背景:淋巴浆细胞性肠炎(LPE)和低度肠道T细胞淋巴瘤(LGITL)是老年猫的常见疾病,但它们的诊断和鉴别仍然具有挑战性。
目的:总结目前关于猫LPE和LGITL的病因和诊断的文献,为猫LPE和LGITL的鉴别提供指导。提供使用基于证据的方法或缺乏此类证据的陈述,基于该领域专家共识的声明。
方法:无。
方法:该领域的6名专家组成的小组(2名内科医生,1个放射科医生,1位解剖病理学家,1个克隆专家,1名肿瘤学家)在人类医学免疫学家的支持下,旨在评估和总结同行评审文献中的证据,并以共识建议作为补充。
结果:尽管临床医生和病理学家对该主题的兴趣日益浓厚,很少有前瞻性研究可用,由于案例的异质性,对相关文献的解释往往具有挑战性。专家小组的大多数建议都得到了中等或低水平证据的支持。确定了几个研究不足的地区,包括使用免疫组织化学的细胞标记,基因组学,和转录组学研究。
结论:迄今为止,没有单一的诊断标准或已知的生物标志物能够可靠地区分猫肠道的炎性病变和肿瘤淋巴增生,目前的诊断是通过整合所有可用的临床和诊断数据来建立的.在患有慢性肠病的猫中,组织病理学仍然是更好地区分LPE和LGITL的主要方法。
BACKGROUND: Lymphoplasmacytic enteritis (LPE) and low-grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging.
OBJECTIVE: To summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats and provide guidance on the differentiation between LPE and LGITL in cats. To provide statements established using evidence-based approaches or where such evidence is lacking, statements based on
consensus of experts in the field.
METHODS: None.
METHODS: A panel of 6 experts in the field (2 internists, 1 radiologist, 1 anatomic pathologist, 1 clonality expert, 1 oncologist) with the support of a human medical immunologist, was formed to assess and summarize evidence in the peer-reviewed literature and complement it with
consensus recommendations.
RESULTS: Despite increasing interest on the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature often was challenging because of the heterogeneity of the cases. Most recommendations by the panel were supported by a moderate or low level of evidence. Several understudied areas were identified, including cellular markers using immunohistochemistry, genomics, and transcriptomic studies.
CONCLUSIONS: To date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats and a diagnosis currently is established by integrating all available clinical and diagnostic data. Histopathology remains the mainstay to better differentiate LPE from LGITL in cats with chronic enteropathy.