Ultrasonographic and clinicopathological features of pyloroduodenal adenomatous polyps in cats

Evence Daure, Rachel Jania,et al.

Background
Pyloroduodenal adenomatous polyps are benign lesions of the gastrointestinal tract in cats that can cause severe clinical signs such as vomiting, anorexia, and gastrointestinal bleeding. While their histopathological characteristics are well-documented, their ultrasonographic features have not been previously described. This study aimed to report ultrasonographic, clinical, and histological findings in cats with confirmed pyloroduodenal polyps.

Methods
The study reviewed medical records of six cats from veterinary institutions in North America between 2001 and 2014. Inclusion criteria included abdominal ultrasound imaging and histological confirmation of pyloroduodenal polyps. Ultrasonographic assessments examined lesion location, size, shape, echogenicity, and other gastrointestinal characteristics. Histopathological diagnosis followed established criteria, distinguishing polyps from other lesions.

Results
All six cats exhibited discrete, homogeneous, moderately echogenic nodules (up to 1.5 cm) located in the pyloroduodenal lumen. Most cases involved single pedunculated nodules. Clinical signs included vomiting (4/6 cats), anorexia (4/6), lethargy (3/6), and gastrointestinal bleeding in some instances. Two cats presented with severe anemia due to bleeding. Surgical removal of the polyps resolved clinical signs, with five cats surviving long-term (mean follow-up: 817 days). The nodules were histologically confirmed as adenomatous polyps, demonstrating benign characteristics without stromal invasion or severe dysplasia.

Limitations
The study's retrospective design and small sample size limit generalizability. The prevalence and broader clinical impact of pyloroduodenal polyps in cats remain unclear. Prospective, multicenter studies are needed to evaluate their true incidence and significance.

Conclusions
Pyloroduodenal polyps in cats are rare but benign lesions that can cause significant clinical signs, including gastrointestinal bleeding and obstruction. Subtle ultrasonographic changes may mimic ingesta, complicating diagnosis. Surgical removal carries an excellent prognosis, emphasizing the importance of considering these polyps in differential diagnoses for gastrointestinal masses in cats. Further research is required to understand their pathogenesis and potential recurrence.

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