Difference between revisions of "Feline Eosinophilic Granuloma"

Revision as of 10:22, 21 August 2009

Typical Signalment

More commonly found in young cats (2-6 years)
More common in females than males

Description

Feline eosinophilic granuloma complex includes three lesions:

Eosinophilic ulcer - on lip or oral mucosa of middle-aged cats.
Eosinophilic plaque - on the skin of the medial thighs and abdomen.
Eosinophilic granuloma - on the posterior aspect of the rear legs of young cats and also found on the tongue, palate and oral mucosa.

Eosinophilic granulomas of the oral cavity appear as yellow/pink raised linear lesions. They can occur on the oral mucosa, hard palate mucosa, soft palate, or the base of the tongue. Cats with eosinophilic lesions of the mouth often have concurrent skin lesions.

The cause of feline eosinophilic granuloma is unknown but it has been associated with food and insect bite allergies, atopy, immunosuppression, bacteral and viral infections.

Diagnosis

An ulcerated mass may be found at the base of the tongue or on the hard palate, the glossopalatine arches or anywhere else in the mouth.

Clinical Signs

dysphagia
halitosis
+/- anorexia

Laboratory tests

Peripheral blood eosinophilia may be present.

Biopsy

A deep biopsy specimen of the mass is required for a definitive diagnosis
Histology reveals an eosinophilic tissue infiltrate

Treatment

Medical
- Control ectoparasites
- Diet trial and skin testing may be carried out to rule out food allergy and atopy
- Antibiotics if there is evidence of a bacterial infection
- Corticosteroid therapy if the patient is refractory to the above. Treatment should be tapered gradually once a response is seen then discontinued once signs have completely disappeared.
- Chlorambucil may be useful in resistent cases

Surgical
- Surgical excision is required for large lesions that interfere with breathing or swallowing.

Prognosis

Good but the lesion can recur.

References

Tutt, C., Deeprose, J. and Crossley, D. (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA

Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier

@@ Line 1: / Line 1: @@
-{{OpenPagesTop}}
+{{unfinished}}
-Also known as: '''''Rodent ulcer — Eosinophilic ulcer — Eosinophilic plaques — Eosinophilic granuloma'''''
-== Introduction ==
+{{cat}}
-Feline eosinophilic granuloma complex includes three types of lesions:
+==Typical Signalment==
+*More commonly found in young cats (2-6 years)
+*More common in females than males
-#Eosinophilic or rodent '''ulcers''' which present as a well circumscribed, erythematous ulcer on the lip or oral mucosa of middle-aged cats
+==Description==
-#Eosinophilic '''plaques''' which present as raised erythematous lesions on the skin of the medial thighs and abdomen
+Feline eosinophilic granuloma complex includes three lesions:
-#Eosinophilic or linear '''granuloma''' which present on the posterior aspect of the rear legs of young cats and also found on the [[Tongue - Anatomy & Physiology|tongue]], [[Hard Palate|hard palate]] and oral mucosa.
+#Eosinophilic ulcer - on lip or oral mucosa of middle-aged cats.
+#Eosinophilic plaque - on the skin of the medial thighs and abdomen.
+#Eosinophilic granuloma -  on the posterior aspect of the rear legs of young cats and also found on the tongue, palate and oral mucosa.
-Eosinophilic granulomas of the '''oral cavity''' appear as '''yellow/pink raised linear lesions'''. They can also occur on the soft palate, or the base of the tongue. Cats with eosinophilic lesions of the mouth often have concurrent skin lesions.
+Eosinophilic granulomas of the oral cavity appear as yellow/pink raised linear lesions. They can occur on the oral mucosa, hard palate mucosa, soft palate, or the base of the tongue. Cats with eosinophilic lesions of the mouth often have concurrent skin lesions.
-The cause of feline eosinophilic granuloma is unknown but it has been associated with food and insect bite allergies ([[:Category:Hypersensitivity|hypersensitivity]]), [[atopy]], immunosuppression, bacterial and viral infections.
+The cause of feline eosinophilic granuloma is unknown but it has been associated with food and insect bite allergies, atopy, immunosuppression, bacteral and viral infections.
-== Signalment ==
+==Diagnosis==
+An ulcerated mass may be found at the base of the tongue or on the hard palate, the glossopalatine arches or anywhere else in the mouth.
-More commonly found in young cats (2-6 years) and also more common in females than males. It can also occur in dogs, particularly Siberian Huskies.
+===Clinical Signs===
+*dysphagia
+*halitosis
+*+/- anorexia
-== Clinical Signs ==
+===Laboratory tests===
+*Peripheral blood [[Changes in Inflammatory Cells Circulating in Blood - Pathology#Eosinophilia|eosinophilia]] may be present.
-Depending on site of lesion can include dysphagia, halitosis and anorexia. Eosinophilic plaque lesions are intensely pruritic.
+===Biopsy===
+*A deep biopsy specimen of the mass is required for a definitive diagnosis
+*Histology reveals an eosinophilic tissue infiltrate
-== Diagnosis ==
+==Treatment==
-An ulcerated mass may be found at the base of the tongue or on the hard palate, the glossopalatine arches or anywhere else in the mouth as described above. On laboratory tests, a peripheral blood [[Eosinophilia|eosinophilia]] may be present, especially for eosinophilic plaques.
+*'''Medical'''
+**Control ectoparasites
+**Diet trial and skin testing may be carried out to rule out food allergy and atopy
+**Antibiotics if there is evidence of a bacterial infection
+**Corticosteroid therapy if the patient is refractory to the above. Treatment should be tapered gradually once a response is seen then discontinued once signs have completely disappeared.
+**Chlorambucil may be useful in resistent cases
-Impression smears: Eosinophilic plaques exfoliate easily and eosinophils predominate the sample.
+*'''Surgical'''
+**Surgical excision is required for large lesions that interfere with breathing or swallowing.
+==Prognosis==
+*Good but the lesion can recur.
+==References==
-A deep biopsy specimen of the mass is required for a definitive diagnosis.
+*Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
-== Pathology ==
+*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''
-Grossly, there are raised plaques, erythematous, pruritic, erosed or ulcerated areas.
-Microscopically, acanthosis, spongiosis, erosions or ulceration, predominantly eosinophilic dermatitis, possibly areas of collagen degeneration can all be found.
-Histology reveals:
-:Eosinophilic ulcers: show hyperplastic, ulcerated, superficial perivascular to interstitial dermatitis. Fibrosis may also be present.
-:Eosinophilic plaques: appear as superficial hyperplasia, deep perivascular dermatitis with eosinophilia. Diffuse spongiosis of the outer root sheaths of hair follicles may also be noted.
-:Eosinophilic granulomas: reveal nodular to diffuse granulomatous dermatitis with flame figures. Eosinophils and multinucleated histiocytic giant cells are commonly found.
-== Treatment ==
-Initial medical treatment is to control any ectoparasites. Secondly a diet trial and intradermal allergy testing may be carried out to rule out food allergy and atopy. If there is evidence of a bacterial infection [[Antibiotics|antibiotics]] are necessary.
-If the patient is refractory to the above [[Steroids|Corticosteroid]] should be administered. Treatment should be tapered gradually once a response is seen then discontinued once signs have completely disappeared.
-Chlorambucil may also be useful in resistant cases.
-Surgical excision is required for large lesions that interfere with breathing or swallowing.
-== Prognosis ==
-Good if the allergy is identified and addressed. Otherwise the lesion can recur and lifelong steroid treatment may be necessary.
-{{Learning
-|flashcards = [[Veterinary Dentistry Q&A 05]]<br>[[Small Animal Dermatology Q&A 05]]
-|literature search = [http://www.cabdirect.org/search.html?q=%28title%3A%28%22Eosinophilic+Granuloma%22%29+OR+title%3A%28%22Rodent+ulcer%22%29+OR+title%3A%28%22Eosinophilic+ulcer%22%29+OR+title%3A%28%22Eosinophilic+plaques%22%29%29+AND+od%3A%28cats%29 Feline Eosinophilic Granuloma publications]
-|Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis60003.asp Eosinophilic Granuloma]
-}}
-== References ==
-Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry'''(3rd Edition) ''BSAVA''
-Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine''' (Fourth Edition) Mosby Elsevier.
-Norsworthy, G. (2010) '''The Feline Patient''' ''John Wiley and Sons''
-{{review}}
-{{OpenPages}}
-[[Category:Integumentary_System_-_Pathology]] [[Category:Oral_Cavity_and_Gingiva_-_Pathology]] [[Category:Oral_Diseases_-_Cat]] [[Category:Dermatological_Diseases_-_Cat]] [[Category:Expert_Review - Small Animal]] [[Category:Allergic_Skin_Diseases]]
-[[Category:Oral Proliferations]]
-[[Category:LisaM reviewing]]