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Feline Nasopharyngeal Polyps

Feline Nasopharyngeal Polyps. Erica Fields, DVM Nov. 16, 2009 Acc # 124825. Maddie. MRN 152368 6 year old FS DSH Purulent left ear discharge for 2 mos Fleshy pink mass visible in external ear canal. CT images. CT images. Differential Diagnoses. Inflam. polyp

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Feline Nasopharyngeal Polyps

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  1. Feline Nasopharyngeal Polyps Erica Fields, DVM Nov. 16, 2009 Acc # 124825

  2. Maddie • MRN 152368 • 6 year old FS DSH • Purulent left ear discharge for 2 mos • Fleshy pink mass visible in external ear canal

  3. CT images

  4. CT images

  5. Differential Diagnoses • Inflam. polyp • Neoplasia* – external canal • Ceruminous gland adenoma • SCC • Sebaceous gland adenocarcinoma • Neoplasia* – middle ear • Carcinomas (esp. SCC) • LSA • FSA • Cholesteatoma (esp. dogs) * 87.5 % of feline ear canal tumors are malignant Fan and de Lorimier, 2004

  6. Inflammatory (Nasopharyngeal) Polyps • Arise from mucosa of middle ear, auditory tube, or pharynx • Loose fibrovascular tissue covered by epithelial layer, with mixed inflammatory infiltrates • Presence of ciliated epithelium is characteristic, but not always seen • Etiology unknown • Congenital? • Chronic URT inflammation? • Viral (Calicivirus, Herpesvirus-1)? • Chronic otitis media? • Ascending nasopharyngeal infection? www.adelaidevet.com.au Fan and de Lorimier, 2004 and Seitz, et al, 1996

  7. Young cats – most are under 3 yo (mean is 24 mos) • Most unilateral, but can be bilateral • Abyssinians overrepresented • Clinical signs: • Upper respiratory (sneezing, dysphonia, dyspnea, dysphagia, stertor, nasal dc) • Otitis media/interna (head tilt, nystagmus, Horner’s syndrome) • Otitis externa (otorrhea, head shaking) • Can extend to cerebellum, temporal lobe, or brainstem! www.acfacat.com Fan and de Lorimier, 2004 and Cook, et al, 2003

  8. Diagnosis • Otoscopy • Oropharyngeal examination • IMAGING • Radiographs – open-mouth skull, plus thorax (look for lower respiratory tract signs) • CT • Less superimposition • Can see brain extension • Better detail and localization • Treatment • Must know location to select right procedure! • Traction vs. VBO/TECA veterinarynews.dvm360.com Seitz, et al, 1996 and Fan and de Lorimier, 2004

  9. Carcinoma

  10. Carcinoma

  11. Cholesteatoma

  12. References • Cook LB, Bergman RL, Bahr A, Boothe HW. 2003. Inflammatory polyp in the middle ear with secondary suppurative meningoencephalitis in a cat. Veterinary Radiology and Ultrasound. 44(6): 648-651. • Fan TM and de Lorimier L-P. 2004. Inflammatory polyps and aural neoplasia. Veterinary Clinics: Small Animal Practice. 34: 489-509. • Seitz SE, Losonsky JM, Maretta SM. 1996. Computed tomographic appearance of inflammatory polyps in three cats. Veterinary Radiology and Ultrasound. 37 (2): 99-104.

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