An approximately 10-year-old, male castrated domestic shorthair cat presented to Cornell’s Internal Medicine Department for chronic upper respiratory infections and recent development of fluctuant nasal swelling. The cat was adopted at approximately 2 years of age as a stray. He had a 6 year history of persistent and recurrent sneezing, variable nasal discharge, ocular discharge, and respiratory stertor. Treatment had been attempted several times with antibiotics including clavamox, clindamycin, and convenia with minimal improvement noted. Additionally, the owner noticed a new soft fluctuant nasal swelling had developed on the bridge of the nose approximately 2.5 weeks prior to presentation. The cat also had a history of aural polyps, likely chronic kidney disease and likely concurrent gastrointestinal disease.

On presentation the cat was bright and alert with marked respiratory stertor, mild serous nasal discharge, mild mucoid ocular discharge, and severe dental tartar and gingivitis. Problem list for this case included upper respiratory disease, dental disease, and historic aural polyps, chronic kidney disease and GI disease. CBC, chemistry, and urinalysis were unremarkable. The test for Cryptococcus antigen was negative. Chest radiographs revealed two ballistic foreign bodies and no evidence of metastatic neoplasia. Abdominal ultrasound showed changes consistent with the history of chronic kidney disease. A CT scan was performed under general anesthesia and showed a large right sided nasal mass causing bony lysis and incorporating two ballistic foreign bodies. Blind nasal biopsies were taken. Histopathology and immunohistochemistry led to the diagnosis of the mass as B-cell lymphoma. Options for treatment include steroids, radiation therapy, chemotherapy, or a combination.

This report will discuss the differential diagnoses and approach to the diagnosis for upper respiratory disease in the cat. It will then discuss prognosis and treatment options for nasal lymphoma in the cat.