A Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia in a Scottish Fold Cat: A Case Report

Abstract

A 2-year-old intact female Scottish fold cat was presented to the Prasu-Arthorn Animal Hospital, Faculty of Veterinary Science, Mahidol University, for a right nephrectomy because a renal mass was suspected. During the physical examination, the animal had an intra-abdominal mass with abdominal discomfort. No history of vomiting and diarrhea was reported. The blood chemistry and hematology revealed a markedly low albumin/globulin ratio and mild anemia with normal leukogram. The abdominal ultrasonographic examination and CT scan revealed an intestinal mass at the ileocecocolic junction. The mass was surgically excised, and jejuno-colic anastomosis was performed. Grossly, the mass was firm, very well circumscribed, measured 6×7×5 cm in diameter, and had fairly discrete central areas of tan to white discoloration. Microscopically, the wall of the large intestine was regionally extensively expanded by abundant, dense, thick bands of fibroplasia with associated dense infiltrates of predominant eosinophils, fewer lymphocytes and plasma cells, and multifocal areas of necrosis. Special staining for toluidine blue, Masson’s trichrome, Periodic Acid Schiff (PAS), and Grocott Gomori methenamine silver stain (GMS) along with immunohistochemistry for CD3, CD20, and KIT was performed to rule out the possibility of infectious disease and other potential neoplasms such as mast cell tumor, lymphoma, and gastrointestinal stromal tumor. Taken together, the observed findings were most consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). The immunosuppressive drugs were administered: prednisolone 2 mg/kg, orally every 24 hours, and cyclosporine 4.8 mg/kg, orally every 24 hours. The prednisolone dosage was tapered down by 25% every six weeks. There was no evidence of local recurrence detected in 172 days post-operation. In this case, a successful combination of surgical and medical treatment protocols and diagnostic techniques of the FGESF case was presented.