Feline Lymphoma Diagnosis and Treatment
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Questions and Answers

What is the typical onset time frame for clinical signs of T cell involvement?

  • Days to weeks
  • Weeks to months
  • Immediately
  • Months (correct)

    • Which imaging technique is considered to have a better diagnostic yield for intestinal issues?

  • AXR
  • AUS (correct)
  • MRI
  • CT scan

    • What is the sensitivity of the routine histopathology combined with immunohistochemistry (IHC) for diagnosing inflammatory bowel disease?

  • 72%
  • 83% (correct)
  • 90%
  • 78%

    • What is the median survival time (MST) for a cat with solitary nasal lymphoma treated with radiation therapy?

    <p>1.5-3 years</p> Signup and view all the answers

    Which of the following treatment options has been associated with a 75% response rate for renal lymphoma?

    <p>Chemotherapy</p> Signup and view all the answers

    Which of the following findings is less likely associated with GI lymphoma imaging?

    <p>Discrete mass</p> Signup and view all the answers

    Which diagnostic method shows a low reliability in differentiating small cell GI lymphoma from inflammatory bowel disease?

    <p>Cytology</p> Signup and view all the answers

    Which diagnostic method is typically used for confirming renal lymphoma?

    <p>U/S guided renal FNA</p> Signup and view all the answers

    What indicates a poor prognosis in patients undergoing treatment for feline lymphoma?

    <p>B-cell lymphoma type</p> Signup and view all the answers

    Which symptom is primarily associated with azotemia in renal lymphoma?

    <p>Lethargy</p> Signup and view all the answers

    What is the most common malignancy found in ferrets?

    <p>Insulinoma</p> Signup and view all the answers

    Which presentation type of ferret lymphoma is most likely associated with dyspnea?

    <p>Mediastinal</p> Signup and view all the answers

    When diagnosing ferret lymphoma, what is a common reason for potential false-negative results?

    <p>Presence of chronic GI disease</p> Signup and view all the answers

    Which diagnostic tests are indicated for staging ferret lymphoma?

    <p>CBC, Chem, and UA</p> Signup and view all the answers

    How does the prognosis for ferret lymphoma compare to that of cats?

    <p>The prognosis is generally similar</p> Signup and view all the answers

    What is the most common feline cancer, particularly in the gastrointestinal tract?

    <p>Feline lymphoma</p> Signup and view all the answers

    Which of the following subtypes of feline GI lymphoma is characterized by a less aggressive behavior?

    <p>Small cell lymphoma</p> Signup and view all the answers

    What immunophenotype is predominantly associated with small cell lymphoma in felines?

    <p>T-cell</p> Signup and view all the answers

    In which location is feline GI lymphoma most commonly found?

    <p>Ileum</p> Signup and view all the answers

    What general risk factor is associated with an increased risk of feline lymphoma?

    <p>Being a purebred, especially Siamese</p> Signup and view all the answers

    What behavior is associated with large cell lymphoma in felines?

    <p>Aggressive with transmural depth of invasion</p> Signup and view all the answers

    What factor is considered a general prognostic factor regardless of the anatomic site of feline lymphoma?

    <p>Age of the cat at diagnosis</p> Signup and view all the answers

    During the FeLV control era, which age range became more common for feline lymphoma diagnoses?

    <p>11 years and older</p> Signup and view all the answers

    What is the historical median survival time for cats with lymphoma?

    <p>2-3 months</p> Signup and view all the answers

    What type of lymphoma is most commonly associated with FeLV in felines?

    <p>Nodal Lymphoma</p> Signup and view all the answers

    Which treatment combination is typically used for high-grade nodal lymphoma in cats?

    <p>CHOP or COP</p> Signup and view all the answers

    What is a common sign of nasal lymphoma in cats?

    <p>Facial deformity</p> Signup and view all the answers

    What type of diagnostic procedure is recommended for establishing the diagnosis of Hodgkins-like lymphoma in cats?

    <p>Histopathology</p> Signup and view all the answers

    Which of the following is NOT a characteristic sign of nasal lymphoma?

    <p>Chronic vomiting</p> Signup and view all the answers

    Which treatment option is considered to have a very good prognosis for low-grade lymphoma in cats?

    <p>Chlorambucil + Prednisolone</p> Signup and view all the answers

    What percentage of cats with nasal lymphoma is reported to have extra-nasal disease?

    <p>20%</p> Signup and view all the answers

    What is the primary limitation of endoscopic biopsy compared to surgical biopsy?

    <p>It cannot reach the whole GI tract.</p> Signup and view all the answers

    What is the expected response rate for treatment of large cell lymphoma using COP/CHOP chemotherapy?

    <p>30-40%</p> Signup and view all the answers

    Which of the following is a common clinical presentation of mediastinal lymphoma in cats?

