Podcast
Questions and Answers
Which statement about multicentric lymphoma in dogs is correct?
Which statement about multicentric lymphoma in dogs is correct?
What is the clinical significance of polyuria and polydipsia in cases of lymphoma?
What is the clinical significance of polyuria and polydipsia in cases of lymphoma?
Which of the following tests is NOT typically included in the diagnostic evaluation of lymphoma?
Which of the following tests is NOT typically included in the diagnostic evaluation of lymphoma?
How is Stage II lymphoma characterized?
How is Stage II lymphoma characterized?
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What percentage of dogs with lymphoma may experience ophthalmic problems?
What percentage of dogs with lymphoma may experience ophthalmic problems?
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What type of anemia is commonly found in animals with lymphoma?
What type of anemia is commonly found in animals with lymphoma?
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Which lymphocyte type is typically seen in circulation during lymphoma?
Which lymphocyte type is typically seen in circulation during lymphoma?
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In the staging of lymphoma, what does Stage IV indicate?
In the staging of lymphoma, what does Stage IV indicate?
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Why is it recommended to continue chemotherapy after apparent remission?
Why is it recommended to continue chemotherapy after apparent remission?
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What is the best method for providing a definitive diagnosis in tumor evaluation?
What is the best method for providing a definitive diagnosis in tumor evaluation?
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Which of the following is a common consequence of malnutrition in cancer patients?
Which of the following is a common consequence of malnutrition in cancer patients?
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What role does ultrasound play in tumor assessment?
What role does ultrasound play in tumor assessment?
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What might be indicated if a patient does not eat for more than 5 days?
What might be indicated if a patient does not eat for more than 5 days?
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What is a major risk factor for tumors becoming drug resistant?
What is a major risk factor for tumors becoming drug resistant?
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Which of the following is crucial in surgical principles when dealing with tumors?
Which of the following is crucial in surgical principles when dealing with tumors?
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Which statement highlights a consequence of effective pain management in cancer patients?
Which statement highlights a consequence of effective pain management in cancer patients?
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What is the most common site for osteosarcoma (OSA) in dogs?
What is the most common site for osteosarcoma (OSA) in dogs?
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Which breed types are more likely to be predisposed to osteosarcoma?
Which breed types are more likely to be predisposed to osteosarcoma?
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How is osteosarcoma typically treated?
How is osteosarcoma typically treated?
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What factors indicate a poor prognosis for a patient with osteosarcoma?
What factors indicate a poor prognosis for a patient with osteosarcoma?
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Which statement about chondrosarcomas is correct?
Which statement about chondrosarcomas is correct?
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What is a common treatment approach for fibrosarcomas and hemangiosarcomas in dogs?
What is a common treatment approach for fibrosarcomas and hemangiosarcomas in dogs?
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Which of the following is true about the prognosis of chondrosarcomas?
Which of the following is true about the prognosis of chondrosarcomas?
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Which cytology technique is NOT recommended for evaluating mammary tumors?
Which cytology technique is NOT recommended for evaluating mammary tumors?
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What percentage of cases experience remission with the mentioned chemotherapy regimen?
What percentage of cases experience remission with the mentioned chemotherapy regimen?
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Which of the following is a common treatment strategy after remission is lost?
Which of the following is a common treatment strategy after remission is lost?
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Which clinical signs are associated with chronic lymphocytic leukemia in dogs?
Which clinical signs are associated with chronic lymphocytic leukemia in dogs?
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Which of the following clinical pathologies is commonly seen in dogs with chronic lymphocytic leukemia?
Which of the following clinical pathologies is commonly seen in dogs with chronic lymphocytic leukemia?
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What is a characteristic of extramedullary plasmacytomas?
What is a characteristic of extramedullary plasmacytomas?
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What is the usual prognosis for chronic lymphocytic leukemia (CLL) compared to other conditions?
What is the usual prognosis for chronic lymphocytic leukemia (CLL) compared to other conditions?
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What is a common treatment option for solitary plasmacytoma?
What is a common treatment option for solitary plasmacytoma?
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What is the primary cause of soft tissue sarcomas?
What is the primary cause of soft tissue sarcomas?
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What is the most common location for primary tumors in carcinomas?
What is the most common location for primary tumors in carcinomas?
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Which surgical procedure is considered the treatment of choice for mammary gland tumors?
Which surgical procedure is considered the treatment of choice for mammary gland tumors?
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When dealing with multiple nonadjacent glands in mammary gland neoplasia, which procedure should be performed?
