared to samples collected by endoscopy. Conventional histopathological analysis can be complemented with additional tests, including immunocytochemistry, immunohistochemistry, and clonality testing, for a more accurate diagnosis. Recent studies have discovered other diagnostic approaches, such as the utility of histology-guided mass spectrometry or the identification of a lymphoma biomarker, which have proven to be promising. Nutritional therapy involving easily digestible diets, single-protein diets, or hydrolyzed foods can improve the clinical signs of lymphoplasmacytic enteritis, but in many cases, corticosteroid therapy is necessary to maintain the patient in remission. In the case of lymphoma, depending on its characteristics, chemotherapy is the treatment of choice, although relapses may occur.
Description
Keywords
Enteropatia Crónica Felina Enterite Linfoplasmocitária Linfoma Gastrointestinal de Células Pequenas Imunohistoquímica Teste de Clonalidade Espectrometria de Massa Biomarcador Corticoterapia Quimioterapia Feline Chronic Enteropathy Lymphoplasmacytic Enteritis Small Cell Lymphoma Immunohistochemistry Clonality Test Mass Spectrometry Biomarker Corticosteroid Therapy Chemotherapy