    <p>Tachypnea</p> Signup and view all the answers

    What is the primary type of cell lymphoma more commonly associated with diffusely thickened intestines?

    <p>Small cell (low-grade) lymphoma</p> Signup and view all the answers

    What is the benefit of using ultrasound-guided fine needle aspiration (FNA) in diagnosing mediastinal lymphoma?

    <p>It is less invasive than surgical options.</p> Signup and view all the answers

    In which demographic is mediastinal lymphoma most commonly observed?

    <p>Young FeLV+ cats</p> Signup and view all the answers

    What negative outcome is associated with the diagnosis of small cell lymphoma in terms of biopsy results?

    <p>Low yield with risk of false negatives</p> Signup and view all the answers

    Which of the following statements is true regarding the general behavior of mediastinal lymphoma?

    <p>It behaves aggressively with a poor response to treatment.</p> Signup and view all the answers

    Study Notes

    Feline Lymphoma

    • Feline lymphoma is a malignancy of lymphocytes, most commonly impacting lymphoreticular organs
    • These include lymph nodes, spleen, and bone marrow
    • The biological behavior is often local, with diffuse infiltration of primary organs
      • Distant spread is considered systemic until confirmed through staging
    • Distinct from canine lymphoma in many ways
    • Risk factors include FeLV+, purebred cats (especially Siamese), chronic immunosuppression, post-renal transplant, FIV+, and a slight increase from secondary smoke exposure

    Lecture Objectives

    • Predict feline lymphoma's likely biological behavior based on anatomical location
    • Develop diagnostic and treatment plans for suspected feline lymphoma in various anatomical sites
    • Compare diagnostic, treatment, and prognostic differences between large-cell and small-cell lymphoma of the feline gastrointestinal tract
    • Identify general prognostic factors for feline lymphoma regardless of location

    Feline GI Lymphoma

    • Most common feline gastrointestinal cancer
    • Jejunum and ileum are the most common affected areas
    • Small cell lymphoma is 3x more frequent than large-cell lymphoma
      • Small cell subtype is generally less aggressive (indolent). This presentation typically has mucosal invasion, slower progression, and a longer onset of clinical symptoms.
      • Large cell subtype is more aggressive, with transmural invasion, rapid progression, and shorter onset of symptoms.
    • Imaging like abdominal ultrasound (AUS) is more likely to show helpful diagnostic results for feline GI lymphoma versus abdominal x-ray (AXR)
      • AUS shows thickened bowel, loss of bowel layering (diffuse or focal), or bowel obstruction
      • In addition, enlarged abdominal lymph nodes (≤ 33% of low-grade cancers) and peritoneal fluid are possible indicators of the disease.
    • Differentiating between inflammatory bowel disease and small-cell GI lymphoma can be difficult
      • Biochemical values, biomarkers, imaging, and cytology have low reliability
      • Routine histology and IHC + routines histology show 72% and 78% sensitivity, respectively; routine histopath/IHC/PARR is around 83% sensitive
    • Taking a biopsy is recommended to ensure an accurate diagnosis over cytology

    Temporal Changes in Feline Lymphoma

    • Before FeLV vaccines, median age of feline lymphoma was 4-6 years, with mediastinal, nodal, and leukemia dominating
      • Prognosis was very poor
    • After FeLV control era, median age was 11 years
      • Alimentary forms (esp. low-grade/small cell) are common, with better prognosis

    Mediastinal Lymphoma

    • Thymus and/or mediastinal lymph nodes are affected
    • Commonly seen in FeLV+ cats, especially young Siamese cats
    • Good potential for an improved prognosis
    • Aggressive behavior and poor response to chemotherapy are common characteristics

    Mediastinal Lymphoma: Clinical Presentation

    • Respiratory signs include tachypnea, dyspnea, cyanotic mucous membranes, and decreased lung sounds (pleural effusion)
      • Weight loss and/or Horner's syndrome are also possible
      • Obstruction of the cranial vena cava (caval syndrome) might occur

    Mediastinal Lymphoma: Diagnosis

    • Chest radiographs may reveal a mediastinal mass, pleural effusions
    • Cytology of any mass/effusion; ultrasound-guided FNA are preferred
    • Flow cytometry or PARR can further aid diagnosis, particularly for small cell lymphoma
    • Chylothorax vs. lymphoma requires analysis to determine
    • Abdominal ultrasound (AUS) staging

    Mediastinal Lymphoma: Tx + Px

    • CHOP or COP treatment has low response rates
    • Average survival time for historical Multiple System Treatment is 2-3 months
    • Young Siamese cats and FeLV-negative cats may have improved prognoses

    Feline Nodal Lymphoma

    • Much less common than in dogs, accounting for around 4-10% of all feline lymphoma cases
    • Historically associated with FeLV
    • A subset may present as Hodgkins-like lymphoma
    • Typically involves a single lymph node or lymph node chain
    • Diagnosis often begins with fine-needle aspiration (FNA) and cytology, but may require flow cytometry, PARR, and/or histopathology to confirm a diagnosis, especially for Hodgkins-like lymphoma

    Feline Nodal Lymphoma: Tx and Px

    • Chemotherapy and localized treatment like surgery or radiotherapy are options based on the grade (high/low). High-grade (large cell) generally has a poor prognosis compared with low-grade (small cell), which has a far better prognosis.

