found to match the WHO entity EATL type II. and distinguishes two entities : first, “mucosal lymphomas” which are usually low-grade forms of alimentary lymphoma (LGAL) and are predominantly of small T-cell type (nuclear diameter < 2 red cell diameters) that Moore et al. The current classification system for this disease has been defined by Moore et al. EATL type II has been recently renamed as Monomorphic Epitheliotropic T-cell Lymphoma (MEITL), calling into question its relationship with classical EATL and implying that it might be best to consider it as a separate entity. EATL type II (10–20% of EATL) is less frequently associated with coeliac disease and is characterised by monomorphic population with frequent expression of CD56. They also differ in how frequently they are associated with coeliac disease : EATL type I (80–90% of EATL) is strongly associated with coeliac disease, has usually a large-cell or pleomorphic cytology and may express CD30. Recent studies in human medicine indicate that EATL consists of two diseases that are morphologically and genetically distinct. Originally, lymphomas were classified according to the World Health Organization (WHO) scheme into Enteropathy-Associated T-cell Lymphoma (EATL) type 1 and 2. Several subtypes of AL can be defined according to the histological grade (low, intermediate or high), cell size (small or large) and phenotype (T or B) of the neoplastic lymphocytes. Not only is this the most common anatomical form of lymphoma (50 to 75%), it is also the most common alimentary neoplasia in cats. A final type, alimentary lymphoma (AL) targets the gastrointestinal tract with variable involvement of extra-intestinal sites including lymph nodes, liver, spleen. Feline lymphomas are usually classified according to anatomical location, with various types recognised including mediastinal, multicentric, and extra-nodal. Lymphoma is a clonal expansion of neoplastic lymphocytes in solid organs and is the most common feline neoplasm. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. The pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. 130 studies were found from the veterinary literature and 46 from the human medicine literature. ResultsĪ total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Low-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine.
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