Multiple small intestinal pseudodiverticula associated with lymphoma in three horses

Abstract

SummaryThree mature horses presented with progressive weight loss, inappetence, ventral abdominal oedema and lethargy. Two of the animals had intermittent signs of low grade abdominal pain. At presentation, all 3 had hypoalbuminaemia; 2 had hyperfibrinogenaemia and the other had neutrophilia. An oral glucose tolerance test was performed in 2 cases, both of which demonstrated impaired glucose absorption. One pony treated with corticosteroids failed to improve and developed peritonitis and was subjected to euthanasia after 2 weeks. One pony had small intestinal biopsies obtained via a standing flank laparotomy, which revealed a mainly mononuclear cell infiltrate of the mucosa. It failed to respond to treatment with antibiotics and corticosteroids and, after 2 months, developed sternal oedema in addition to the ventral abdominal oedema and peritonitis and was subjected to euthanasia. The remaining pony deteriorated despite symptomatic therapy and was subjected to euthanasia after one week. At post mortem examination, all 3 animals had multifocal lesions of small intestinal wall thickening, mucosal ulceration, pseudodiverticula and enlarged mesenteric lymph nodes. One pony also had a multinodular mass at the root of the mesentery, a mediastinal mass and a lung mass. Histological examination confirmed the presence of lymphoma of the intestinal wall at post mortem examination in each case and immunohistochemistry (including retrospective evaluation of the intestinal biopsies obtained from the pony that underwent a flank laparotomy) indicated that the lymphomas were of T cell origin.

Transdiaphragmatic Hepatic and Pulmonary Abscess Attributed to Ileal Diverticulitis in a Horse

“…Suggested predisposing factors for small intestinal muscular hypertrophy include Anoplocephala perfoliata at the ileocecal junction, mucosal inflammation, uncontrolled peristalsis, and intestinal sand accumulation. An association between ileal muscular hypertrophy and ileal diverticula has been suggested . In contrast to the current case report, the most common clinical presentation of horses with small intestinal diverticula is chronic colic.…”

Ultrasound as a diagnostic tool in the investigation of a pony with intestinal lymphoma

“…Additionally, pseudodiverticula recognised in horses with lymphoma have been noted on the antimesenteric border attributed to the location of the Peyer's patches (Mair et al . ) in contrast to this lesion which affected the intestine circumferentially.…”

“…Pseudodiverticula have been previously identified grossly in horses with lymphoma (Mair et al . ). Although these pseudodiverticula measured up to 10 cm diameter they were not identified ultrasongraphically (Mair et al .…”

“…Although these pseudodiverticula measured up to 10 cm diameter they were not identified ultrasongraphically (Mair et al . ). The lesion in this case may have represented a pseudodiverticulum defined as a mucosal outpouching through the muscularis but the circumferential loss of structure and increase in diameter is suggestive of a focal intestinal dilatation.…”

Caecal perforation

“…; Mair et al . ) and muscular hypertrophy. Acquired pseudodiverticula associated with muscular hypertrophy have been recorded occasionally in the duodenum (Cordes and Dewes ) and jejunum (Chaffin et al .…”