Haematopoetic Neoplasia 1 (Annaleise Stell) Flashcards Preview

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Flashcards in Haematopoetic Neoplasia 1 (Annaleise Stell) Deck (56)
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1

Where does lymphoma orginiate?

- LNs, spleen, lymphoid tissue anywhere in body

2

What is the most common canine and feline malignant tumours?

Lymphome for both

3

What signalment is pdf lymphoma in dogs?

- middle aged/older BUT can be any age (reported

4

Aetiology of lymphoma in dogs?

- unknown
- ?genetic factors
- chromosomal abnormalities and mutations in tumour suppressors genes eg. p53
- environmental factors (herbicides, magnetic fields, industrial areas)

5

Signalment pdf lymphoma in cats?

- ~10yo @ onset (previously younger cats more common but v incidence as FeLV numbers v)
- siamese/oriental cats pdf mediastinal lymphoma

6

Aetiology of lymphoma in cats?

- FeLV+ ^ risk d/t retrovirus recombination encouraging malignant transformation and immunosuppressive role (vax has v no.s lymphoma d/t FeLV, though some cases testing -ve may still be d/t FeLV infection in the past which has been cleared)
- FIV+ ^ risk, mechanism unknown (?Immunosuppression)
- Genetic factors
- Environmental tobacco smoke
- Sites of chronic inflammation (eg. IBD)
- immunosuppression eg. cyclosporine post renal-transplant int he USA
- spontaneous (Aetiology not fully understood)

7

Most common presentation of lymphoma in dogs?

> multicentric 85% dog lymphomas
- peripheral lymphadenomegaly (painless, movable, multiple LNs)
- otherwise asymptomatic or nonspecific signs (malaise, lethargy, wt loss, anorexia, pyrexia, PUPD if hyperCa)
± liver/spleen enlargement

8

Which LNs are easiest to assess on PE?

- submand
- prescap
- popliteal
±axillary
±superficial inguinal

9

Does FeLV affect old cats?

No young

10

Ddx for multicentric lymphoma in dogs?

- disseminate infection -> lymphadenitis (bacteria/virus/rickettsial/protozoal/parasitic/fungal)
- immune mediated dz
- other haem tumours (leukaemia, myeloma)
- mets/disseminate neoplasia eg. histiocytic sarcoma, MCT
- generalised skin dz
- sterile granulomatous lymphadenitis (rare)

11

What is the 2nd most common presentation of lymphoma in dogs?

> GI/alimentary lymphoma 7% cases
- wt loss, anorexia, VD+, ± jaundice if concurrent liver involvement
- localised mass/multifocal diffuse thickened loops of intestine ± mesenteric LN enlargement

12

Ddx for GI lymphoma in the dog?

- IBD (especially if difuse)
- other GI tumours (adenocarcinoma, leimyoma, leiomyosarcoma, gastrointestinal stromal tumours (GISTs)
- FB/intusseseption

13

Which forms of lymphoma are less commonly seen in dogs?

> mediastinal 3% cases
- cranial mediastinal mass ± pleural fluid
- cough, regurge, dyspnoea/tachypnoea, v heart sounds or caudal displacmeent of heart, loss of compressability, caval syndrome (impedence of venous return from head -> oedema) Horners syndrome
- often T cell phenotypes
± hyperCa (rare in cats) -> PUPD, dehydration, malaise, V+, bradycardia, constipation, mm tremors
> cutaneous (solitary/generalised)
- epitheliotropic (in epidermis, "mycoides fungoides", chronic dz, assoc with T cells, casues 3 stage scaling, alopecia, pruritis -> erythematous, thickened, ulcerated and exudatice -> proliferative plaques and nodules, may involve oral mucosa/mucocutaneous junction)
- non-epitheliotropic form (deeper, can be T or B cell, causes nodules rather than scaling)

14

Ddx for mediastinal lymphoma in the dog?

