Exam 1 - Feline Lymphoma Flashcards
what breed is associated with feline lymphoma?
siamese cats
what is the most common tumor in renal transplant cats?
lymphoma - high grade diffuse large b-cell lymphoma
what organs are involved in cats that get lymphoma after renal transplants?
liver, spleen, peripheral/mesenteric lymph nodes, small intestines, bladder, heart, mesenteric fat, & body wall
what is the proposed mechanism for why renal transplant cats get lymphoma?
chronic immunosuppresion
what viral factors are apart of the etiology of feline lymphoma?
FeLV & FIV
what are the 3 forms of FeLV-associated lymphoma?
mediastinal, multicentric, & spinal
what cats are typically affected by FeLV-associated lymphoma?
younger cats - under 2 years old
what is the mechanism of FeLV-associated lymphosarcoma?
direct mechanism - insertional mutagenesis (virus inserts into the cell)
what is the common immunophenotype of FeLV-associated lymphoma?
t-cell
what is the common immunophenotype of FIV-associated lymphoma?
b cell lymphoma
what is the mechanism of FIV-associated lymphosarcoma?
indirect mechanism - chronic immunosuppression
T/F: there is a five-fold increased risk of lymphosarcoma in FIV positive cats
true
there has been an increase in prevalence of lymphoma in cats now past the felv era due to relative frequency of alimentary lymphoma - why?
we see it more now but it’s typically in older cats with different forms (alimentary)
how is lymphoma classified in cats?
anatomic location & histologic & immunophenotypic criteria
T/F: only 4-10% of cats diagnosed with lymphoma involves the peripheral lymph nodes (multicentric)
what is the common name for tarsal lymphoma?
terrible tumor of the hock - surrounds the joint fully
what is the most common intestinal tumor in cats?
feline alimentary lymphoma - 55%
what cats are typically affected by alimentary lymphoma?
older, felv negative cats, & siamese breeds
what other organs can be involved in alimentary lymphoma?
intestines, mesenteric lymph nodes, liver, & spleen
what are the clinical signs associated with alimentary lymphoma?
weight loss, anorexia, diarrhea, & vomiting
what may be palpated upon physical exam of a cat with alimentary lymphoma?
palpable abdominal mass or thickened ‘ropey’ loops of intestine
what is another name for low-grade gi lymphoma?
small cell or lymphocytic lymphoma
what pathology is caused by low-grade gi lymphoma?
diffuse intestinal wall thickening with intact wall layering
what other organs may be involved in low-grade gi lymphoma?
abdominal lymph nodes & liver
what other organs may be involved in high-grade gi lymphoma?
abdominal lymph node involvement, liver, spleen, & kidney
what is another name for high-grade lymphoma?
lymphoblastic
what pathology is caused by high-grade lymphoma?
transmural intestinal wall thickening, loss of layering, & maybe a solitary mass
how is low-grade gi lymphoma diagnosed?
endoscopic or surgical biopsy
what other disease is hard to distinguish from small cell gi lymphoma?
IBD
how is small cell lymphoma treated?
chlorambucil & prednisolone
what percentage of patients with small cell lymphoma respond to therapy?
98%
what is the median survival of small cell gi lymphoma?
700 days
T/F: the history of a cat with small cell gi lymphoma is typically prolonged and clinical signs aren’t as pronounced
true
which has the worst prognosis: small cell or large cell lymphoma?
large cell
how is large cell gi lymphoma diagnosed?
ultrasound guided FNA & cytology
+/- flow cytometry (88% b-cell)
what is the treatment for large cell gi lymphoma?
aggressive, multi agent chemo
survival benefit found in cats treated with doxorubicin
T/F: doxorubicin can cause permanent anorexia in cats
true
what is the median survival time of cats with large cell gi lymphoma?
6 months
what % of cats with large cell gi lymphoma respond to therapy?
50-60%
what is feline large granular lymphocyte lymphoma?
very biologically aggressive subtype of lymphoma arising from CD3+ t cytotoxic t cells
what organs are typically involved in feline large granular lymphocyte lymphoma?
small intestines, mesenteric lymph nodes, +/- spleen, liver, & bone marrow
what are the clinical signs of feline large granular lymphocyte lymphoma?
acute onset of anorexia, weight loss, lethargy, & vomiting
T/F: most cats with feline large granular lymphocyte lymphoma are FeLV/FIV negative
true
what is the median survival time of feline large granular lymphocyte lymphoma?
57 days
what percentage of animals with feline large granular lymphocyte lymphoma respond to therapy?
<30% - minimally responsive
what may you see in cytology when looking at the cytoplasm of cells in cats with feline large granular lymphocyte lymphoma?
granular bodies
what are the clinical signs of mediastinal lymphoma?
dyspnea, tachypnea, cough, inappetence, & regurgitation
what is the signalment of cats typically affected by mediastinal lymphoma?
younger siamese cats
what are 2 common physical exam findings associated with mediastinal lymphoma?
muffled heart & lung sounds, 51% of cats have pleural effusions, & non-compressible thorax
how is mediastinal lymphoma diagnosed?
thoracic radiographs, thoracocentesis, +/- ultrasound guided FNA & cytology (diagnose off of pleural fluid)
what is the treatment for mediastinal lymphoma?
supportive therapy - thoracocentesis
chemotherapy
emergency radiation therapy
what percentage of animals respond to treatment for mediastinal lymphoma?
