Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 SA - Oncology > Feline lymphoma, leukaemia and myeloma > Flashcards

Feline lymphoma, leukaemia and myeloma Flashcards

1
Q

Pre-FeLV lymphoma is most commonly in which form?

A

Mediastinal/multicentric lymphoma in young/adult cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Post-FeLV lymphoma is most commonly in which form?

A

Gastrointestinal lymphoma in geriatric cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common form of feline lymphoma?

A

Gastrointestinal lymphoma in geriatric cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is FeLV linked to lymphoma?

A

One of the most important aetiologic factors
FeLV+ have 62 times risk of developing lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Are feline lymphomas more commonly T or B cell?

A

B-cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some other aetiological factors for feline lymphomas

A
  • Genetic predisposition
  • Altered expression of oncogenes, tumour suppressor genes
  • Epigenetic modifications
  • Tobacco smoke
  • Chronic inflammatory conditions (i.e. IBD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List the different types of lymphoma cats can get

A

Nodal lymphoma (multicentric)
Alimentary lymphoma
Mediastinal lymphoma
Extranodal lymphoma
- Nasal/retrobulbar lymphoma
- Laryngeal lymphoma (pharynx and trachea)
- Renal lymphoma
- CNS lymphoma
- Ocular lymphoma
- Cutaneous lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe ‘true’ multicentric lymphoma in cats

A

“True” multicentric lymphoma with symmetrical generalised lymphadenopathy is rare in cats (most common form in dogs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the clinical signs of nodal/multicentric lymphoma in cats

A

Non-painful lymph node enlargement
Anorexia
Depression
Non-specific malaise
Pyrexia
(PU/PD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some DDx of nodal/multicentric lymphoma in cats

A
  • Retroviral, viral, bacterial, fungal, mycobacterial and (protozoal), infections
  • (Other haemopoietic malignancies)
  • Immune mediated disease
  • Idiopathic forms
  • Metastatic disease (regional)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mediastinal lymphoma is most commonly seen in which cats?

A

Younger cats? - Siamese?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the clinical signs of mediastinal feline lymphoma

A

Respiratory distress
Regurgitation/dysphagia
Weight loss
Lethargy, exercise intolerance
Cough (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

On clinical exam what findings may indicate a mediastinal lymphoma?

A

Palpable reduction in compressibility of cranial thorax
Decreased lung sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List the DDx for mediastinal feline lymphoma

A

Thymoma (double pos CD4/CD8)
Other cranial mediastinal lymphadenopathy
Other causes of pleural effusion
- Congestive cardiac failure
- Pyothorax
- FIP
- (Haemothorax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the clinical presentation/signs of a cat with alimentary lymphoma

A
  • Older cats
  • Insidious weight loss
  • Anorexia: more common and severe in cats than dogs
  • Diarrhoea (may not be observed)
  • Malabsorption/PLE
  • Occasionally vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List the DDx of feline alimentary lymphoma

A
  • Many and various other causes of GI signs
  • All other causes of mesenteric lymphadenopathy: FIP, IBD, metastatic neoplasia, pancreatitis, mycobacterial infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List the clinical signs of a nasal/retrobulbar extranodal lymphoma

A

Nasal discharge, epistaxis, obstruction, exophthalmos etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the clinical signs of a renal extranodal lymphoma

A

Malaise, anorexia
Renomegaly (bilateral)
Azotaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the main features of renal lymphoma

A
  • Degree of azotaemia is not prognostic of outcome
  • Overall low response rate and poor survival time
  • High incidence of CNS involvement in cats with renal lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which form of cutaneous lymphoma is most commonly seen in cats?

A

Non-epitheliotropic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the use of FNA is feline lymphomas

A

Cats often have low grade small cell or mixed lymphomas
- Especially multicentric/peripheral lymphomas
- Difficult to differentiate from reactive hyperplasia on cytology
- FNAs are much less likely to be diagnostic than in dogs

22
Q

Which forms of feline lymphoma may be easier to diagnose on FNA, why?

A

Cranial mediastinal and extranodal lymphomas may be higher grade - Easier to diagnose on FNA

23
Q

Describe the use of biopsy for feline lymphomas

A
  • Excisional biopsy of node
  • Avoid Trucut needle biopsies: except for renal lymphoma (check co-ag times)
  • Wedge biopsy from extranodal lesion or enormous node
  • Impression smears
24
Q

What does PARR stand for?

A

PCR for antigen receptor rearrangements

25
Q

Describe the pros of using PARR for diagnosing lymphoma

A
  • Clonality is a feature of neoplasia
  • Identify a clonal population in a background of normal lymphocytes
  • High specificity, a positive results support the diagnosis of lymphoma
26
Q

Describe the cons of using PARR for diagnosing lymphoma

A
  • Clonality is not only a feature of neoplasia
  • Oligoclonality and monoclonality in inflammation
  • Negative result if no enough cells
  • Primers
  • Identify only 65-70% of lymphomas in cats
  • A negative result does not exclude lymphoma
27
Q

Compare staging of tumours in cats compared to dogs

A
  • Cats do not fit in the standard clinical staging ‘boxes’ used for dogs
  • Numerous staging systems allowing for anatomical site proposed
28
Q

What are the positive prognostic indicators for feline lymphoma?

