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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
What is the mechanism of hypercalcemia?
PTHrp secretion by neoplastic lymphocytes
26
PARR stands for \_\_\_\_\_\_\_
PCR for Antigen Receptor Rearrangements
27
Three common CBC findings with canine lymphoma
1. non-regenerative anemia 2. thrombocytopenia 3. lymphocytosis
28
Diffuse pulmonary infiltrates on chest radiographs of a lymphoma patient may look like \_\_\_\_\_\_\_\_
pneumonia
29
\_\_\_\_% of dogs with multicentric lymphoma will have diffuse pulmonary infiltrates
30
30
What is the standard of care for the majority of canine lymphoma?
chemotherapy
31
When might surgery be warranted in a case of canine lymphoma?
Example: if there is a solitary obstructive intestinal lesion
32
About how long is the CHOP protocol?
25 weeks
33
What is the remission rate and MST for CHOP protocol treatment of multicentric, high grade lymphoma?
* 75-94% remission; generally strong remission * 10-14 months MST
34
What is the remission rate and MST associated with single agent chemo (doxorubicin) for multicentric, high grade lymphoma?
* 80-85% remission rate * 6-8 months MST
35
What is the MST for no treatment of canine multicentric high grade lymphoma?
1-1.5 months
36
Prednisone alone can have a remission rate of \_\_\_\_\_% when used to treat canine multicentric high grade lymphoma
50-60%
37
What does "CHOP" stand for?
C=cyclophosphamide (Cytoxan) H=hydroxydaunorubicin (Doxorubicin/Adriamycin) O=vincristine (Oncovin) P=prednisone (+/- L-asparaginase; Elspar)
38
MST for canine B-cell lymphoma treated with CHOP
12-14 months
39
MST for canine T-cell lymphoma treated with CHOP
4-6 months
40
How are indolent lymhpomas diagnosed?
only by histopathology
41
What percentage of all canine lymphomas are indolent?
29%
42
Treatment of indolent lymphomas
* mild chemo e.g. pred/cholorambucil * CHOP * may not even need treatment
43
Survival times of over _____ are not uncommon for dogs with indolent lymphoma
4 years
44
Feline lymphoma accounts for _____ of feline neoplasms
1/3
45
FeLV increases a cats risk of developing LSA by how much?
66 times
46
What percent of cats with LSA are FeLV+ today?
13%
47
\_\_\_\_% of FeLV+ cats will develop LSA
25-50%
48
The risk of developing LSA is increased 77x in cats that have \_\_\_\_\_\_
FeLV + FIV infection
49
What is a risk factor for cats developing lymphoma besides FeLV and FIV?
Smoking households
50
What is the most common form of lymphoma in the cat?
alimentary
51
Clinical signs of alimentary lymphoma in the cat
* chronic, progressive anorexia & weight loss * +/-diarrhea, vomiting * palpable mass or thickened intestines * hematochezia or tenesmus if colon involvement
52
Lymphocytic lymhphoma (cats) is important to distinguish from \_\_\_\_\_
IBD; full-thickness, surgically obtained biopsy
53
Recommended treatment for lymphocytic alimentary lymphoma in cats? What is the response rate and remission time?
* pred + chlorambucil * 95% response rate * median remission = 2 years
54
Which form of alimentary lymphoma (cats) usually present with palpable mass lesions vs. thickened bowel loops?
* lymphoblastic---mass lesions * lymphocytic---thickened bowel
55
What is a very important differential for multicentric lymphoma in a **young** cat?
**Benign peripheral lymph node hyperplasia of cats**
56
How is a diagnosis of benign peripheral lymph node hyperplasia made in a cat?
have to have **histopathology**
57
How does viral status (FeLV+) affect the response to therapy and survival time in cats with multicentric lymphoma?
* usually no influence on therapy response * may influence the survival time
58
Differential for mediastinal lymphoma
thymoma
59
Clinical signs of mediastinal lymphoma in cats
* acute onset dyspnea * dysphagia * Horner's syndrome
60
A non-compressible cranial thorax in a cat is a good indicator of \_\_\_\_\_
mediastinal lymphoma
61
If an FNA/cytology is not able to differentiate thymoma from mediastinal lymphoma, what can you do?
histopathology, flow cytometery
62
Treatment for mediastinal lymphoma?
Chemo +/- RT
63
What is a situation where you might not have to treat a case of mediastinal lymphoma in cats?
young, FeLV negative
64
Should you remove a kidney of a cat that you find lymphoma in? why or not?
No, there is almost certainly lymphoma in the other, even if not detectable yet

Companion Animal Med & Surgery (12 decks)

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