Hematopoietic Neoplasia

Question 1

which species is lymphoma common in?

Answer 1

all species

Question 2

what percentage of canine tumors are lymphoma?

Answer 2

20%

Question 3

what is the average age of canine lymphoma?

Answer 3

10 years
as young as 1-3 years

Question 4

what percentage of feline tumors are lymphoma?

Answer 4

30%

Question 5

how old are cats usually when they get lymphoma?

Answer 5

2-6 years

Question 6

where might you find lymphoma?

Answer 6

anywhere

Question 7

what is the definition of lymphoma/lymphosarcoma?

Answer 7

solid tissue tumor originating outside of the bone marrow

Question 8

can lymphoma cause both discrete tissue masses and diffuse tissue infiltration?

Answer 8

yes

Question 9

what does lymphoma look like on cytology?

Answer 9

homogenous population of (usually) medium to large lymphoid cells

Question 10

what are the possible abnormalities with lymphoma on a CBC?

Answer 10

mild, nonregenerative anemia
lymphopenia
lymphocytosis

Question 11

how can you distinguish between reactive lymphocytes and neoplastic lymphocytes?

Answer 11

history
lymph count
other findings

Question 12

infiltration of liver or kidney by lymphoma can result in _________________________

Answer 12

failure of these organs

Question 13

how can you classify lymphoma?

Answer 13

anatomic site
clinical stage
histology grade
immunophenotype

Question 14

what is the most common classification of lymphoma based on location in dogs?

Answer 14

multicentric

Question 15

what is the most common classification of lymphoma based on location in cats?

Answer 15

alimentary: older cats
mediastinal: less than 2 years old

Question 16

_________________ seen in some cases of T cell lymphoma

Answer 16

hypercalcemia

Question 17

what is the decreased renal response to ADH in lymphoma often due to?

Answer 17

PTH-rp secretion by T lymphocytes

Question 18

what does PTH-rp secretion by T lymphocytes lead to?

Answer 18

increased serum calcium
normal to decreased serum phosphorous

Question 19

what does “staging” of multicentric lymphoma describe?

Answer 19

neoplastic spread in dogs

Question 20

what is stage I lymphoma?

Answer 20

one node only

Question 21

what is stage II lymphoma?

Answer 21

regional nodes involved

Question 22

what is stage III lymphoma?

Answer 22

generalized lymphadenopathy

Question 23

what is histologic “grading” by pathologists for lymphoma based on?

Answer 23

arrangement of tumor
lymphocyte size
mitotic rate

Question 24

what grade are most canine lymphomas?

Answer 24

high grade
diffuse neoplasms

Question 25

what can immunophenotyping lymphoma provide?

Answer 25

information about prognosis

Question 26

what is immunophenotyping in lymphoma based on?

Answer 26

immunohistochemistry: antibodies on cell membranes

Question 27

what markers for immunophenotyping lymphoma are on B lymphocytes?

Answer 27

CD79a+ CD20+ PAX5+

Question 28

are B cell tumors or T cell tumors better for prognosis?

Answer 28

B cell tumors

Question 29

what grades of lymphoma have worse prognosis?

Answer 29

III/IV

Question 30

where are the predominant abnormalities in leukemias?

Answer 30

blood bone marrow

Question 31

what is a marker of indolent lymphoma?

Answer 31

small CD5+ cells lacking panleukocyte marker (CD45-)

Question 32

what classifies acute leukemias?

Answer 32

rapid clinical course if untreated predominance of undifferentiated (immature) cells bimodal age distribution: older animals and young

Question 33

what classifies chronic leukemias?

Answer 33

slowly progressive with predominance of mature cells must distinguish from reactive/hyperplastic processes older patients

Question 34

what are the general principles of acute leukemia?

Answer 34

originates in bone marrow CBC: WBC counts often very high maybe tissue infiltration classification as lymphoid or myeloid can be difficult

Question 35

what predominates in acute lymphoid leukemia?

Answer 35

medium to large lymphocytes

Question 36

what do you often need to diagnose acute myeloid leukemia?

Answer 36

immunophenotyping

Question 37

why might you want to distinguish between acute myeloid leukemia and acute lymphoid leukemia?

Answer 37

very bad prognosis for acute myeloid leukemia

Question 38

when might it not be possible to distinguish the tumor origin between lymphoma and acute leukemia?

Answer 38

late in course of disease: once in marrow, prognosis is bad

Question 39

what is leukemic?

Answer 39

neoplastic cells are in the bloodstream

Question 40

what is aleukemic leukemia?

Answer 40

leukemia in bone marrow, but not abnormal neoplastic cells in bloodstream

Question 41

if no masses are present, is leukemia or lymphoma more likely?

Answer 41

acute leukemia

Question 42

what is chronic leukemia usually a disease of?

Answer 42

geriatric patients

Question 43

what is the hallmark of chronic leukemia?

Answer 43

peripheral leukocytosis with increased normal looking differentiated cells

Question 44

what is the marrow usually like in chronic leukemia?

Answer 44

not overwhelmed: cytopenias uncommon may have mildly increased lymphcytes

Question 45

what is the prognosis of chronic leukemia?

Answer 45

fair to good

Question 46

is a bone marrow exam usually helpful for chronic leukemia?

Answer 46

may not be helpful

Question 47

what might chronic leukemia terminate in?

Answer 47

blast crisis

Question 48

what is multiple myeloma?

Answer 48

malignant plasma cell tumor that arises in bone marrow

Question 49

what is the hallmark feature of multiple myeloma?

Answer 49

protein abnormalities

Question 50

how common are non-secretory myelomas?

Answer 50

rare

Question 51

what do you need at least three of to diagnose multiple myeloma?

Answer 51

monoclonal gammopathy light chain proteins in urine plasmacytosis in bone marrow or other sites lytic bone lesions hypercalcemia

Question 52

what do you need a negative test of to diagnose multiple myeloma?

Answer 52

Ehrlichia canis

Question 53

what is protein electrophoresis used for?

Answer 53

to fractionate proteins as they move through a gel

Question 54

what is protein migration in an electrical field based on?

Answer 54

size and charge

Question 55

what might plasma cells be like in marrow with multiple myeloma?

Answer 55

may be unevenly distributed can look normal or abnormal >10-20% plasma cells suggests, but also seen with chronic antigenic stimulation

Question 56

what can hyperviscosity in multiple myeloma cause?

Answer 56

organ failure

Question 57

what do histiocytic disorders arise from?

Answer 57

histiocytes: macrophages and dendritic cells

Question 58

what are the histiocytic disorders?

Answer 58

cutaneous histiocytosis reactive histiocytosis histiocytic sarcoma

Question 59

what can histiocytic sarcoma involve?

Answer 59

bone marrow

Question 60

what are the types of histiocytic sarcoma?

Answer 60

localized disseminated

Question 61

what characterizes a large lymphocyte?

Answer 61

high N:C ratio euchromatin +/- visible nuclei basophilic cytoplasm

Question 62

what must you distinguish chronic leukemias from?

Answer 62

reactive/hyperplastic processes

Question 63

what does diagnosis of acute leukemia require?

Answer 63

>20% blasts in marrow

Question 64

what do cats with acute lymphoid leukemia usually have?

Answer 64

FeLV

Question 65

what is a strong risk factor for acute myeloid leukemia with cats?

Answer 65

FeLV infection

Question 66

which breeds are predisposed to histiocytic sarcoma complex?

Answer 66

bernese mountain dogs flat-coated, golden, labrador retrievers rottweiler