Term
| _____________ is a collection of neoplasms arising from the proliferation of malignant lymphocytes. |
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Definition
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Term
| Lymphoma makes up ______% of all canine tumors. |
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Definition
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Term
| What neoplasm is the most often treated with chemotherapy in general and in private practice? |
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Definition
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Term
| ______% of dogs with lymphoma experience a complete remission. |
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Definition
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Term
| What are some differentials for generalized lymphadenomegaly? |
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Definition
Lymphoma
Histiocytic sarcoma
Metastatic neoplasia
Lymphadenitis--fungal, bacterial, parasitic, rickettsial
Immune-mediated diseases |
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Term
| T/F: lymphoma is possible in dogs <6 months of age. |
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Definition
| True. Lymphoma is more common in middle aged dogs, though. |
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Term
| Which breeds of dogs are considered "high risk" for developing lymphoma? |
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Definition
Boxer
St. Bernard
Scottish Terrier
Rottweiler
Retrievers
Basset Hounds
Bulldogs
Bull Mastiffs
Airedale |
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Term
| Exposure to what compounds can increase a dog's risk of developing lymphoma? |
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Definition
2,4D
Paint solvent/industrial areas |
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Term
| Describe the presentation of lymphoma in dogs. |
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Definition
The tumor will be indolent or aggressive.
The tumor will present as a painless, peripheral lymph node enlargement for a few days-weeks.
Systemic signs will be vague or will have no signs.
Clinical signs may reflect organ involvement. |
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Term
| What are some of the extranodal sites for lymphoma to develop? |
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Definition
CNS
Skin (Cutaneous lymphoma)
Liver
Ocular |
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Term
| ____% of dogs with extranodal lymphoma have ocular involvement. |
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Definition
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Term
While all of the following can be done in the diagnostic workup for lymphoma, which of the following is considered the most diagnostic?
a. CBC/Chemistry
b. Radiographs
c. Fine needle aspirate
d. Ultrasound |
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Definition
c. fine needle aspirate
Lymphoblasts will be seen. |
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Term
| Which lymph nodes should be avoided when running diagnostics to determine if a dog has lymphoma? |
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Definition
| The submandibular lymph nodes (superficial cervical) should be avoided, as they may have oral contaminants. |
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Term
| T/F: in diagnosing extranodal lymphoma, cytology on a lymph node biopsy/excision will be questionable and therefore cannot be used for a definitive diagnosis. |
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Definition
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Term
| What diagnostic tool allows the grade, architecture, and immunophenotype of lymphoma to be determined? |
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Definition
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Term
| What diagnostic test will help confirm a clinical suspicion of lymphoma by detecting clonal rearrangements within the gene that encode for B cell and T cell antigen receptors? |
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Definition
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Term
| In dogs, PCR is ____% sensitive and _____% specific for lymphoma. In cats, PCR is only ____% sensitive, but is ______% specific. |
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Definition
Dogs: 85% sensitive, 99% specific
Cats: 60% sensitive, 100% specific |
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Term
| Increased calcium levels are associated with what form of lymphoma? |
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Definition
| Increased calcium (hypercalcemia) is associated with the mediastinal form of lymphoma. |
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Term
| What abnormalities will be found on a CBC/chemistry of a dog with lymphoma? |
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Definition
Nonregenerative anemia of chronic dz.
Thrombocytopenia without clinical signs.
Circulating lymphoblasts.