A
  • Achieving a complete response
  • Small volume of extranodal disease
29
Q

What are the negative prognostic indicators for feline lymphoma?

A
  • Failure to achieve a complete response
  • FeLV +ve status
  • Previous therapy with corticosteroids
30
Q

List the treatment options for feline lymphoma

A

(None)
Corticosteroids
Multi drug regimens
- COP
- CHOP
- COAP

31
Q

Which multidrug regime is most used in cats with lymphoma?

A

COP is an excellent protocol for cats
- High dose COP
- 1 year survival 49%, 2 year survival 40%
- Vincristine, cyclophosphamide, prednisolone

32
Q

How should patients be monitored for side effects following chemotherapy?

A

Myelosuppressive agents
- Check haem prior to every bolus dose
- On low dose COP, check at appropriate intervals
Probably a good idea to intermittently check urine
- ?UTI
Hair loss (whiskers)
GI signs

33
Q

Describe how to treat alimentary lymphoma in cats

A
  • Surgical excision of solitary mass lesion: Must biopsy nodes (and other organs)
  • Follow up chemotherapy (?)
  • Adequate supportive therapy: Appetite stimulants, O-tube? Vitamin B12
  • Gastric lymphoma very difficult to treat
34
Q

How is leukaemia classified?

A

Classification by cell type and progression
- Acute vs chronic
- Lymphoid vs myeloid

35
Q

Describe the prognosis of leukaemia

A

Acute lymphoid leukaemia (ALL) and acute myeloid leukaemia (AML) are rapidly progressive, fatal diseases
- High WBC counts
- Concurrent pancytopenias
- Poor prognosis (weeks-months) even with chemotherapy

36
Q

Which syndromes is recognised as a precursor to acute leukaemias in FeLV positive cats?

A

Myelodysplastic syndrome (MDS)

37
Q

How is Myelodysplastic syndrome (MDS) characterised?

A

Cytopenias (RBCs, platelets, neutrophils) without circulating neoplastic cells.

38
Q

Describe treatment for acute leukaemia’s

A

Supportive therapy – very sick patients
- Blood transfusion
- Antibiotics
- Barrier nursing
- CSF?
Multi-agent chemotherapy protocols
- COP vs CHOP
- Addition of cytarabine infusions may improve response

39
Q

Define chronic lymphoid leukaemia

A

Proliferation of mature lymphocytes in bone marrow.
Rare (T cell > B cell > T-ve, B-ve)

40
Q

Describe treatment of chronic lymphoid leukaemia

A

Decision to treat based on the individual (presence of CS, degree of lymphocytosis)
Treatment with prednisolone/chlorambucil – survival times of 1-3 years reported.

41
Q

Define chronic myeloid leukaemia

A

Proliferation of mature myeloid cells (normally neutrophils) in bone marrow
Even rarer!

42
Q

When diagnosing chronic myeloid leukaemia, which conditions need to be excluded?

A

Have to exclude other causes of extreme neutrophilia; infection, immune mediated disease; paraneoplastic syndrome

43
Q

How is leukaemia diagnosed?

A
  1. Haematology with manual differential and smear evaluation
  2. Flow cytometry of peripheral blood
  3. Staging to evaluate extent of disease
    - Thoracic radiographs
    - Abdominal ultrasound
    - Cytology of liver/spleen
  4. Bone marrow biopsy (cytology + histology)
44
Q

Name a myeloid related disorder

A

Multiple myeloma

45
Q

What is multiple myeloma?

A
  • Rare - <1% of malignant tumours in animals
  • Systemic neoplastic proliferation of plasma cells results in overproduction of antibody (IgA or IgG)
  • Can get local disease – extramedullary plasmacytoma which can progress to multiple myeloma
46
Q

In multiple myeloma, hyperproteinaemia can lead to ..?

A

Hyperviscosity syndrome

47
Q

Describe the characteristics of hyperviscosity syndrome

A

Neurological symptoms, retinal detachment, congestive heart failure (cats > dogs), hypertension, coagulopathy

48
Q

Describe the haematology, biochemistry and urinalysis characteristics in a patient with multiple myeloma

A
  • Non-specific, may see circulating plasma cells
  • Proteinuria (Bence-Jones proteins)
  • Hypercalcemia
  • Hyperglobulinemia
49
Q

How else is multiple myeloma diagnosed?

A
  • Serum protein electrophoresis: Monoclonal gammopathy
  • Diagnostic imaging: Hepatosplenomegaly, Osteolytic bone lesions
  • Cytology: Liver, spleen + bone marrow
50
Q

In dogs, to confirm diagnosis of multiple myeloma they need to have at least 2/4 of which criteria?

A
  1. Monoclonal gammopathy
  2. Radiographic evidence of osteolytic bone lesions
  3. > 5% neoplastic plasma cells or >10-20% plasmacytosis in the bone marrow
  4. Bence-Jones proteinuria
51
Q

How is multiple myeloma different in cats?

A

In feline myeloma related disorder there is rarely bone marrow involvement so should demonstrate plasma cell infiltration of visceral organs.

52
Q

How is multiple myeloma treated?

A

Supportive care
- Blood transfusions
- Plasmaphoeresis
- Antibiotics if secondary infection
- Therapy for hypercalcaemia
Systemic disease
- Prednisolone (~ 40 days)
- Chemotherapy

Y4 SA - Oncology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions