Clinical, CT, and ultrasonographic features of canine and feline pleural and peritoneal carcinomatosis and sarcomatosis

Abstract

Carcinomatosis and sarcomatosis describe the widespread dissemination of metastatic neoplastic cells throughout the body. Studies describing their clinical and imaging features in veterinary patients are limited. The objective of this retrospective, multicenter, cross-sectional study is to describe the clinical, ultrasonographic, and CT features of pleural and peritoneal carcinomatosis and sarcomatosis in dogs and cats to aid detection and differentiation of these lesions. Medical records and CT and ultrasonographic images were reviewed. Although a large degree of overlap was observed between the imaging features and clinical signs of canine and feline carcinomatosis and sarcomatosis, some distinguishing features were observed. Dogs were significantly more likely to present with abdominal pain compared to cats (P = .022), whereas cats more commonly presented with inappetence (P = .019). Dogs with sarcomatosis had a significantly heavier bodyweight than dogs with carcinomatosis (P = .005), largely due to a higher prevalence of splenic hemangiosarcoma in this patient cohort. Peritoneal effusion was more frequently observed in dogs with carcinomatosis compared to dogs with sarcomatosis (P = .021). Imaging and clinical features observed in this study may help to distinguish sarcomatosis and carcinomatosis lesions. Due to the large degree of overlap observed, cytological or histopathological analysis is recommended for definitive diagnosis.

Computed tomographic findings of peritoneal lymphomatosis in a cat: a case report

“…The amount of ascites was similar to previous reports in human medicine. The typical CT findings described in feline peritoneal and pleural sarcomatosis, which included well-marginated, variable nodule size with heterogeneous soft tissue attenuation, remarkable rim-like enhancement (24 HU pre-contrast, 80 HU post-contrast), and cavitated, hyperattenuating mineralized foci, were not consistent with this patient [15]. The lack of histopathological analysis was a limitation in this case.…”

Feline abdominal ultrasonography: What’s normal? What’s abnormal? Abdominal lymph nodes, peritoneal cavity and aorta

“…Carcinomatosis refers to the widespread dissemination of neoplasia throughout a body cavity (peritoneal or, less commonly, pleural or cerebrospinal) and encompasses metastatic spread from epithelial (carcinomatosis), mes-enchymal (sarcomatosis) and haematopoietic (lymphomatosis) tumours. 37–42 Based on two studies comprising a total of 24 cats with abdominal carcinomatosis, primary tumours most commonly originated in the pancreas (n = 9), hepatobiliary system (n = 7) or small intestine (n = 5). 37,41 The vast majority of these cats had carcinomatosis due to spread of a primary epithelial tumour (n = 21).…”

“…37–42 Based on two studies comprising a total of 24 cats with abdominal carcinomatosis, primary tumours most commonly originated in the pancreas (n = 9), hepatobiliary system (n = 7) or small intestine (n = 5). 37,41 The vast majority of these cats had carcinomatosis due to spread of a primary epithelial tumour (n = 21). Two cats were diagnosed with lymphomatosis (ie, metastatic spread of lymphoma to the peritoneum) and a single cat with abdominal sarcomatosis owing to metastatic spread of haemangiosarcoma.…”

“…In the more recent of the two studies, the most common presenting complaint was inappetence, whereas abdominal pain, a relatively common finding in dogs with carcinomatosis, was not documented in any cat. 41 On ultrasound examination, multiple, variably sized, but often small, hypo-echoic nodules were present throughout the connecting peritoneal cavity, mesentery and omentum, associated with a variable volume of either anechoic or echogenic peritoneal effusion (Figure 20). 37,41 Primary or metastatic masses and nodules within solid organs, visceral and parietal peritoneal masses, lymph node enlargement and pleural effusion were also recognised.…”

“…In all four studies, ultrasound-guided fine-needle aspiration of visceral masses, peritoneal nodules and/or fluid was often helpful in confirming the diagnosis and ruling out differentials such as feline infectious peritonitis, pancreatitis, chronic peritonitis and mesothelioma. 37,41,43,44…”