Brainscape's Knowledge GenomeTM

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


See full index

LCB2 > Leukaemia and lymphadenopathy 2 > Flashcards

Leukaemia and lymphadenopathy 2 Flashcards

1
Q

What are the 2 forms of plasmacytomas?

A

Cutaneous and extramedullary

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

Describe cutaneous plasmacytomas

A
  • Solid masses which may be single or multiple
  • Usually benign, best prognosis
  • Well demarcated, excision with good margins generally curative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe extramedullar plasmacytomas

A
  • Solid tissue tumour
  • Malignant
  • Produce monoclonal immunoclobulins
  • Solitary masses
  • Cause amyloidosis
  • Take over tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which organs are commonly affected by extramedullary plasmacytomas?

A
  • Arises most frequently in GIT

- Also trachea, spleen, kidney, uterus, CNS, elsewhere

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

How are extramedullary plasmacytomas diagnosed?

A

On serum/plasma

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

What are the effects of amyloidosis?

A

Deposition of abnormal proteins that cannot be broken down in the liver/kidney, leading to loss of function and atrophy of normal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are multiple myelomas?

A

Malignant tumour of plasma cells arising in the bone marrow

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

Describe the pathogenesis of multiple myelomas

A
  • Secrete large amounts of Ig (hyperglobulinaemia, monoclonal gammopathy) and cytokines that activate osteoclasts
  • Osteolysis leads to hypercalcaemia
  • Highly proliferative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the appearance of multiple myelomas

A
  • Shotgun appearance lesions in bone
  • Light chain proteinuria
  • Possible anaemia
  • Possible amyloidosis
  • haemorrhages due to secondary platelet dysfunction
  • Hyperviscosity syndrome
  • Cytopaenias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical signs of myeloid tumours generally caused by?

A

Loss of other cell lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Outline myeloid dysplasias

A
  • Rare

- Tumours starting in bone

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

Name histiocytic neoplasias

A
  • Cutaneous histiocytoma

- Histiocytic sarcoma

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

Describe the typical presentation of a cutaneous histiocytoma

A
  • Young dog
  • Circular raised, alopecic nodule
  • No damage to surrounding tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Outline the treatment for a cutaneous histiocytoma

A
  • Often spontaneously regress

- Can be left, but excise if needed

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

Describe histiocytic sarcomas

A

Uncommon, malignant tumours of dendritic cells or macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How may histiocytic sarcomas cause anaemia?

A

Sometimes cause haemophagocytic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which breeds are predisposed to histiocytic sarcomas?

A

Rottweilers, Bernese Mountain dogs

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

Which form of histiocytic sarcomas is rapid and aggressive?

A

Disseminated form

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

Describe the cytological appearance of a histiocytic sarcoma

A
  • Neoplastic cells are round cells with abundant grey-blue cytoplasm
  • Multinucleation, prominent nucleoli, mitotic figures visible
  • Hyperchromatic nuclei
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the gross appearance of a spleen with a haemophagocytic histiocytic sarcoma of macrophage origin

A

Diffuse splenomegaly with ill-defined mass formation

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

Where do mast cell proliferations typically develop?

A

Mostly cutaneous or subcutaneous, can occasionally develop in the spleen, liver, intestine or elsewhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Outline the importance of KIT in the development of mast cell proliferations

A
  • Mutations of the c-kit protooncogene that codes for KIT protein stem cell factor receptor may be responsible for the development or progression of mast cell tumours
  • KIT expression is inversely related to the degree of differentiation of canine mast cell tumours
  • Increased KIT = less differentiated tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the appearance of mast cell proliferations

A
  • Solitary or multicentric, dermal or subcutaneous, nodular or pedunculated
  • May be erythematous and oedematous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the behaviour of mast cell proliferations

A

Some benign, others malignant. Some may appear benign but behave malignantly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe canine cutaneous mast cell tumours (prevalence, behaviour)

A
  • Common
  • Biological behaviour varies from benign to fatal malignancy
  • Histological grading used to try and assess potential biological behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Explain why eosinophils are often seen in mast cell tumours

A

IL-5 produced by mast cells attract them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What grading methods are used for canine cutaneous mast cell tumours?

A

Bostock, Patnaik, Kiupel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the Patnaik grading system for canine cutaneous mast cell tumours based on?