- other neoplasia (thymoma, ectopic thyroid tumour, thymic carcinoma, chemodectoma, mets)
- non-neoplastic mass lesions (abscess, granuloma, cyst)
- other casues of effusion (pyothorax, chylothorax, heart failure, haemothorax)

15

Ddx cutaneous lymphoma

- infectious deramatitis
- immune mediated dermatitis
- histiocytic skin dz
- other cutaneous neoplasia (eg. MCT, mets)

16

Which extranodal forms of lymphoma occour very rarely in dogs?

- hepatic
- spenic
- ocular (can be seen alone or with generalised disease, signs of uveitis, blepharospasm , infiltration, haemorrhage, retinal detachment)
- renal lymphoma
- CNS/spinal lymphoma
- nasal/nasopharyngeal/laryngeal/tracheal

17

Most common presentation of feline lymphoma?

> GIT >50% cases (very rare to see generalised lymphadenopathy)
- wt loss, anorexia, VD+ ±jaundice if concurrent liver invovlemnet
~ High grade form (mass lesions GI or mesenteric LNs, acute onset, signs of obstruction, commonly ~10yo)
~ Low grade form (may be diffuse thickening of intestinal loops/mild lymphadenomegaly, chronic hx, commonly ~13yo)

18

Ddx for feline GI lymphoma?

- IBD
- other Gi neoplasia (Adenocarcinoma, leimyoma, leiomyosarcoma, GI stronal tumours (GISTs) intestinal MCT
- FB,/intusseseption
- r/o other dz of old cats -> wt loss eg. hyperthyroidism , renal failure, DM

19

2nd most common form of lymphoma in cats?

> mediastinal 20% cases
- cranial mediastinal mass ± pleural fluid ± other sites affected concurrently
- esp younger cats
- often T cell phenotype
- HyperCa RARE in cats cf. dogs

20

Ddx mediastinal lymphoma in cats?

- other neoplasia (thymoma, ectopic thyroid tumour, thymic carcinoma, chemodectoma, mets)
- non-neoplastic mass lesions (abscess, granuloma, cyst)
- other casues of effusion (pyothorax, chylothorax, heart failure, haemothorax, FIP)

21

Which forms of lymphoma are seen in ~5-10% lymphoma cases in cats?

- nodal
- renal
- hepatic/splenic
- nasal/nasopharyngeal

22

Outline clinical picture with nodal lymphoma in cats

- rare alone but more common as a component of disease
- in pure node forms, single/regional elargement more common than generalised lymphadenomegaly.
- uncommon distinct form HODGKINS-LIKE LYMPHOMA (T cell rich B cell lymphoma) only affects head or neck

23

How may Hodgkins-like lymphome be treated in cats?

May be amenable to surgery as localised

24

Ddx nodal lymphoma cats

=== dogs
- benign hyperplastic LN syndromes unique to cats

25

Outline clinical picture with renal lymphoma in cats

- large irregular kidneys, often bilateral
- signs of kidney dz (PUPD, anorexia, weight loss)
- ~9yo
- can be concurrent with lymphoma elsehere
- 50% cats also develop CNS lymphoma (link unknown)
- often intermediate - high grade

26

Ddx for renal lymphoma in cats

- polycystic kidney disease
- pyelonephritis
- FIP
- acute renal failure
- hydronephrosis
- perinephric pseudocyst
- other renal tumours eg carcinoma (can also be bilateral) HS

27

Outline clinical picture with hepatic/splenic lymphoma in cats

- malaise ± jaundice if liver invovled
- may be concurrent with GI lymphoma

28

Ddx hepatic/splenic lymphoma?

- other splenic masses (feline MCT, HSA)
- other causes of hepatic enlargement/jaundice (cholangiohepatitis, other neoplasia)

29

Outline clinical picture with nasal/nasopharyngeal lymphoma in cats

- older cats ~10yo
- mostly B cell
- often localised, can spread to local LNs or appear elsewhere later on!
- intermediate - high grade
- clinical signs: sneezing, chronic nasal discharge (serosanguinous to mucopurulent), epistaxis, stertor, anorexia, facial deformity, exopthalmus, epiphora

30

Ddx for nasal lymphoma in cats

- cat flu
- neoplasia (carcinoma)
- fungal ( cryptococcus)
- lymphocytic rhinitis
- dental dz