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A. Small Animal Medicine and Surgery II > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

what can be seen on a CBC with lymphoma?

A

hypercalcemia
hypoproteinemia
hyperglobinemia

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2
Q

what are the common breeds with lymphoma?

A

boxers
bulldogs
bassets
rottweilers
retrievers
beagles

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3
Q

what is staging?

A

clinical assessment of the extent of lymphoma in the body

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4
Q

what can you use to assess stage of lymphoma?

A

bloodwork
thoracic radiographs
abdominal ultrasound

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5
Q

what determines if an animal with lymphoma is substage a or b?

A

a: clinically healthy, no systemic signs
b: clinically ill, systemic signs

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6
Q

what is immunophenotype?

A

determining the type of lymphocyte based on surface antigens

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7
Q

what is PARR?

A

PCR for antigen-receptor rearrangement

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8
Q

dogs with ______ cell lymphoma have shorter remission and survival times than with _______ cell lymphoma

A

T
B

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9
Q

do dogs with substage b or substage a have worse prognoses?

A

substage b

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10
Q

what is the mainstay of treatment for lymphoma?

A

chemotherapy

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11
Q

what do chemotherapy drugs target?

A

DNA or mitotic apparatus and halt cell division

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12
Q

what percentage of patients have significant adverse effects?

A

<25%

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13
Q

what are median survival times with CHOP-based protocols?

A

B cell: 12-14 months
T cell: 6-9 months

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14
Q

what is median survival for lymphoma without treatment?

A

4-6 weeks

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15
Q

what drugs are given in CHOP-based protocols?

A

cyclophosphamide/cytoxan
hydroxydaunorubicin/doxorubicin and adriamycin
oncovin/vincristine
prednisone

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16
Q

what is a unique toxicity with doxorubicin in CHOP?

A

cardiac toxicity: acute ventricular arrhythmias and cumulative toxicity similar to DCM

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17
Q

what is partial remission?

A

at least 30% decrease in sum of lymph node diameter

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18
Q

what are cautions with L-asparaginase?

A

anaphylaxis
resistance, usually after 2-3 doses
acute tumor lysis syndrome

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19
Q

what is acute tumor lysis syndrome?

A

rapid die-off of lymphoma or leukemia cells causes electrolyte disturbances

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20
Q

what is median survival time of gastrointestinal lymphoma?

A

2-3 months

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21
Q

what are most cutaneous lymphomas?

A

most tend to be T cell
epitheliotropic

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22
Q

what is leukemia?

A

disease originates in bone marrow

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23
Q

which cat breeds are predisposed to lymphoma?

A

siamese
DSH

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24
Q

what can be felt on abdominal palpation with low grade/small cell lymphoma in cats?

A

intestinal thickening

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25
Q

how can you diagnose low grade/small cell lymphoma in a cat?

A

definitive: need histopathology
cytology usually insufficient to differentiate small cell from IBD

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26
Q

what is treatment and prognosis of feline lymphoma dependent on?

A

more on anatomic location than staging

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27
Q

what is the response rate to chemotherapy with low grade/small cell lymphoma in cats?

A

> 80%

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28
Q

what is the prognosis of mediastinal lymphoma in cats?

A

poor if FeLV+: 2-3 months
good if FeLV-: about a year

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29
Q

what does lymphoma originate from?

A

lymphoid tissues: lymph nodes, spleen, bone marrow
may affect any organ

30
Q

what is large cell lymphoma like?

A

high grade, large lymphocytes
rapidly dividing, rapid progression if untreated

31
Q

what is small cell lymphoma like?

A

low grade, small lymphocytes
slowly-dividing, more chronic

32
Q

what is precaval syndrome in dogs often related to?

A

mediastinal mass
swelling of face and forelimbs

33
Q

which lymph nodes should you not do fine needle aspirates on?

A

mandibular lymph nodes: drain the oral cavity

34
Q

what is stage I lymphoma?

A

single lymph node

35
Q

what is stage II lymphoma?

A

regional lymph nodes, same side of diaphragm

36
Q

what immunophenotypes are B lymphocytes?

A

CD79a
CD20
CD21

37
Q

what immunophenotypes are T lymphocytes?

A

CD3
CD5
CD4: helper T
CD8: cytotoxic T

38
Q

what are cells separated by in flow cytometry in immunophenotyping?

