Gastrointestinal granuloma due to Candida albicans in an immunocompetent cat

Duchaussoy, Anne-Claire; Rose, Annie; Talbot, Jessica J.; Barrs, Vanessa R.

Thoracic radiographs were unremarkable, and an exploratory laparotomy was performed on Day 1. The origin of the proximal duodenum circumferential mass was confirmed to be just cranial to the pyloric sphincter extending 3 cm along the proximal duodenum. The mass was firm and hyperaemic and incorporated the opening of the common bile duct into the duodenum (Fig. 2 ). Gastric and mesenteric lymph nodes were also enlarged. Full resection of the mass and cholecystojejunostomy was recommended but declined by the owner due to financial constraints and potential complications of the procedure. Fine needle aspirates of the duodenal mass and gastric lymph node, full-thickness incisional biopsies of the mass, stomach, jejunum and ileum and excisional biopsies of the jejunal and gastric lymph nodes were performed. Repeat cytology of the duodenal mass revealed an eosinophil-rich inflammatory response and intralesional fungal elements (Fig. 3) . Inflammatory cells comprised neutrophils (32-90%), eosinophils (2-44%), mast cells (0-18%), lymphocytes (6%), macrophages (0-2%) and occasional plasma cells (Fig. 1) . In some of the cytological preparations there were numerous extracellular septate acute angle branching fungal hyphae (3-5 mm diameter), occasionally with a globose terminal end. Round to oval blastospores and germ tubes (2-3 mm diameter), some of which were intracellular within neutrophils, were also noted. Repeated cytology of the lymph node confirmed reactive lymphoid hyperplasia.