Multicentric Round Cell Neoplasia with Plasmacytic Differentiation in a Cat with Systemic Progression: Multimodal Imaging and Treatment Response

Plasma cell neoplasia is uncommon in cats, and multicentric nodal-predominant involvement has not been well characterized. This report describes a multicentric round cell neoplasia with plasmacytic differentiation in a 14-year-old Domestic Shorthair cat, emphasizing multimodal imaging features and treatment response. Contrast-enhanced computed tomography and magnetic resonance imaging were performed for staging and longitudinal assessment. Cytomorphology supported plasmacytic differentiation, and flow cytometry did not demonstrate an immunophenotype consistent with conventional B- or T-cell lymphoma. Because histopathology, immunohistochemistry, bone marrow evaluation, and assessment for monoclonal gammopathy were not performed, definitive classification was not possible; however, cytomorphology supported plasmacytic differentiation, with plasma cell neoplasia remaining an important diagnostic consideration. A hypofractionated radiotherapy protocol (36 Gy in six fractions) combined with systemic chemotherapy was administered. Serial imaging demonstrated complete radiologic resolution of the irradiated mass, whereas non-irradiated presumed nodal lesions progressed and an extradural spinal lesion subsequently developed. These findings highlight the capacity of round cell neoplasia with plasmacytic differentiation to mimic lymphoma on imaging and illustrate the dissociation between effective local control and ongoing systemic progression.