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Flashcards in Lymphoma (E2) Deck (34)
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1

What is the most common hematopoietic tumor?

Lymphoma 

2

Fill in the blanks 

(E.g. Lymphoid cells in Bone Marrow -- Lymphoid Leukemia
Lymohoid cells in the Body -- Lymphoma) 

T- and B- Lymphocytes -- __________

Macrophages -- ​______ leukemia 

Neutrophils -- ​______ leukemia 

PTLs  -- __________

RBC -- ______leukemia or  __________

Multiple myeloma

Monocytic leukemia 

Myelogenous leukemia 

Primary thrombocytopenia

Erythroleukemia or Polycythemia vera

3

In which ways are lymphomas classified in dogs?

Anatomical

Histopathological

Lymphoma type (blastic or cytic)

Phenotype 

4

What is the importance of phenotype and lymphoma type classification?

Prognostication: B-cell = Better, T-cell= Terrible

Cytic= Better than blastic 

5

Lymphoma is based on the number of _____ affected. 

Lymph nodes 

6

How is lypmhoma classified in cats? What is the most common form?

Anatomic site

Small cell (low grade) vs Large cell (intermediate-high grade)

Most common: Intermediate grade Large Cell Alimentary/GI 

7

How do most dogs with lymphoma present?

Clinically healthy (substage a)

8

You know what to do. 

Lymph nodes: 

1. Retropharyngeal and Submandibular

2. Prescapular

3. Axillary 

4. Inguinal 

5. Poplyteal 

10

What type of lymphoma causes dyspnea, muddled eart sounds, pre-caval syndrome, and often paraneoplastic hypercalcemia?

Mediastinal lymphoma

11

What breed of cat is over-represented in terms of lymphoma cases?

Siamese 

12

How do most cats with lymphoma present?

Moderately Sick (substage b) 

Often with GI signs (since alimentary is most common)

13

Why is an opthamological exam important to include in your physical exam when trying to diagnose lymphoma in a dog?

Uveitis/Retinal hemorrhage occurs in 30-50% of dogs 

14

What will you generally find in a CBC in a dog with a neoplastic condition?

Normocytic normochronic non-regenerative anemia 

Myelopthisis - neutropenia, thrombocytopenia, anemia

15

What sites do you use for a bone marrow aspirate in dogs? Cats? Why is this done?

Dog: Greater tubercle of humerus, Iliac Crest

Cat: Demoral intertrochanteric fossa

For prognosis and staging 

16

What is the most common imaging modality for lymphoma diagnosis?

Ultrasound

17

What is the gold standard for multicentric lymphoma diagnosis? Why? What will you find?

Histopathology of biopsy + Flow-cytomoetry of FNA

Cytology for immunophenotype, Histopath for grade of tumor

Will see - Cytology: Anisocytosis, Anisokaryosis, Multiple nulcei, Mitotic figures, Free nuclear material 

IHC: stain for B and T cell markers

18

How long will a dog or cat live if lymphoma is not treated?

4-6 weeks 

19

Is chemotherapy better for cats or dogs with lymphoma?

Dogs 

20

What is the most common chemo protocol for canine lymphoma?

Multi-agent: CHOP protocol (CDVP protocol)

Cyclophosphamide 

Doxorubicin

Vincristine

Predniosolone 

21

Why may you not be able to treat a dog with chemotherapy if the dog is highly aggressive?

Because most drugs must be given IV and in hospital 

22

How long can a dog live with lymphoma solely on pred?

1-2months 

23

What is the most common chemotherapy protocol for cats with lymphoma?

Multi-Agent: Modified Wisconsin-Madison Protocol

Or: COP protocol (cyclophosphamide, vinrcristine, pred)

24

What drug can you give cats with low-grade small cell alimentary lympoma? 

Chlorambucil + Prednisolone

25

What drugs/drug combinations can you give dogs with low-grade lymphoma? 

Chlorambucil + Pred 

or 

Cyclophosphamide + Pred 

(Surgery if confined to spleen or solitary LN)

26

How long should intitial lymphoma treatment be given?

Until remission 

27

Since relapse occurs in most, if not all patients, what protocol can you use if the replapse occurs more than 2 months after the initial treatment course? Less than 2 months?

<2mo: Same as initial protocol 

>2mo: Cannot use any drugs from initital therapy due to resistance development, "Rescue chemo" - Lomustine/CCNU, Mitoxantrone, Melphalan

 

28

What genetic test should be performed before intitiating chemotherapy in dogs?

MDR-1 gene analysis 

29

What type of lymphoma respons well to radiation?

Nasal lymphoma 

30

What does it indicate if a dog develops chemotherapy induced neutropenia?

It's a GOOD thing- indicates prolonged remission rate 

31

What is the proliferation of neoplastic cells in the bone marrow? How is it categorized?

Leukemia

Categorized as acute lymphoblastic (ALL) or chronic lymphocytic (CLL)

(Note: Acute lymphoblAstic , Chronic lymphoCytic)