A CASE OF PRIMARY INTRATHORACIC FELINE EOSINOPHILIC SCLEROSING FIBROPLASIA WITH INTRALESIONAL BACTERIA

Type:
Case Report
Topic:
Feline Medicine
Companies:
(1) UCD Veterinary Hospital, Dublin, Ireland
Authors:
Antoine Duclos (1)
Carmel Mooney (1)
RESUMEN CORTO - SHORT SUMMARY:

A 9-year-old neutered female domestic short-hair cat was presented for investigation of a cranial mediastinal mass. Peripheral eosinophilia (2.68 (reference interval 0-1.5) x109/L, and hyperglobulinaemia (globulin 60.6 (reference interval 25-45) g/L) with polyclonal gammopathy were identified. Thoraco-abdominal CT-scan documented a cranial mediastinal mass encircling the trachea. Given the clinical presentation, neoplasia (lymphoma, mast cell tumour) was primarily suspected but inflammatory and infectious causes were also considered.
Cytology and histopathology obtained through ultrasound-guided fine-needle aspiration and biopsy were inconclusive. Surgical debulking was performed.
Histopathology identified severe pyogranulomatous and eosinophilic fibrosing mediastinitis, consistent with extra-abdominal feline eosinophilic sclerosing fibroplasia. Gram staining and fluorescence in-situ hybridisation (FISH) identified numerous intralesional coccoid gram-positive bacteria. Eosinophilia and hyperglobulinaema resolved following surgery and combined antimicrobial and immunosuppressive therapy. The cat died 2 months later after developing acute haemorrhagic diarrhoea and dyspnoea.

Feline eosinophilic sclerosing fibroplasia is mainly confined to the gastrointestinal tract although intra-abdominal extra-gastrointestinal cases have been reported, as well as primary gastrointestinal cases with secondary involvement of mediastinal lymph nodes, with or without pleural effusion. 

To the authors’ knowledge, this is the first report of primary intrathoracic feline eosinophilic sclerosing fibroplasia. Although not observed on histopathology, intralesional bacteria were identified using Gram staining and FISH examination. The presence of intralesional bacteria in the mediastinal tissue supports their involvement in the pathogenesis of the disease rather than representing secondary infection.

Feline eosinophilic sclerosing fibroplasia should be suspected in any cat with abdominal and/or thoracic masses particularly if associated with peripheral eosinophilia and polyclonal gammopathy.

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