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27 Cards in this Set
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Treatment for local and systemic dz
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Local: surgical, local chemo, RT
systemic: chemo, immunotherapy most chemo pat has good qulity of life during tx |
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Lymphoma in cats
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FeLV assoc with mediastinal lymphoma. Lymphoma common in cats, Young cats usually have FeLV and Mediastinal lymphoma, Old cats with no FeLV and GI lymphoma
sometimes get lymphoma after LYMPHOCYTIC, PLASMOCYTIC IBD in cats |
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Dogs
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middle aged dogs most commonly affected, but out of cancer affecting young dogs (as young as 6 months), LSA common
GENETICS is biggest thing: boxer, mastiff, basset, st. bernard, Mastiff |
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Location of lymphoma
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Cats get it in GI(cause of FeLV vx, young cats not affected as much), Dogs get it in LN (BAR, happy dog, come in in with big node, dont' feel sick when come in, no pain)
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3 LNs should be able to feel in dogs
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popliteal, prescap and sumandibular
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Etiology of lymphoma
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Cats: FeLV+ LSA in young cats and is T cell
FeLV directly cause malignancy FIV- predisposed to lymphoma with immune dysfunction IBD may progress to lymphoma (no proven) dogs: genetics |
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History and signs of lymphoma in cats
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Cat: GI form most common ( microscopic diffuse (thickened like IBD) or mass (better aspirate and get ddx)
Signs: wt loss, inappetance, lethargy, vomit and/ or diaarhea |
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History and signs of lymphoma in dogs
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multicentric form most common (multiple peripheral LN)
typically asytomatic and present with enlarged LN (lump under chin) GI lymphoma in dog median suvival time 10-20 days hepatic lymphoma in single site really bad, usually very ill |
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PE findings of lymphoma in LN and GI
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1. peripheral nodes: enlarged, firm, NONPAINFUL, common in dogs, rare in cats
2. Gi: thickened bowel loops +/- mass, uncommon in dogs, common in cts |
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PE findings of lymphoma in liver / spleen and nasal
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3.Liver/ Spleem : palpable hepatosplenomegaly +/- nodes, seen in dogs, uncommon in cats
4. Nasal: epistaxis, nasal discharge, exothalmus, rare in dogs, uncommon in cats |
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PE exam of lymphoma in mediastinal site
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Mediastinal: decrease compressability of thorax, resp distress, regurgitation, rare in dogs, FeLV cats
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PE exam of lymphoma in Renal, skin, ocular sites and CNS (uncommon)
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Renal: bilateral renal enlargement, rare in dogs, uncommon in cats
Skin: alopecia, may be pruritic, ulcerated, flasky skin, uncommon in dogs and rare in cats Ocular: hyphema, corneal edema, uncommon in dogs, rare in cats CNS: paresis most common clinical findings, rare in dogs, uncommon in cats |
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Bio behavior of lymphoma in cats and dogs
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usually arise in lymphoid tissue (LN, spleen, bone marrow) but can arise or invade any tissue
always systemic, chemo tx of choice diff anatomic sites prognostic |
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Sites and response to tx
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multicentric (LN) do great in dog, even if liver one of the site
liver itself: bad Mediastinal: fair to good for both GI: bad for dog, bad to good for cat nasal: good to excelent others: poor to fair |
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Prognostic factor for dogs (KNOW)
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1. hypercalcemia -ve prognostic factor
2. immunophenotype- B cell better (treat the same) 3. histological subtype: high grade better response to chemo, low grade less aggressive tumor 4. Stage: stage 1& 2 better, Stage 5 with bone marrow involved do worst 5. Substage: ONE OF THE MOST IMPT PROGNOSTIC FACTOR, A (healthy) BETTER THAN B (sick) 6. Anatomical site impt prognostic factor |
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Prognostic factor for cats
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B worst than A
FeLV status (+ve w/ decreased remission time) Response to therapy (cats go into remission have greatly prolonged survival) |
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Diagnostic of LSA
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easy, FNA
Is sick cat with thick gut loop, need surgical biopsy, if use scope, won't have whole villi and seroa |
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Staging of LSA- almost always systemic dz, staging impt
(KNOW) |
1. FNA- >50% lymphoblast (large cell)
2. CBC- may be nonrmal, may be cytopenia of leukemia. (tx lymphoma and leukemia improves) 3. chem- may be normal, may reveal abnormalities related to organs. Hypercalcemia (paraneoplastic syndrome) is a poor prognostic factor UA: asses b4 chemo, UTI can become sepsis with chemo chest rads(for lung), ab rads (for organomegaly), ab ultrasound for cats (GI involvement), not dog unless GI involvement suspected bone marrow aspirate: more than 50% LSA infiltration in marrow= poor prognostic factor tissue biopsy: rarely done |
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Staging (KNOW)
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Stage 1- single LN
stage 2- LN and on region stage 3- generalized LN Stage 4- liver/ spleen stage 5- marow/ peripheral blood and/ or other organs |
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clinical substage
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a- pt clinically normal
b- pt is ill |
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Paraneoplastic syndrome assoc with canine lymphoma
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1. Hypoglycemia (rare)
2. Hypercalcemia (2nd to parathyroid hormone related peptide (PTHrP) produced by maglinant cells- poor prognostic factor 3. Hyoproteinemia- rare finding 2nd to antibody production by tumor cells 4. imune- mediated hemolytic anemia or thrmbocytopenia cuasing cytopenia |
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Aleukemia leukemia
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When bone marroe is so heavily infiltrated with lymphblast so no maglinant cells are circulatig in tissues
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tissue biopsy
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rarely needed cause FNA just as good.
Needed for small cell LSA in dogs (rare) and some LSA in cats (thickened gut loop, need surgical biopsy, scope biopsy don't get seroa and villi) |
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Treatment for multicentric LSA in dog
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65-90% response to tx with complete remission wihin 1st few wks
RARELY CURE w/o tx MST= 4-6wk w/ prednisone MST= 11wks w/ combiation therapy MST= 12mths |
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Induction therapy
maintenance therapy resuce therapy |
Induction therapy= initial therapy
maintenance therapy= tx given in progressively longer interval Resuce therapy= given when animal come out of remission |
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chemo resistance
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eventually chemo cell become resistance to chem mostly cause of p- glycoprotein pumping out toxins from cell cytoplasm. Most LSA tx fails eventually because of this
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Cats GI lymphoma tx
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33% response to multidrug tx and MST of 1yr
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