Increased calcium in 10-15% of dogs. |
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Term
| T/F: for a leukemia/leukemic component of lymphoma, a bone marrow aspirate may be warranted. |
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Definition
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Term
| T/F: a CBC will show abnormal results in a dog with aleukemic leukemia. |
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Definition
| False: in many instances, a dog with aleukemic leukemia will have a normal CBC. |
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Term
| Radiographs are often abnormal in _____% of dogs with lymphoma. |
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Definition
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Term
| Describe the stages for clinically staging lymphoma in dogs: |
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Definition
Stage I: single lymph node
Stage II: regional lymph node
Stage III: generalized lymph node
Stage IV: liver, +/-spleen, +/- Stage III
Stage V: blood, bone marrow, nonlymphoid organ involvement
Stage V Substage A: patient well
Stage V Substage B: patient sick |
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Term
| Most lymphomas are ___ cell lymphomas, which provide a better remission rate and prolonged lifespan. |
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Definition
Most lymphomas are B cell lymphomas (vs. T cell).
Note: leukemias don't follow the same pattern, so some B cell leukemias are *more aggressive* |
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Term
| What are the grades for lymphoma? |
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Definition
High
Intermediate--most common
Low
The remission rate is greater, but survival times are lower, for high grade lymphomas. |
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Term
| List some negative prognostic indicators for canine lymphoma: |
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Definition
Poor response to therapy in 4-6 weeks.
T-cell immunophenotype
Advanced clinical stage
Clinical substage B
Hypercalcemia
Younger dog
Increasing grade of malignancy
Pretreatment with prednisone
Anemia <34%
Presence of multidrug resistance protein (p-Gp)
Extranodal location |
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Term
| List some positive prognostic indicators for canine lymphoma: |
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Definition
Body weight <15kg (more drug toxicity)
B cell immunophenotype
Complete response to therapy
Toxicity from therapy
Female
Low histologic grade
Diet--n-3 fatty acids (fish oil)
Indolent histologic subtype |
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Term
| Describe the characteristics/biologic behavior of Acute Lymphoblastic Lymphoma: |
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Definition
Younger dogs
Blast cells in bone marrow
Spleen/liver involvement
Extranodal sites
Severe hematologic changes
Must kill stem cells to treat--aggressive
Survival prognosis is very poor |
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Term
| Describe the characteristics/biologic behavior of Chronic Lymphocytic Lymphoma: |
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Definition
Older dogs
Small lymphocytes in bone marrow
Splenomegaly common
Monoclonal gammopathy
Mild hematologic changes
Slow proliferation--mild illness
Survival prognosis is good--up to 2 years |
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Term
| Cats with retroviral infection have an increased risk of lymphoma. Cats with only FeLV have ___x incidence of lymphoma, while cats with FeLV and FIV together have a ___x incidence of lymphoma. |
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Definition
FeLV: 60x incidence of lymphoma
FeLV/FIV: 75x incidence of lymphoma |
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Term
| Cats have different differentials for lymphadenomegaly than dogs. What is a top differential (besides lymphoma) for a cat with enlarged lymph nodes? |
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Definition
| Peripheral lymph node hyperplasia of the young cat |
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Term
| Younger cats have a higher incidence of ___ cell lymphoma, while older cats have a higher incidence of ___ cell lymphoma. |
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Definition
| Younger cats have a higher incidence of T cell lymphoma, while older cats have a higher incidence of B cell lymphoma. |
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Term
| Cats that are young and FeLV positive are likely to have a T cell, ___________ lymphoma. |
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Definition
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Term
| Cats that are older and FeLV negative, but FIV positive are more likely to have a B cell, ________/___________ lymphoma. |
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Definition
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Term
| What is the most common form of lymphoma in the cat? |
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Definition
| GI lymphoma is the most common. |
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Term
| The diagnostic tests in the cat are the same as for the dog, except for what additional test that should be performed in the cat? |
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Definition
| T4 determination with FeLV and FIV serology |
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Term
| T/F: clinical staging in the cat is the same as it is in the dog. |
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Definition
False. Clinical staging in the cat is based on anatomic presentation and is predictive of survival.
