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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
how can you diagnose low grade/small cell lymphoma in a cat?
definitive: need histopathology cytology usually insufficient to differentiate small cell from IBD
26
what is treatment and prognosis of feline lymphoma dependent on?
more on anatomic location than staging
27
what is the response rate to chemotherapy with low grade/small cell lymphoma in cats?
>80%
28
what is the prognosis of mediastinal lymphoma in cats?
poor if FeLV+: 2-3 months good if FeLV-: about a year
29
what does lymphoma originate from?
lymphoid tissues: lymph nodes, spleen, bone marrow may affect any organ
30
what is large cell lymphoma like?
high grade, large lymphocytes rapidly dividing, rapid progression if untreated
31
what is small cell lymphoma like?
low grade, small lymphocytes slowly-dividing, more chronic
32
what is precaval syndrome in dogs often related to?
mediastinal mass swelling of face and forelimbs
33
which lymph nodes should you not do fine needle aspirates on?
mandibular lymph nodes: drain the oral cavity
34
what is stage I lymphoma?
single lymph node
35
what is stage II lymphoma?
regional lymph nodes, same side of diaphragm
36
what immunophenotypes are B lymphocytes?
CD79a CD20 CD21
37
what immunophenotypes are T lymphocytes?
CD3 CD5 CD4: helper T CD8: cytotoxic T
38
what are cells separated by in flow cytometry in immunophenotyping?
size and granularity: B vs T cell
39
what is the hallmark of malignancy?
clonality
40
which stages have better prognoses?
stages I and II > III, IV, V V is more guarded
41
where do chemotherapy drugs have their greatest effects?
rapidly dividing cells
42
how are chemotherapy side effects usually controlled?
supportive medications
43
what are the treatment options for lymphoma in dogs?
multi-agent, CHOP-based protocols: gold standard single-agent protocols prednisone alone no treatment
44
what is the unique toxicity to cyclophosphamide in CHOP?
sterile hemorrhagic cystitis
45
what is the unique toxicity to vincristine in CHOP?
ileus
46
what is progressive disease?
at least 20% increase in sum of lymph node diameter
47
what is remission rate with CHOP in dogs?
80-95%
48
what is L-asparaginase's mechanism of action?
asparagine depletion lymphoma cells lack L-asparagine synthetase but normal lymphocytes have halts protein synthesis in lymphoma cells
49
what is L-asparaginase reserved for?
when patients are sick at diagnosis or relapse when patients are neutropenic and disease is progressing
50
what electrolyte changes are seen with L-asparaginase?
hyperphosphatemia hypocalcemia hyperkalemia +/- azotemia
51
what are the treatment alternatives to CHOP?
doxorubicin tanovea/rabacfosadine CCNU/lomustine
52
how is gastrointestinal lymphoma treated in dogs?
CHOP CCNU: less GI toxicity
53
how is cutaneous lymphoma treated?
CHOP CCNU potentially better efficacy
54
what is the CBC like in patients with acute lymphoblastic leukemia?
circulating lymphoblasts or "unclassified cells" neutropeenia, thrombocytopenia, anemia
55
how is acute lymphoblastic leukemia treated?
CHOP: challenging with cytopenias supportive care: blood transfusions and antibiotics
56
what is prognosis of acute lymphoblastic leukemia?
poor median survival 1-4 months with CHOP chemotherapy
57
which dogs usually get indolent lymphoma/leukemia?
golden retrievers shih tzus
58
what is prognosis of indolent lymphoma/leukemia?
good median survival 2-3 years risk transformation to large cell lymphoma
59
are FeLV and FIV associated with feline lymphoma?
FeLV rare FIV possible
60
what are the sites of feline lymphoma?
gastric/intestinal infiltration mesenteric lymph nodes liver and/or spleen involvement peripheral lymph node enlargement rare in cats
61
what are the three histologic subtypes of feline lymphoma?
low grade/small cell GI lymphoma: most common high grade/large cell GI lymphoma large granular lymphoma: least common, most aggressive
62
what is clinical progression like of high grade/large cell?
acute
63
what is abdominal ultrasound like in high grade/large cell feline lymphoma?
gastric or intestinal mass loss of normal wall layering lymphadenopathy +/- effusion
64
what is large granular lymphoma like on cytology?
magenta granules seen within lymphoblasts
65
what is treatment of low grade/small cell feline lymphoma?
oral chemotherapy: chlorambucil or prednisolone frequent, lower doses
66
what does prognosis of feline GI lymphoma depend on?
histologic grade response to treatment low grade: transmural extension high grade: many negative prognostic factors
67
what is median survival time of low grade/small cell feline GI lymphoma?
1.5-3 years
68
what is survival or large granular feline GI lymphoma?
2-3 months with treatment response poor: 30%
69
how do cats with mediastinal lymphoma present?
acute respiratory distress dyspnea effusion
70
what are kidneys like with feline renal lymphoma?
enlarged, irregular frequently bilateral classic ultrasound appearance
71
what is median survival of feline nasal lymphoma?
1-3 years if cats achieve complete remission

A. Small Animal Medicine and Surgery II (31 decks)

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