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Tierarztl Prax Ausg K Kleintiere Heimtiere 2015; 43(01): 15-22
DOI: 10.15654/TPK-140241
Original Article
Schattauer GmbH

Cytology of endoscopically obtained biopsies for the diagnosis of chronic intestinal diseases in cats

Wert der zytologischen Untersuchung endoskopisch gewonnener Darmbioptate zur Diagnostik chronischer Enteropathien bei der Katze
S. Mangelsdorf
1   Small Animal Clinic Haar, Haar, Germany
1   Small Animal Clinic Haar, Haar, Germany
,
E. Teske
1   Small Animal Clinic Haar, Haar, Germany
2   Department of Clinical Sciences of Companion Animals, University of Utrecht, The Netherlands
,
W. v. Bomhard
1   Small Animal Clinic Haar, Haar, Germany
3   Speciality Practice for Veterinary Pathology, Munich, Germany
,
C. Stockhaus
1   Small Animal Clinic Haar, Haar, Germany
1   Small Animal Clinic Haar, Haar, Germany
› Author Affiliations
Further Information

Publication History

Received: 12 March 2014

Accepted after revision: 08 January 2014

Publication Date:
08 January 2018 (online)

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Summary

Objective: To evaluate the diagnostic value of cytology of endoscopically obtained biopsies in cats presented for chronic gastrointestinal complaints with emphasis on the diagnosis of low-grade alimentary lymphoma (LGAL). Materials and methods: Data of endoscopically obtained duodenal biopsies from 137 cats were evaluated retrospectively. Cytology was performed using the squash smear technique with subsequent Diff Quick® staining. Pathological findings were categorized according to type and grade of the inflammatory infiltrate. Moreover, reports were reviewed with regard to diagnosis of LGAL. Histopathology reports were analysed correspondingly and compared to cytology results. Histopathological samples were further evaluated by immunohistochemistry (IHC) if a diagnosis of LGAL had been expressed. Results: Squash smear preparation of intestinal biopsies was adequate for cytological examination in > 97% of cases. Using histopathology as gold standard, with cytology, a sensitivity and specificity for detection of a pathologic process in feline intestinal biopsies of 68.1% and 70.6% were calculated, respectively. Regarding the detection of lymphoplasmacytic (LPE) and eosinophilic enteritis a statistically significant correlation with histopathology (p < 0.05) was observed. With regard to grade of the inflammatory infiltrate, a weak correlation was calculated (r = 0.482). Of 21 cats diagnosed or suspected with LGAL by cytology, IHC confirmed nine cases whereas 11 cases were reclassified as LPE. None of the confirmed LGAL had been missed with histopathology. A sensitivity of 60.0% and specificity of 90.6% for cytological detection of feline LGAL was obtained. Conclusion and clinical relevance: The sensitivity of cytology to diagnose LGAL is low and it has no additional significance to histological biopsies.

Zusammenfassung

Gegenstand und Ziel: Ermittlung der diagnostischen Wertigkeit einer zytologischen Untersuchung endoskopisch gewonnener Dünndarmbioptate von Katzen mit chronischen gastrointestinalen Symptomen mit dem Schwerpunkt der Diagnose eines reifzelligen alimentären Lymphoms. Material und Methoden: Die zytologischen Befunde endoskopisch gewonnener Darmbioptate von 137 Katzen wurden retrospektiv ausgewertet und mit den Resultaten der histologischen Untersuchung verglichen. Die zytologischen Proben wurden mit der Quetschtechnik vorbereitet und mit Diff Quick® gefärbt. Die zytologische Untersuchung erfolgte hinsichtlich Art und Schweregrad der Entzündung sowie Hinweisen auf ein reifzelliges alimentäres Lymphom. Die Histologieberichte wurden dementsprechend ausgewertet. Bioptate mit zytologischem oder histologischem Verdacht eines reifzelligen alimentären Lymphoms wurden mittels Immunhistochemie (IHC) evaluiert. Ergebnisse: Die Quetschtechnik ergab mehr als 97% qualitativ adäquate Darmpräparate. Sensitivität und Spezifität der zytologischen Untersuchung für die Diagnose eines pathologischen Befundes betrugen 68,1% bzw. 70,6%. Die histologische Untersuchung war als Goldstandard definiert. Eine statistisch signifikante Korrelation bestand zwischen zytologischer sowie histologischer Beschreibung von Lymphozyten/Plasmazellen und eosinophilen Granulozyten (p < 0,05). Hinsichtlich des Grades der Entzündungszellinfiltration wurde lediglich eine schwache Korrelation ermittelt (r = 0,482). Von 21 Bioptaten mit zytologischer Diagnose oder Verdacht eines reifzelligen alimentären Lymphoms ließen sich neun Fälle durch die IHC bestätigen. Elf der lymphomverdächtigen Proben wurden nach der IHC als lymphoplasmazelluläre Enteritis eingestuft. Sensitivität und Spezifität für die zytologische Erkennung eines alimentären Lymphoms lagen bei 60,0% bzw. 90,6%. Schlussfolgerung und klinische Relevanz: Die zytologische Untersuchung von Darmbioptaten hat eine relativ geringe Sensitivität in der Diagnostik eines reifzelligen alimentären Lymphoms und besitzt demnach keinen zusätzlichen Nutzen zur Histologie.

Keywords

Squash smear technique - inflammatory bowel disease - lymphoma - immunohistochemistry - histopathology

Schlüsselwörter

Quetschausstrichtechnik - entzündliche Darmerkrankung - Lymphom - Immunhistochemie - Histologie
 

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