    Nasal Lymphoma

    • Most common form of feline extra-nodal and non-GI lymphoma
    • Typically localized to the nasal cavity in 80% of cases, with 20% having systemic spread
    • Usually high-grade B-cell lymphoma
    • It can frequently be confused with chronic rhinitis
    • Often exhibits signs such as upper respiratory noises, discharge (including epistaxis), sneezing, hyporexia, weight loss, trouble sleeping, and discharge, upper respiratory noises, facial deformity, and decreased nasal airflow

    Nasal Lymphoma: Signs and PE

    • Clinical signs may include upper respiratory noises, discharge (including epistaxis), sneezing, hyporexia, weight loss, and trouble sleeping
    • Physical exam findings may include discharge, upper respiratory noises, facial deformity, decreased nasal airflow, and potential inability to retropulse eyes

    Nasal Lymphoma: Diagnosis

    • Staging generally starts with abdominal ultrasound (AUS) and chest radiographs
    • Additional diagnostic steps are skull CT scan (ideally with radiation therapy set-up).
    • Biopsy is crucial to confirm diagnosis. Rhinoscopy-guided biopsies and aggressive nasal flushing are used to collect tissue samples from the nasal cavity, though cytology of nasal discharge yield low success.

    Nasal Lymphoma: Tx and Px

    • Radiation therapy is highly effective in treating solitary nasal lymphoma, which achieves a 75-95% response rate and allows clinical improvement within 1 to 2 weeks
    • Median survival time is estimated at 1.5 to 3 years from the time of treatment
    • Chemotherapeutic treatment is indicated if the lymphoma is disseminated or has spread beyond the nasal cavity; palliative radiation is also common for this disseminated type
    • Palliative radiation is often used to improve nasal cavity signs (e.g., discharge)

    Renal Lymphoma

    • Characterized by azotemia (e.g., PU/PD, lethargy, hyporexia, weight loss) and enlarged kidneys with an irregular shape
    • Associated with CNS involvement
    • Diagnostic tools: abdominal X-rays (AXR) for bilateral renomegaly, abdominal ultrasound (AUS) for bilateral renomegaly, hypoechoic subcapsular thickening, and a “halo sign”; U/S guided renal FNA is the preferred method
    • Poor prognosis

    Renal Lymphoma: Diagnosis

    • Treatment involves CHOP or COP chemotherapy protocols, usually with a 75% response rate
    • Survival time is generally low, with median survival time between 3 and 7 months in the untreated patients

    General Prognostic Factors for Feline LSA

    • Factors such as response to treatment, tumor grade/size, substage (a versus b), FeLV status, and weight loss during treatment are considered crucial prognostic factors
    • Factors such as B-cell versus T-cell, stage, and breed are not consistent indicators of prognosis

    Ferret Lymphoma

    • A relatively common malignancy in ferrets
    • The disease usually mimics the pattern seen in felines, except for presenting in different sites
    • Presentation often resembles cats and it is site-dependent. Patients exhibit a variety of symptoms, including generalized/nodal (asymptomatic), mediastinal (dyspnea, caval syndrome), gastrointestinal (weight loss, vomiting, diarrhea), and cutaneous (cutaneous lesions) signs
    • Diagnosis may involve FNA/biopsies of affected lymph nodes and/or organs
    • The prognosis and treatment options are generally similar to those for feline lymphomas

    Ferret Lymphoma: Dx, Tx, and Px

    • Full staging procedures
    • CBC/Chem/UA
    • CXR, AUS
    • Chemotherapeutic protocols and site-specific (e.g., mediastinal) radiation therapy may be used as treatments; chemo protocol options mirror those used for feline patients, and the protocols are largely based on lesion site
    • Prognosis in ferrets mirrors that in cats

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    Related Documents

    Feline Lymphoma: VetM5291 Lecture Notes (2025) PDF

    Description

    Test your knowledge about the diagnosis and treatment of feline lymphoma. This quiz covers various imaging techniques, survival rates, and the efficacy of histopathology and immunohistochemistry in diagnosing inflammatory bowel disease. Challenge yourself with questions regarding clinical signs and treatment options.

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