Mediastinal
GI--most common--good prognosis
Multicentric
Nasal
Extranodal--spinal cord--bad prognosis |
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Term
| T/F: FeLV negative cats with minimal disease live the longest. |
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Definition
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Term
| T/F: The GI and nasal forms of lymphoma in the cat provide the poorest prognosis. |
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Definition
| False. Cats with the nasal/GI forms live longer. |
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Term
| T/F: hypercalcemia is a common finding in cats with mediastinal lymphoma. |
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Definition
| False: hypercalcemia in the cat is uncommon. |
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Term
| T/F: Sick cats experience more adverse drug effects and may have a poorer response to therapy and may not live as long. |
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Definition
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Term
| Do dogs or cats live longer with lymphoma? |
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Definition
| Dogs live longer. Untreated cats live 1-3 weeks, and those that are treated are usually diagnosed at a later clinical stage than dogs. |
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Term
| T/F: histology determines therapy for cats with GI lymphoma. |
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Definition
True
Low grade, small cell: oral therapy
High grade, large cell: bad, 4 month MST with chemo |
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Term
| GI lymphoma must be distinguished from what other disease? |
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Definition
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Term
| In cats, mirtazipine can be used for what therapeutic purpose? |
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Definition
| Nutritional support--stimulates appetite |
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Term
| In cats receiving therapy for lymphoma, adequate hydration and fluid therapy are important to help prevent __________ disease. |
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Definition
| Renal disease--avoid nephrotoxic drugs. |
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Term
| With treatment, cats experience a ____-____% remission and have a MST of ______ months. |
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Definition
40-70% remission
6-10 months MST |
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Term
| What type of human lymphoma do canine and feline lymphomas resemble? |
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Definition
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Term
| What lesion is often observed in dogs with ocular lymphoma? What other lesion is sometimes noted? |
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Definition
| Anterior uveitis is most commonly observed, but retinitis is not uncommon. |
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Term
| Though FNA is often sufficient for diagnosis, what is considered the gold standard for lymphoma diagnosis? |
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Definition
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Term
| Though FNA is often sufficient for diagnosis, what is considered the gold standard for lymphoma diagnosis? |
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Definition
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Term
| T/F: dogs with clinical substage b do not respond as well to treatment and have more difficulty metabolizing drugs. |
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Definition
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Term
| T/F: one mechanism of paraneoplastic immune-mediated hemolytic anemia or thrombocytopenia is caused by tumor made proteins. |
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Definition
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Term
| Dogs with greater than ___-____% lymphoblasts in the bone marrow are considered to have lymphoma by many clinical pathologists. |
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Definition
30-50%
Note: the presence of circulating lymphoblasts (in low numbers) does not necessarily mean that a dog has leukemia. |
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Term
| Which chemotherapeutic agent is the exception to the "single drugs don't work well" rule when treating canine lymphoma? |
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Definition
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Term
| What is considered the best protocol for treating canine lymphoma? |
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Definition
UW-Madison protocol using vincristine, cyclophosphamide, prednisone, L-asparaginase, and doxorubicin.
This is costly and time-consuming. |
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Term
| The use of cyclophosphamide, vincristine, and oral prednisone in combination elicits a complete response in ____% of dogs and MST of ____ months. |
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Definition
| 70% of dogs experienced complete remission and had a MST of 5 months. |
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Term
| T/F: prednisone alone does not increase survival of canine lymphoma. |
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Definition
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Term
| The UW-Madison protocol allows what MST in dogs with lymphoma? |
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Definition
| About 1 year; 25% live to two years. |
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Term
| T/F: lymphoma is considered a systemic disease, even if it is only found in one area of a cat. |
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Definition
| True. Microscopically, lymphoma is elsewhere in the body. |
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Term
| T/F: dogs with intestinal lymphoma have a good prognosis. |
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Definition
| False. Unlike cats, dogs with GI lymphoma have a poor response to chemotherapy and MST of 6 months at best. |
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Term
| What type of drug protocols should be used for treatment of feline lymphoma? |
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Definition
Multidrug protocols:
UW-Madison protocol
Surgery + Radiation + chemotherapy protocols also helpful |
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