A
  • Histologic criteria
  • Cellular morphology (nuceli, size, granularity), degree of differentiation
  • Mitotic index
  • Cellularity
  • Invasiveness
  • Stromal reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the criteria for a grade 1MCT based on the Patnaik system

A
  • No mitotic figures

- Minimal stromal reaction or necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe the criteria for a grade 2MCT based on the Patnaik system

A
  • Moderate to high cellularity
  • Moderately pleomorphic cells with round to indented nuclei
  • Mostly finely granular cytoplasm
  • Extend to lower dermis, subcutis and occasionally deeper tissues
  • 0-2 mitotic figures per high power field
  • Some contain areas of oedema, necrosis and hyalinised collaged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe the criteria for a grade 3MCT based on the Patnaik system

A
  • Highly cellular
  • Composed of pleomorphic mast cells
  • Indented to round vesicular nuclei and 1 to multiple prominent nucleoli arranged in sheets that replace the subcutis and underlying tissues
  • 3-6 mitotic figures per hpf
  • Contain areas of haemorrhage, oedema, necrosis, hyalinised collagen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the prognosis for a dog with a grade 1 MCT (Patnaik)

A
  • 93% of dogs survive longer than 1500

- Good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe the prognosis for a dog with a grade 2 MCT (Patnaik)

A

Low to moderate metastatic potential and ~47% survive 1500 days (cannot tell which have good and which have poor prognosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the prognosis for a dog with a grade 3 MCT (Patnaik)

A

High metastatic rate and ~6^ survival rate of 1500 days

Palliative care only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe the Kiupel grading system for MCTs

A

2-teir histologic grading system, giving diagnosis of either high or low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the criteria for a high grade MCT based on the Kiupel system

A

Based on any one of the following

  • at least 7 mitotic figures in 10 HPFs
  • At least 3 multinucleated in 10HPFs
  • At least 3 bizarre (marked indentation, segmentation, irregular shape) nuclei in 10 HPFs
  • Karyomegaly
  • 10% of neoplastic cells vary by at least two-fold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Compare the prognosis for a high grade vs a low grade MCT based on the Kiupel system

A
  • High: <4month survival, shorter time to metastases

- Low: more favourable prognosis, >2yr survival time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which of the grading systems for MCTs has a higher prognostic value?

A

Kiupel, also able to correctly predict the negative outcomes of some grade II MCTs on the Patnaik scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which dog and cat breeds are predisposed to lymphoma?

A
  • Boxer/mastiff

- Siamese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the anatomical classifications of lymphoma?

A
  • Multicentric
  • Alimentary
  • Cutaneous
  • Mediastinal
  • Extra-nodal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the histological classifications of lymphoma?

A
  • Low, intermediate or high grade

- Small or large cell

42
Q

What are the immunophenotypic classifications of lymphoma?

A
  • B cell
  • T cell
  • Null cell
43
Q

Which immunophenotypic classification of lymphoma carries the worst prognosis?

A

T cell

44
Q

Discuss the monitoring of lymphoma

A
  • Multicentric: palpate and measure nodes when come for chemo
  • Extranodal: harder to monitor, use imaging, clinical signs, pleural fluid in mediastinal disease
  • Hard to be sure of remission
  • Best guess using blood tests looking for acute phase proteins, PCR etc. but not well validated or commercially available
45
Q

Compare the median survival times in lymphoma when treated with either prednisolone only, COP or doxorubicin based protocols

A
  • Pred: ~3 months
  • COP: ~6 months
  • CHOP: ~9 months
46
Q

What are the main factors that influence how well an animal will respond to treatment for lymphoma?

A
  • Clinical stage, substage, immunophenotype, pre-treatment with steroids
  • Cats also FeLV status
  • Major influence on outcome is initial response to treatment
47
Q

Describe the breed predispositions for canine mast cell tumours

A
  • Boxers, golden retrievers, pugs
  • Pugs: multiple independent MCTs developing simultaneously, generally low grade
  • Young Shar Peis and Labradors often higher grade
  • Gold retrievers: multiple, recurrent primary mast cell tumours
48
Q

Where do canine mast cell tumours generally metastasise to?

A
  • Readily to the local lymph nodes, liver, spleen, bone marrow
  • Not commonly the lungs
49
Q

What are features of a mast cell tumour can act as grade predictors?

A

The site and mass type

50
Q

Describe the typical gross appearance of well differentiated and poorly differentiated mast cell tumours

A
  • Well: slow growing, hairless, solitary

- Poorly: rapid growing, ulcerated, pruritic

51
Q

Which sites carry poorer prognosis for mast cell tumours?

A
  • Visceral, intestinal, marrow involvement

- Mucocutaneous, muzzle, inguinal lesions may carry poorer prognosis, but controversia

52
Q

What is required for the diagnosis of a canine mast cell tumour?