When dealing with multiple nonadjacent glands in mammary gland neoplasia, which procedure should be performed?
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What factor significantly reduces the risk of developing mammary gland tumors in dogs?
What factor significantly reduces the risk of developing mammary gland tumors in dogs?
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Which of the following carcinomas is known to metastasize to bone?
Which of the following carcinomas is known to metastasize to bone?
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What is the prognosis for cats with tumors larger than 3cm in diameter?
What is the prognosis for cats with tumors larger than 3cm in diameter?
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Which chemotherapy agent has been used in conjunction with surgery for treating metastases in dogs?
Which chemotherapy agent has been used in conjunction with surgery for treating metastases in dogs?
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What is the common outcome for papillomas in young dogs?
What is the common outcome for papillomas in young dogs?
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What percentage of cats with mediastinal lymphoma are FeLV positive?
What percentage of cats with mediastinal lymphoma are FeLV positive?
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Which type of lymphoma is associated with a poor prognosis in dogs due to shorter remission and survival times?
Which type of lymphoma is associated with a poor prognosis in dogs due to shorter remission and survival times?
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In feline lymphoma, which anatomic site has the highest relative frequency?
In feline lymphoma, which anatomic site has the highest relative frequency?
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Which of the following conditions is commonly associated with kidney involvement in lymphoma?
Which of the following conditions is commonly associated with kidney involvement in lymphoma?
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What is the median survival time for dogs that achieve remission with chemotherapy?
What is the median survival time for dogs that achieve remission with chemotherapy?
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Which condition is likely to indicate a worse prognosis in dogs with T-cell lymphoma?
Which condition is likely to indicate a worse prognosis in dogs with T-cell lymphoma?
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Which feline leukemia virus (FeLV) status is most likely seen in younger cats with lymphoma?
Which feline leukemia virus (FeLV) status is most likely seen in younger cats with lymphoma?
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Which treatment modality has shown to be effective for cutaneous lymphoma resistant to chemotherapy?
Which treatment modality has shown to be effective for cutaneous lymphoma resistant to chemotherapy?
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What age group is most commonly associated with nasal lymphoma in cats?
What age group is most commonly associated with nasal lymphoma in cats?
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Which subtype of lymphoma is characterized by the absence of clinical signs of disease?
Which subtype of lymphoma is characterized by the absence of clinical signs of disease?
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What is an adverse effect concern when treating cats with doxorubicin for lymphoma?
What is an adverse effect concern when treating cats with doxorubicin for lymphoma?
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What is the likelihood of T-cell association in alimentary lymphoma in cats?
What is the likelihood of T-cell association in alimentary lymphoma in cats?
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What percentage of cats may enter remission with chemotherapy for lymphoma?
What percentage of cats may enter remission with chemotherapy for lymphoma?
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Which anatomic site of feline lymphoma has the lowest frequency of appearance?
Which anatomic site of feline lymphoma has the lowest frequency of appearance?
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Which factor is NOT associated with poorer prognosis in cats with lymphoma?
Which factor is NOT associated with poorer prognosis in cats with lymphoma?
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Which type of lymphoma has the poorest prognosis among cats?
Which type of lymphoma has the poorest prognosis among cats?
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What is a notable clinical sign associated with metastatic lesions in dogs?
What is a notable clinical sign associated with metastatic lesions in dogs?
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Which breed is commonly associated with an increased risk of mammary tumors?
Which breed is commonly associated with an increased risk of mammary tumors?
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What is the primary purpose of administering H1-antagonists before surgery?
What is the primary purpose of administering H1-antagonists before surgery?
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What treatment is often combined with surgery when a tumor cannot be completely excised?
What treatment is often combined with surgery when a tumor cannot be completely excised?
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How does the risk for mammary tumors change with age, specifically after 6 years?
How does the risk for mammary tumors change with age, specifically after 6 years?
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Which drug is NOT commonly used for chemotherapy in systemic mastocytosis?
Which drug is NOT commonly used for chemotherapy in systemic mastocytosis?
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Which breed is NOT listed as being at increased risk for plasma cell neoplasia?
Which breed is NOT listed as being at increased risk for plasma cell neoplasia?
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What is a common incidental finding in the diagnosis of mammary tumors?
What is a common incidental finding in the diagnosis of mammary tumors?
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Which of the following is a characteristic of inflammatory tumors in the mammary glands?
Which of the following is a characteristic of inflammatory tumors in the mammary glands?