94.7% respond to CHOP/COP
what is the median survival time of mediastinal lymphoma if the cat is FeLV positive?
2-3 months
what is the median survival time of mediastinal lymphoma if the cat is an older FeLV negative patient?
373 days
T/F: 60-75% of cats with complete response to therapy had an overall median survival time of 980 days
true
what are some commonly reported locations of feline extra-nodal lymphoma?
nasal, upper respiratory, renal, CNS, subcutaneous, & terrible tumor of the hock
what are the clinical signs of feline nasal lymphoma?
nasal discharge, stertor, sneezing, epistaxis, & facial deformity/asymmetry
what is the typical duration of clinical signs prior to a feline nasal lymphoma patient being referred?
about 3 months
what is the common immunophenotype of feline nasal lymphoma?
majority are b-cell lymphoma
how is feline nasal lymphoma diagnosed & staged?
thoracic radiographs, AUS, CT with rhinoscopy, & biopsy
T/F: approximately 15% of cats with feline nasal lymphoma have disease located beyond the nasal cavity & will require more systemic treatment
true
what is the median survival time for feline nasal lymphoma?
536 days
what is the median survival time for stage 1 localized feline nasal lymphoma?
955 days
how do most cats with nasal lymphoma present?
many cats present with stage 1 disease that is localized to the anatomic site & are still eating well (substage a)
what are the average response rates to treatment of feline nasal lymphoma?
66-75%
T/F: nasal lymphoma is prognostically the best variant
true - radiation therapy can treat locally!
what are the general clinical signs of renal lymphoma?
depression, anorexia, PU/PD, bilateral renomegaly
how is renal lymphoma diagnosed?
cytology, thoracic radiographs, ultrasound, & FNA
what is the common immunophenotype of renal lymphoma?
b-cell lymphoma
what other organ system is commonly affected in renal lymphoma?
relapse in the CNS!!
what is the median survival time of renal lymphoma?
4-7 months
what are the clinical signs associated with feline CNS lymphoma?
posterior paresis, behavior changes, circling, seizures, & altered consciousness - often diffusely effects cerebrum or brainstem +/- spinal cord
T/F: cats with feline CNS lymphoma have concurrent renal and/or bone marrow involvement
true
there is a high incidence of what disease in feline CNS lymphoma?
FeLV
how is feline CNS lymphoma staged?
thoracic rads & abdominal ultrasound
how is feline CNS lymphoma diagnosed?
MRI or CT scan with CSF tap & cytology
what is the treatment for feline CNS lymphoma?
local radiation therapy & chemo - cats showing a complete response can enjoy long term disease control
what is the median survival time of cats with CNS lymphoma that have a poor response to chemo?
70 days - maybe better survival with lomustine
what is the distribution for cutaneous epitheliotropic t-cell lymphoma?
solitary or multiple lesions without predilection for any particular locations
what are the dermatological clinical signs of cutaneous epitheliotropic t-cell lymphoma?
erythematous plaques/patches, scaly alopecia patches, & non-healing ulcers or nodules
‘eosinophilic plaque like’
ulcerative pododermatitis & exfoliative alopecia with focal erythema are commonly seen with what cancer?
cutaneous epitheliotropic t-cell lymphoma
how is cutaneous epitheliotropic t-cell lymphoma diagnosed?
skin biopsy & histopathology with immunohistochemistry
how is cutaneous epitheliotropic t-cell lymphoma staged?
thoracic rads & ultrasound
what is another name for eosinophilic granuloma?
rodent ulcer
what is the treatment for cutaneous epitheliotropic t-cell lymphoma?
surgery for ulcerated lesions, electron beam irradiation, & multi-agent chemo
what is the median survival time for cutaneous epitheliotropic t-cell lymphoma?
10 months
T/F: cutaneous epitheliotropic t-cell lymphoma is rare in cats
true
what is the most common form of lymphoma in cats?
gastrointestinal
in cats with high grade gi lymphoma, how many animals respond to therapy? what is the average duration of response?
50-70%
4-6 months
why is it important to use immunophenotyping & PARR in cats with suspect gi lymphoma?
can help distinguish lymphoma from IBD
what are positive prognostic factors for feline lymphoma in regards to response to treatment, histopathology grade, anatomic location, & retroviral status?
complete response
low grade
FeLV negative
nasal lymphoma
T/F: in cats, immunophenotype & pre-treatment with glucocorticoids does not play a role in prognosis
true
for feline lymphoma, what are the chemo treatment options?
CHOP/COP & lomustine
for feline lymphoma, what are the radiation treatment options?
nasal, CNS/spinal lesions, & mediastinal lymphoma
for feline lymphoma, what are the surgical treatment options?
rarely indicated because most lymphomas are considered systemic except for getting biopsies for diagnosis or to relieve intestinal obstruction
what are the 2 classifications used in feline lymphoma?
anatomic location & histologic criteria
what cancer is this?
cutaneous epitheliotropic t-cell lymphoma