A
  • FNA of mass
  • FNA of local lymph node
  • Cytological grading based on histopathology
53
Q

Describe the use of mass FNAs in the diagnosis of a canine mast cell tumour

A
  • Tol blue/Giemsa stain to reliably see granules

- Does not give grade, but provides strong suspicion of mass being MCT

54
Q

Describe the use of local lymph node FNAs in the diagnosis of canine mast cell tumours

A
  • Positive node: high suspicion for metastasis

- Metastasis requires different treatment

55
Q

Describe the staging required for canine mast cell tumours

A
  • Crucial to assess regional lymph node
  • Scan liver and spleen with FNA of each to be complete
  • Unlikely to metastasis to lungs so thoracic radiographs not important
56
Q

Explain the assessment of regional lymph nodes for the staging of canine mast cell tumours

A
  • Many dogs have local mets at time of presentation

- Rare to develop distant mets if local LN not involved

57
Q

Explain the examination of the liver and spleen for the staging of canine mast cell tumours

A
  • Unclear value if local LN is clear

- Some evidence that affected LN not always obvious regional node, and MCTs commonly metastasise to the liver and spleen

58
Q

What are the 2 histological subtypes of feline mast cell tumours?

A
  • Mastocytic

- Atypical form

59
Q

Describe the cutaneous form of feline mast cell tumours (appearance, behaviour, treatment)

A
  • Solitary dermal nodule 0.5-3cm diameter or multiple massess and ulceration common
  • Can see plaque-like form which is siimilar to EGC
  • Head and neck commonest site, esp/ ear base
  • Typically behaviourally benign, single better prognosis than multiple or organ involvement
  • Surgical treatment can be enough
60
Q

Describe the visceral form of feline mast cell tumours (appearance, signs)

A
  • Can be solitary masses but still poor prognosis
  • Spleen, LN and liver; may be incidental finding but poor prognosis in general
  • Intestinal forms exit but less common, generally solitary mass but may be diffuse and may cause diarrhoea
61
Q

Describe the clinical presentation of mediastinal lymphoma in dogs

A
  • Tachypnoea
  • Hyperapnoea
  • Mass compromising lung expansion
62
Q

Describe the clinical presentation of CNS lymphoma in the dog

A

Seizures

63
Q

Describe the clinical presentation of cutaneous lymphoma in the dog

A

Pruritus, scaling

64
Q

Describe the clinical presentation of multicentric lymphoma in the dog

A
  • Lymphadenopathy

- Often well despite this

65
Q

Describe the paraneoplastic syndromes that may occur with lymphoma in the dog

A
  • Hypercalcaemia leading to PUPD (most common with T cell lymphoma, or mediastinal lymphoma)
  • Thrombocytopaenia
66
Q

Describe the clinical presentation of lymphoma in cats

A
  • Multicentric form rare
  • Major association with FeLV: young cats typically with mediastinal involvement
  • Extranodol more common than in dogs: hepatic, nasal CNS, mediastinal, renal
  • Alimentary most common
  • Lymphoma on any differentias list for a sick cat
67
Q

Describe a common clinical presentation of lymphoma in calves and the treatment

A
  • Thymic lymphoma will cause chronic bloat as this prevents eructation, diagnosis on percusion
  • No treatment
68
Q

Describe a common clinical presentation of lymphoma in horses and the treatment

A
  • Can get splenic lymphoma
  • Colic
  • Splenectomy feasible but rare
69
Q

Describe a common clinical presentation of lymphoma in camelids and the treatment

A
  • Extranodal lymphoma

- Treat as dog if owner keen

70
Q

What methods can be used to identify lymphoma as T or B cell?

A
  • Flow cytometry
  • Clonality testing (PARR)
  • Immunohisochemistry
71
Q

What are some oddities regarding lymphoma in dogs?

A
  • Indolent lymphoma
  • GI lymphoma
  • Primary cutaneous lymphoma
72
Q

Briefly describe indolent lymphomas in dogs

A
  • Single node presentation, tend not to do so well

- Surgical excision not curative

73
Q

Briefly describe GI lymphomas in dogs

A
  • Thought to do badly
  • Dogs with diarrhoea worse prognosis
  • standard drugs ok, most treated with CHOP protocol
74
Q

Briefly describe primary cutaneous lymphomas in dogs

A
  • Several forms
  • generalised scale
  • Foci of erythroderma, crusting, ulceration
  • Multiple dermal nodules/erythematous plaques
  • Mucocutaneous lesions (may depigment)
  • Lymph nodes may be involve
75
Q

Describe feline alimentary lymphoma (presentation, forms, treatment, prognosis)

A
  • Most common form in cats
  • Lymphocytic: long remission, 17mo
  • Lymphoblastic: short remission, 3mo
  • Presentation: diarrhoea, weight loss, palpable mass, thickened bowel loops
  • Small and large cell forms
  • Small often T cell and low grade, respond well to pred and chlorambucil
  • Large tend to do much worse
  • Can be surgical if small area then chemo
76
Q

Describe feline nasal lymphoma (presentation, diagnosis, progression, treatment)

A
  • Often present as chronic rhinitis
  • Can be associated with good long term survival
  • Need advanced imaging/rhinoscopy
  • May later develop renal lymphoma
  • May just irradiate nose then chemo
77
Q

What methods can be used to inform decisions on appropriate therapy and prognosis of a grade II MCT?