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What is a common clinical sign observed in dogs with plasma cell neoplasia?
What is a common clinical sign observed in dogs with plasma cell neoplasia?
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In plasma cell neoplasia, what type of anemia is commonly associated?
In plasma cell neoplasia, what type of anemia is commonly associated?
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Which statement about the biological behavior of plasma cell neoplasia is true?
Which statement about the biological behavior of plasma cell neoplasia is true?
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Which chemical factor is believed to potentially influence the development of plasma cell neoplasia?
Which chemical factor is believed to potentially influence the development of plasma cell neoplasia?
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What type of protein may be found in the urine of dogs with plasma cell neoplasia?
What type of protein may be found in the urine of dogs with plasma cell neoplasia?
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Which diagnostic feature is commonly observed in around 75% of dogs with plasma cell neoplasia?
Which diagnostic feature is commonly observed in around 75% of dogs with plasma cell neoplasia?
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What is a characteristic finding in approximately 30% of dogs with plasma cell neoplasia?
What is a characteristic finding in approximately 30% of dogs with plasma cell neoplasia?
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Which type of carcinoma is known to prefer metastasizing to bone?
Which type of carcinoma is known to prefer metastasizing to bone?
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What is the effect of spaying dogs before the first estrus on the risk of developing mammary gland tumors?
What is the effect of spaying dogs before the first estrus on the risk of developing mammary gland tumors?
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Which surgical procedure is recommended when multiple, nonadjacent mammary glands are involved?
Which surgical procedure is recommended when multiple, nonadjacent mammary glands are involved?
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Which statement best describes the role of chemotherapy in conjunction with surgery for metastases in dogs?
Which statement best describes the role of chemotherapy in conjunction with surgery for metastases in dogs?
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For which type of tumor in cats is tumor size particularly import as a prognostic indicator?
For which type of tumor in cats is tumor size particularly import as a prognostic indicator?
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What is the common outcome for papillomas in young dogs?
What is the common outcome for papillomas in young dogs?
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What is the primary location of metastasis in bone for carcinoma tumors?
What is the primary location of metastasis in bone for carcinoma tumors?
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Which chemotherapy agents have been used in the treatment of cancers in dogs and cats?
Which chemotherapy agents have been used in the treatment of cancers in dogs and cats?
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Which factor is associated with a shorter remission time in dogs with lymphoma?
Which factor is associated with a shorter remission time in dogs with lymphoma?
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What is a primary treatment approach for canines with cutaneous lymphoma?
What is a primary treatment approach for canines with cutaneous lymphoma?
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Which condition may indicate a poorer prognosis in cases of feline lymphoma?
Which condition may indicate a poorer prognosis in cases of feline lymphoma?
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What is the expected median survival time for dogs that achieve remission with chemotherapy?
What is the expected median survival time for dogs that achieve remission with chemotherapy?
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What differentiates cutaneous lymphoma from other skin disorders in terms of treatment?
What differentiates cutaneous lymphoma from other skin disorders in terms of treatment?
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Which chemotherapy agent is specifically referenced as inappropriate for use in cats with renal disease?
Which chemotherapy agent is specifically referenced as inappropriate for use in cats with renal disease?
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What percentage of cats with lymphoma might achieve remission and survive for an extended period with appropriate treatment?
What percentage of cats with lymphoma might achieve remission and survive for an extended period with appropriate treatment?
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Which statement about the CHOP combination protocol is correct?
Which statement about the CHOP combination protocol is correct?
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Which clinical sign is commonly associated with acute lymphoblastic leukemia (ALL)?
Which clinical sign is commonly associated with acute lymphoblastic leukemia (ALL)?
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What is the survival time when prednisone is used alone for treatment?
What is the survival time when prednisone is used alone for treatment?
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In diagnosing acute lymphoblastic leukemia (ALL), what is generally documented?
In diagnosing acute lymphoblastic leukemia (ALL), what is generally documented?
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What is a common finding in patients with ALL regarding their blood counts?
What is a common finding in patients with ALL regarding their blood counts?
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Which characteristic helps to differentiate ALL from lymphoma?
Which characteristic helps to differentiate ALL from lymphoma?
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What percentage of dogs achieves remission with doxorubicin used alone?
What percentage of dogs achieves remission with doxorubicin used alone?
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Which condition is likely to complicate the prognosis of leukemia patients?
Which condition is likely to complicate the prognosis of leukemia patients?
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Which type of tumor originates from the vascular endothelium?
