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Companion Animal Med & Surgery > Lymphoma > Flashcards

Lymphoma Flashcards

1
Q

List five staging tests for lymphoma and what you are looking for on each.

A
  1. CBC
  • non-regenerative anemia
  • thrombocytopenia
  • lymphocytosis
  1. Serum biochemical profile
  • hypercalcemia
  • organ (esp. liver) dysfunction
  1. Urinalysis-but this is mostly for obtaining baseline values before treatment since some drugs have urinary tract toxicity
  2. Bone marrow aspirate
  • if blasts are in circulation; determine if lymphoma or leukemia
  • if cytopenias are present
  1. Chest rads
    * abnormalities, diffuse pulmonary infiltrates
  2. Abdominal imaging
  • organomegaly
  • lyphadenopathy
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2
Q

What are the minium staging requirements prior to treatment for lymphoma

A

Chest rads & abdominal ultrasound

(from old guide)

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3
Q

_____% of canine lymphomas involve lymph nodes

A

80

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4
Q

What is the most prognostic factor for dogs with lymphoma?

A

Substage

  • A-animal doesn’t show signs
  • B-animal shows signs of disease; feels bad
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5
Q

Differential diagnoses for lymphoma

A
  • can look like most anything; e.g. inflammatory skin disease, infectious(tick-born), immune-mediated, other hematopoetic tumors such as leukemia
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6
Q

Lymphoma accounts for ____% of all canine neoplasms [excluding benign skin tumors)

A

25

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7
Q

Name some breed predilections for lymphoma

A
  • Golden retriever
  • Labrador retriever
  • Rottweiler
  • Boxer
  • Bassett hound
  • Scottish terrier
  • Bulldog
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8
Q

What sex is predisposed to canine lymphoma?

A

no sex predilection

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9
Q

T/F lymphoma risk increases with age

A

True

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10
Q

What genetic/epigenetic factors can affect risk for canine lymphoma?

A
  • gain of chromosomes 13, 31
  • loss of chromsome 14
  • p53
  • N-ras
  • hypomethylation
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11
Q

______ is a known contributor to gastric lymphoma in ferrets

A

Helicobacter

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12
Q

What are some environmental factors that may contribute to canine lymhoma?

A
  • 2,4-D herbicides
  • paint thinner
  • living near factories, incinerators, toxic waste sites, highly populated areas
  • magnetic fields
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13
Q

What are two cases of immune system dysfunction/suppression that are associated with canine lymphoma?

A
  • ITP
  • post-transplant lymphoma
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14
Q

80% of canine lymphoma is ____________

A

multicentric

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15
Q

PPV for FNA cytology dx for lymhpoma

A

98%

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16
Q

____% of dogs are “sick” at time of lymphoma diagnosis

A

40%

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17
Q

40% of canine lymphoma is what type?

A

diffuse lymphoblastic B-cell lymphoma

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18
Q

The majority of dogs have what grade lymphoma?

A

intermediate to high

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19
Q

Characteristics of low grade lymphoma

A
  • small cell, lymphocytic, “indolent”
  • low mitotic rate
  • progress slowly
  • may not need treatment
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20
Q

Characteristics of intermediate to high grade lymphoma

A
  • large cell, lymphoblastic
  • high mitotic rate
  • likely to respond to chemotherapy
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21
Q

What percentage of dogs with intermediate to high grade lymphoma die of their disease?

A

90%

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22
Q

Circulating blasts means what about the lymphoma

A

Stage V

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23
Q

T-cell lymphomas are more likely to be where in the body?

A
  • cutatneous
  • mediastinal
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24
Q

What lymphoma type is more likely to be associated with the paraneoplastic syndrome hypercalcemia?

A

T-cell

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25
Q

What is the mechanism of hypercalcemia?

A

PTHrp secretion by neoplastic lymphocytes

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26
Q

PARR stands for _______

A

PCR for Antigen Receptor Rearrangements

27
Q

Three common CBC findings with canine lymphoma

A
  1. non-regenerative anemia
  2. thrombocytopenia
  3. lymphocytosis
28
Q

Diffuse pulmonary infiltrates on chest radiographs of a lymphoma patient may look like ________

A

pneumonia

29
Q

____% of dogs with multicentric lymphoma will have diffuse pulmonary infiltrates

A

30

30
Q

What is the standard of care for the majority of canine lymphoma?