A
  • Ki-67
  • AgNOR
  • c-KIT
78
Q

Outline the use of Ki-67 as a prognostic marker for MCTs

A
  • Antigen expressed during cell cycle
  • Detect with immunohistochemistry
  • Non-subjective, quantitative prognostic marker to predict MCT behaviour
79
Q

How would you interpret an MCT with low Ki-6 and AgNOR?

A

May not need additional therapy

80
Q

Outline the surgical approach to a MCT

A
  • Send sample for histo to grade and assess surgical margins
  • Pre-med with H1 blockers and H2 blockers to reduce risk of central and peripheral histaminic side effects
  • Re-evaluate after histo report: further staging/surgery, radiation, chemo
81
Q

Outline the follow up to surgical resection of an MCT

A
  • Check scar, drainage, LNs
  • Palpate abdomen
  • FNA new lesions
82
Q

Outline the staging of lymphoma

A
  • Carried out once diagnosis made or during initial diagnostic investigations
  • Stages I-V (only applies to nodal form)
83
Q

Explain the requirement for staging for a lymphoma

A
  • Most important prognostic factor is bone marrow involvement as it influences treatment and prognosis
  • Pragmatic: save money for chemo
  • Bone marrow is a significant site of chemo induced side effects
  • Stage V carries very poor prognosis
  • Need to know this in order to decide on treatment plan and give prognosis to owner
84
Q

Describe the criteria for a stage I lymphoma

A

Single LN affected

85
Q

Describe the criteria for a stage II lymphoma

A

Multiple LN affected in single area/region

86
Q

Describe the criteria for a stage III lymphoma

A

Generalised lymphadenopathy

87
Q

Describe the criteria for a stage IV lymphoma

A

Liver and/or splenic involvement (with or without stage I-III)

88
Q

Describe the criteria for a stage V lymphoma

A

Bone marrow or blood involvement and/or any non-lymphoid organ (with or without stages I-IV)

89
Q

Describe the criteria for substage a and substage b lymphoma and importance of this

A
  • a: without clinical signs of disease

- b: with clinical signs of disease, poorer prognosis regardless of immunophenotype

90
Q

What stage is given to ocular lymphoma without involvement of other LNs?

A

Stage V

91
Q

What are the treatment options for lymphoma?

A
  • Chemotherapy
  • Radiotherpy
  • Euthanasia
92
Q

Why are steroids included in the chemotherapeutic protocols for lymphoma?

A

Lymphocytotoxic as well as anti-inflammatory effects

93
Q

Outline the prognosis for lymphoma following chemotherapy

A
  • 80% of dogs go into remission

- 50-70% of cats go into remission

94
Q

Outline the phases of lymphoma chemotherapeutic treatment

A
  • Diagnosis and decision to treat
  • Induction therapy
  • Remission
  • Around 6 months, start maintenance
  • Withdraw drugs
  • Relapse
  • Rescue treatmetn around 9 months usually
  • Remission
  • Relapse
95
Q

Describe the rescue phase of lymphoma chemotherapeutic treatment

A

Initially try induction drugs again then use different drug protocol

96
Q

Describe the second period of remission with chemotherapy for lymphoma

A

Will be less than 50% of the first period

97
Q

List the chemotherapeutic protocols that can be used for lymphoma treatment

A
  • COP
  • CHOP (aka Madison Wisconsin)
  • Doxorubicine alone
  • Prednisolone alone
98
Q

List the side effects caused by cyclophosphamide during chemotherapy for lymphoma

A
  • Neutropaenia

- Haemorrhagic cystitis

99
Q

List the side effects caused by doxorubicin during chemotherapy for lymphoma

A
  • Neutropaenia
  • Anaphylaxis
  • Arrhythmia and cardiotocicity
  • Severe skin sloughing in contact with skin
100
Q

List the side effects caused by vincristine during chemotherapy for lymphoma

A

Severe skin sloughing in contact with skin

LCB2 (14 decks)

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