Case Report: Palliative benefit of hypofractionated radiation therapy (6 Gy × 6 fractions) with temporary tracheostomy in a cat with laryngeal B-cell lymphoma progressing during chemotherapy.

A 12-year-old spayed female Maine Coon cat was diagnosed with cervical T-cell-rich B-cell lymphoma. During modified L-CHOP-based chemotherapy, the cat developed progressive upper airway obstruction associated with a laryngeal lesion. Initial CT suggested contiguous laryngeal involvement, and follow-up imaging revealed severe laryngeal narrowing. An emergency temporary tracheostomy was performed for airway stabilization, and subsequent punch biopsy of the laryngeal lesion was most consistent with diffuse large B-cell lymphoma. Hypofractionated palliative radiation therapy (6 Gy × 6 fractions; total dose 36 Gy) was initiated to address the obstructive mass. Progressive tumor shrinkage was observed during treatment, and by the fourth fraction the tracheostomy tube was successfully removed without recurrence of airway obstruction. Follow-up CT 17 days after radiation therapy initiation showed no visible laryngeal lesion, and no respiratory signs or airway obstruction recurred before the cat died on day 27 following clinically suspected systemic disease progression. This case suggests that hypofractionated radiation therapy, in combination with temporary tracheostomy, may provide rapid and effective relief of tumor-induced upper airway obstruction in cats with laryngeal B-cell lymphoma progressing during chemotherapy.