A

size and granularity: B vs T cell

39
Q

what is the hallmark of malignancy?

A

clonality

40
Q

which stages have better prognoses?

A

stages I and II > III, IV, V
V is more guarded

41
Q

where do chemotherapy drugs have their greatest effects?

A

rapidly dividing cells

42
Q

how are chemotherapy side effects usually controlled?

A

supportive medications

43
Q

what are the treatment options for lymphoma in dogs?

A

multi-agent, CHOP-based protocols: gold standard
single-agent protocols
prednisone alone
no treatment

44
Q

what is the unique toxicity to cyclophosphamide in CHOP?

A

sterile hemorrhagic cystitis

45
Q

what is the unique toxicity to vincristine in CHOP?

A

ileus

46
Q

what is progressive disease?

A

at least 20% increase in sum of lymph node diameter

47
Q

what is remission rate with CHOP in dogs?

A

80-95%

48
Q

what is L-asparaginase’s mechanism of action?

A

asparagine depletion
lymphoma cells lack L-asparagine synthetase but normal lymphocytes have
halts protein synthesis in lymphoma cells

49
Q

what is L-asparaginase reserved for?

A

when patients are sick at diagnosis or relapse
when patients are neutropenic and disease is progressing

50
Q

what electrolyte changes are seen with L-asparaginase?

A

hyperphosphatemia
hypocalcemia
hyperkalemia
+/- azotemia

51
Q

what are the treatment alternatives to CHOP?

A

doxorubicin
tanovea/rabacfosadine
CCNU/lomustine

52
Q

how is gastrointestinal lymphoma treated in dogs?

A

CHOP
CCNU: less GI toxicity

53
Q

how is cutaneous lymphoma treated?

A

CHOP
CCNU potentially better efficacy

54
Q

what is the CBC like in patients with acute lymphoblastic leukemia?

A

circulating lymphoblasts or “unclassified cells”
neutropeenia, thrombocytopenia, anemia

55
Q

how is acute lymphoblastic leukemia treated?

A

CHOP: challenging with cytopenias
supportive care: blood transfusions and antibiotics

56
Q

what is prognosis of acute lymphoblastic leukemia?

A

poor
median survival 1-4 months with CHOP chemotherapy

57
Q

which dogs usually get indolent lymphoma/leukemia?

A

golden retrievers
shih tzus

58
Q

what is prognosis of indolent lymphoma/leukemia?

A

good
median survival 2-3 years
risk transformation to large cell lymphoma

59
Q

are FeLV and FIV associated with feline lymphoma?

A

FeLV rare
FIV possible

60
Q

what are the sites of feline lymphoma?

A

gastric/intestinal infiltration
mesenteric lymph nodes
liver and/or spleen involvement
peripheral lymph node enlargement rare in cats

61
Q

what are the three histologic subtypes of feline lymphoma?

A

low grade/small cell GI lymphoma: most common
high grade/large cell GI lymphoma
large granular lymphoma: least common, most aggressive

62
Q

what is clinical progression like of high grade/large cell?

A

acute

63
Q

what is abdominal ultrasound like in high grade/large cell feline lymphoma?

A

gastric or intestinal mass
loss of normal wall layering
lymphadenopathy
+/- effusion

64
Q

what is large granular lymphoma like on cytology?

A

magenta granules seen within lymphoblasts

65
Q

what is treatment of low grade/small cell feline lymphoma?

A

oral chemotherapy: chlorambucil or prednisolone
frequent, lower doses

66
Q

what does prognosis of feline GI lymphoma depend on?

A

histologic grade
response to treatment
low grade: transmural extension
high grade: many negative prognostic factors

67
Q

what is median survival time of low grade/small cell feline GI lymphoma?

A

1.5-3 years

68
Q

what is survival or large granular feline GI lymphoma?

A

2-3 months with treatment
response poor: 30%

69
Q

how do cats with mediastinal lymphoma present?

A

acute respiratory distress
dyspnea
effusion

70
Q

what are kidneys like with feline renal lymphoma?

A

enlarged, irregular
frequently bilateral
classic ultrasound appearance

71
Q

what is median survival of feline nasal lymphoma?

A

1-3 years if cats achieve complete remission

A. Small Animal Medicine and Surgery II (17 decks)

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