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Lymphoma, or lymphosarcoma, is a common cancer of the white blood cells (lymphocytes) of middle-aged and older cats.

It may affect the skin, eyes, gastrointestinal tract, liver, spleen, lungs or central nervous system and can be aggressive if left untreated. It may however respond favourably to chemotherapy, which may add months or even years to the cat’s life.


There are no known breed or sex predilections and it is not known how it develops. In some cats Feline Leukaemia Virus (FeLV) may play a role but this is an extremely rare infection in Hong Kong.

Clinical Signs:

These vary on the area of body affected but three common forms occur in cats:

Multicentric form affected multiple sites, including the lymph nodes

Mediastinal form, affecting the front of the chest, leading to breathing difficulties

Alimentary form, affecting any part of the stomach or intestines, leading to weight loss, vomiting and diarrhoea. A mass may be felt on abdominal palpation and also liver or spleen may be involved/ enlarged.

Other forms may causes skin lumps, seizures or blindness.


Tests performed depend on affected site but include:

-       A complete blood count, biochemistry profile, and urinalysis

-       Fine-needle aspiration of any affected mass or lymph node to examine for cancer cells

-       Biopsies (larger samples) surgically obtained from masses

-       Radiographs and ultrasound to examine internal organs for involvement

-       FeLV test

-       Bone marrow biopsy if bone marrow involvement is suspected

-       Specialized testing to determine whether B or T cells are involved


Treatment really depends on the organs involved, but most cases require chemotherapy due to the widespread involvement of the disease.

There are a variety of chemotherapeutic protocols used, consisting of a combination of oral and injectable medications.

Surgery may be indicated in some cases, eg with the alimentary form where a large mass is obstructing the intestine.

Serious discussion is advised with your vet before chemotherapy is embarked upon, in order that you are fully aware of potential costs and problems. If treatment is initiated, it is best to start immediately, even if your cat appears relatively well, as waiting can seriously reduce long-term survival.

The goal of cancer therapy is to achieve long-term remission and good quality of life, but a holistic view should be taken; some cats are not suitable candidates for such intensive treatment.

Prognosis depends on location of the cancer, FeLV status, cell type (B cells are acute and aggressive whilst T cell lymphomas are more low grade and chronic), how the cat tolerates medications, and how quickly the cancer is diagnosed and treatment started.

Remissions of 2 years or more can be achieved in 40% of cats that respond well to chemotherapy.

About 70% of cats will gain at least 6 months of good quality life.

Cats that are not treated will sadly survive only 4-6 weeks after diagnosis.

Lymphoma will always return, and is usually more resistant to medications the second time around.

At Acorn we believe that serious thought and discussion is required between vet and client before the decision as to whether to undergo chemotherapy or not is taken. We always place your pet’s interests first and aim to give an informed and realistic appraisal of prognosis and outcome.