Which type of tumor originates from the vascular endothelium?
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What is a common characteristic of squamous cell carcinoma?
What is a common characteristic of squamous cell carcinoma?
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What is the recommended treatment for a locally invasive tumor that is operable?
What is the recommended treatment for a locally invasive tumor that is operable?
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Which breed is notably predisposed to develop hemangiosarcoma?
Which breed is notably predisposed to develop hemangiosarcoma?
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Which treatment is typically advised if excision of an adenocarcinoma is incomplete?
Which treatment is typically advised if excision of an adenocarcinoma is incomplete?
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What type of mass is characterized as a cauliflower or wart-like structure that may bleed if traumatized?
What type of mass is characterized as a cauliflower or wart-like structure that may bleed if traumatized?
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In which location do squamous cell carcinomas typically occur in dogs?
In which location do squamous cell carcinomas typically occur in dogs?
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What is a significant factor affecting the prognosis of tumors involving subcutaneous tissue?
What is a significant factor affecting the prognosis of tumors involving subcutaneous tissue?
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What is a common treatment used in dogs with chronic lymphocytic leukemia (CLL)?
What is a common treatment used in dogs with chronic lymphocytic leukemia (CLL)?
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Which clinical pathology finding is NOT typically associated with chronic lymphocytic leukemia (CLL) in dogs?
Which clinical pathology finding is NOT typically associated with chronic lymphocytic leukemia (CLL) in dogs?
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What is the prognosis for dogs diagnosed with chronic lymphocytic leukemia (CLL)?
What is the prognosis for dogs diagnosed with chronic lymphocytic leukemia (CLL)?
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In cases of extramedullary plasmacytoma, how is GI extramedullary plasmacytoma characterized?
In cases of extramedullary plasmacytoma, how is GI extramedullary plasmacytoma characterized?
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How is a solitary plasmacytoma typically managed if significant systemic involvement is not present?
How is a solitary plasmacytoma typically managed if significant systemic involvement is not present?
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What signifies the progression from solitary plasmacytoma to multiple myeloma?
What signifies the progression from solitary plasmacytoma to multiple myeloma?
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What characterizes the clinical presentation of dogs with chronic lymphocytic leukemia (CLL)?
What characterizes the clinical presentation of dogs with chronic lymphocytic leukemia (CLL)?
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Which condition is associated with a poor prognosis when treating chronic lymphocytic leukemia (CLL) in dogs?
Which condition is associated with a poor prognosis when treating chronic lymphocytic leukemia (CLL) in dogs?
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What is the most accurate description of M.Histiocytoma in dogs?
What is the most accurate description of M.Histiocytoma in dogs?
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Which of the following statements about Keratoacanthoma is true?
Which of the following statements about Keratoacanthoma is true?
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What common treatment is utilized for Dermoid and epidermal inclusion cysts?
What common treatment is utilized for Dermoid and epidermal inclusion cysts?
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What is a characteristic feature of melanoma in dogs?
What is a characteristic feature of melanoma in dogs?
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Which statement about the transmissible venereal tumor is accurate?
Which statement about the transmissible venereal tumor is accurate?
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What is a typical clinical observation for a dog with hypercalcemia associated with M.Histiocytoma?
What is a typical clinical observation for a dog with hypercalcemia associated with M.Histiocytoma?
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What best describes the typical appearance of a Keratoacanthoma lesion?
What best describes the typical appearance of a Keratoacanthoma lesion?
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In the context of tumor treatment, what is a common characteristic of surgical management decisions?
In the context of tumor treatment, what is a common characteristic of surgical management decisions?
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Which breed is specifically cited as being at increased risk for certain tumors?
Which breed is specifically cited as being at increased risk for certain tumors?
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What is the most common tumor type in young dogs?
What is the most common tumor type in young dogs?
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Which treatment is appropriate for basal cell tumors in dogs?
Which treatment is appropriate for basal cell tumors in dogs?
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What characteristic is associated with ceruminous gland tumors?
What characteristic is associated with ceruminous gland tumors?
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Which cell type is typically evaluated in cytology for tumors?
Which cell type is typically evaluated in cytology for tumors?
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What is a distinguishing feature of histiocytomas in dogs?
What is a distinguishing feature of histiocytomas in dogs?
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What type of radiographs should be taken if malignancy is suspected?
What type of radiographs should be taken if malignancy is suspected?
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Which breed shows an increased risk of developing basal cell tumors?
