Lymphoma cases Flashcards
Ddx for lymphadenopathy?
- Lymphoma
- Reactive lymphadenopathy - IMHA, dental disease, systemic inflammation, IMPA
- Lymphadenitis - immune mediated, leishmania, local infection
- Metastatic neoplasia
What to check on haemotology with lymphoma?
- Presence of cytopenias - Neutropenia, thrombocytopenia could suggest bone marrow involvement
- Atypical lymphoid cells - Bone marrow involvement, Leukemia
What do we check on biochemistry with lymphoma?
- Hypercalcemia - More likely with T-cell
- Azotemia - Possibility of renal involvement, Older patients concurrent CKD
- Liver values - Possibility of liver involvement, Other comorbidities
- Hypoproteinemia - Concerns of GI involvement
What are different methods of finding out immunophenotype?
- Flow cytometry =
- Non-invasive
- More info than PARR - PARR =
- Non-invasive
- Less info than flow cytometry - Biopsy and IHC =
- More invasive
- Less info than flow cytometry
What should you check for on chest radiographs of lymphoma?
- Pulmonary involvement - diffuse interstitial / alveolar pattern
- Intrathoracic lymphadenopathy
What is checked for on abdominal ultrasound?
o Liver involvement
o Spleen involvement
o Abdominal lymph nodes
o Intestinal involvement
o Other comorbidities
What is different between stage 4a and 4b lymphoma?
- Both have liver/spleen involvement
- 4a = no clinical signs
- 4b = has clinical signs
What are treatment options for lymphoma?
- Chemotherapy – CHOP/CEOP protocol
- Chemotherapy – high dose COP protocol
- Prednisolone alone
- Euthanasia
What clinical signs can dogs with lymphoma develop?
- PUPD
- Blindness
- Swelling of the legs + face - cranial caval syndrome
- GI signs - vomiting / diarrhoea
- Dyspnoea
- Neurology signs - seizures, paresis
- Cutaneous lesions
What are DDx for abdominal mass?
- Neoplasia - lymphoma, adenocarcinoma, MCT
- Abscess
- Granuloma - FIP
- Foreign body
- Intussusception
What is the top differential for hyperglycaemia in a cat at the practise?
- STRESS
What is Tx for this cat with localised mass (lymphoma)?
- Surgical resection of intestinal mass
- High dose COP once recovered from surgery
- Supplementation with cobolamin
- Nutritional support
What is the most important prognostic factor in cats with lymphoma?
- Response to treatment
How would you treat chemotherapy toxicity?
- Supportive treatment:
– IV fluid therapy: correct dehydration
– Antibiotics (neutrophils < 1x109/L)
– +/- analgesia, antiemetics, appetite stimulants
– +/- Granulocyte-colony stimulating factor (GCSF)
– Nutritional support - Monitoring of vitals
- Risk of sepsis
- Monitor neutrophil count
What antibiotic would you use and what route for chemotherapy toxicity in a poor animal?
- IV
Amoxi-clav / Cefuroxime