A

chemotherapy

31
Q

When might surgery be warranted in a case of canine lymphoma?

A

Example: if there is a solitary obstructive intestinal lesion

32
Q

About how long is the CHOP protocol?

A

25 weeks

33
Q

What is the remission rate and MST for CHOP protocol treatment of multicentric, high grade lymphoma?

A
  • 75-94% remission; generally strong remission
  • 10-14 months MST
34
Q

What is the remission rate and MST associated with single agent chemo (doxorubicin) for multicentric, high grade lymphoma?

A
  • 80-85% remission rate
  • 6-8 months MST
35
Q

What is the MST for no treatment of canine multicentric high grade lymphoma?

A

1-1.5 months

36
Q

Prednisone alone can have a remission rate of _____% when used to treat canine multicentric high grade lymphoma

A

50-60%

37
Q

What does “CHOP” stand for?

A

C=cyclophosphamide (Cytoxan)

H=hydroxydaunorubicin (Doxorubicin/Adriamycin)

O=vincristine (Oncovin)

P=prednisone (+/- L-asparaginase; Elspar)

38
Q

MST for canine B-cell lymphoma treated with CHOP

A

12-14 months

39
Q

MST for canine T-cell lymphoma treated with CHOP

A

4-6 months

40
Q

How are indolent lymhpomas diagnosed?

A

only by histopathology

41
Q

What percentage of all canine lymphomas are indolent?

A

29%

42
Q

Treatment of indolent lymphomas

A
  • mild chemo e.g. pred/cholorambucil
  • CHOP
  • may not even need treatment
43
Q

Survival times of over _____ are not uncommon for dogs with indolent lymphoma

A

4 years

44
Q

Feline lymphoma accounts for _____ of feline neoplasms

A

1/3

45
Q

FeLV increases a cats risk of developing LSA by how much?

A

66 times

46
Q

What percent of cats with LSA are FeLV+ today?

A

13%

47
Q

____% of FeLV+ cats will develop LSA

A

25-50%

48
Q

The risk of developing LSA is increased 77x in cats that have ______

A

FeLV + FIV infection

49
Q

What is a risk factor for cats developing lymphoma besides FeLV and FIV?

A

Smoking households

50
Q

What is the most common form of lymphoma in the cat?

A

alimentary

51
Q

Clinical signs of alimentary lymphoma in the cat

A
  • chronic, progressive anorexia & weight loss
  • +/-diarrhea, vomiting
  • palpable mass or thickened intestines
  • hematochezia or tenesmus if colon involvement
52
Q

Lymphocytic lymhphoma (cats) is important to distinguish from _____

A

IBD; full-thickness, surgically obtained biopsy

53
Q

Recommended treatment for lymphocytic alimentary lymphoma in cats? What is the response rate and remission time?

A
  • pred + chlorambucil
  • 95% response rate
  • median remission = 2 years
54
Q

Which form of alimentary lymphoma (cats) usually present with palpable mass lesions vs. thickened bowel loops?

A
  • lymphoblastic—mass lesions
  • lymphocytic—thickened bowel
55
Q

What is a very important differential for multicentric lymphoma in a young cat?

A

Benign peripheral lymph node hyperplasia of cats

56
Q

How is a diagnosis of benign peripheral lymph node hyperplasia made in a cat?

A

have to have histopathology

57
Q

How does viral status (FeLV+) affect the response to therapy and survival time in cats with multicentric lymphoma?

A
  • usually no influence on therapy response
  • may influence the survival time
58
Q

Differential for mediastinal lymphoma

A

thymoma

59
Q

Clinical signs of mediastinal lymphoma in cats

A
  • acute onset dyspnea
  • dysphagia
  • Horner’s syndrome
60
Q

A non-compressible cranial thorax in a cat is a good indicator of _____

A

mediastinal lymphoma

61
Q

If an FNA/cytology is not able to differentiate thymoma from mediastinal lymphoma, what can you do?

A

histopathology, flow cytometery

62
Q

Treatment for mediastinal lymphoma?

A

Chemo

+/- RT

63
Q

What is a situation where you might not have to treat a case of mediastinal lymphoma in cats?

A

young, FeLV negative

64
Q

Should you remove a kidney of a cat that you find lymphoma in? why or not?

A

No, there is almost certainly lymphoma in the other, even if not detectable yet

Companion Animal Med & Surgery (12 decks)

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