Which breed shows an increased risk of developing basal cell tumors?
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What does the presence of giant cells in a tumor correlate with?
What does the presence of giant cells in a tumor correlate with?
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Which type of tumor is most commonly associated with injection-site sarcomas in cats?
Which type of tumor is most commonly associated with injection-site sarcomas in cats?
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What primary diagnostic method is typically used for identifying mast cell tumors?
What primary diagnostic method is typically used for identifying mast cell tumors?
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What type of clinical sign might indicate the presence of visceral mast cell tumors?
What type of clinical sign might indicate the presence of visceral mast cell tumors?
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When evaluating for possible bone marrow involvement in a tumor, which diagnostic method is most appropriate?
When evaluating for possible bone marrow involvement in a tumor, which diagnostic method is most appropriate?
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What is a common characteristic of malignant tumors mentioned?
What is a common characteristic of malignant tumors mentioned?
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In the diagnosis of sarcomas, which imaging technique may reveal signs like hepatomegaly or splenomegaly?
In the diagnosis of sarcomas, which imaging technique may reveal signs like hepatomegaly or splenomegaly?
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Surgical excision of tumors should generally include what type of margins?
Surgical excision of tumors should generally include what type of margins?
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What is a significant benefit of using radiation therapy before surgery for tumors?
What is a significant benefit of using radiation therapy before surgery for tumors?
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Which of the following statements about chemotherapy is true?
Which of the following statements about chemotherapy is true?
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What is the role of small doses of radiation in treatment?
What is the role of small doses of radiation in treatment?
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During the assessment of a tumor, why is it important to examine regional lymph nodes?
During the assessment of a tumor, why is it important to examine regional lymph nodes?
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What is the primary use of radiographs in the diagnosis of tumors?
What is the primary use of radiographs in the diagnosis of tumors?
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Which of the following is a requirement for successful radiation therapy?
Which of the following is a requirement for successful radiation therapy?
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Which of the following accurately describes the impact of tumor size on radiation therapy effectiveness?
Which of the following accurately describes the impact of tumor size on radiation therapy effectiveness?
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What is a characteristic feature of lipomas compared to liposarcomas?
What is a characteristic feature of lipomas compared to liposarcomas?
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What is an important consideration during the physical examination of an animal with suspected cancer?
What is an important consideration during the physical examination of an animal with suspected cancer?
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What is the primary developmental origin of fibrosarcoma?
What is the primary developmental origin of fibrosarcoma?
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Which statement is true regarding the prevalence of vaccine-associated fibrosarcomas in cats?
Which statement is true regarding the prevalence of vaccine-associated fibrosarcomas in cats?
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What distinguishes liposarcomas from lipomas in terms of their physical characteristics?
What distinguishes liposarcomas from lipomas in terms of their physical characteristics?
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Which treatment options are applicable for liposarcomas?
Which treatment options are applicable for liposarcomas?
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Which of the following correctly describes lipomas?
Which of the following correctly describes lipomas?
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What is a noted association of fibrosarcomas in cats?
What is a noted association of fibrosarcomas in cats?
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Which tumor type is most likely to metastasize to the lungs and liver?
Which tumor type is most likely to metastasize to the lungs and liver?
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What is the primary reason for continuing chemotherapy after apparent remission?
What is the primary reason for continuing chemotherapy after apparent remission?
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Which of the following is essential in histology sample preparation for an accurate diagnosis?
Which of the following is essential in histology sample preparation for an accurate diagnosis?
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What is a common adverse effect of cancer cachexia in patients?
What is a common adverse effect of cancer cachexia in patients?
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How does malnutrition affect cancer patients post-therapy?
How does malnutrition affect cancer patients post-therapy?
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What is the role of ultrasound in the management of tumors?
What is the role of ultrasound in the management of tumors?
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What should be done if a patient with cancer does not eat for more than 5 days?
What should be done if a patient with cancer does not eat for more than 5 days?
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What is a significant factor contributing to drug resistance in tumors?
What is a significant factor contributing to drug resistance in tumors?
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In surgical principles for tumor management, what is a key practice to prevent the spread of cancer cells?
In surgical principles for tumor management, what is a key practice to prevent the spread of cancer cells?
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Study Notes
Lymphoma
- Most common hematopoietic neoplasia in dogs and cats
- Classified as multicentric, alimentary, mediastinal, or extranodal
- Most animals are middle-aged or older
- Lymphoma in cats commonly involves lymph nodes in the cervical, axillary, popliteal, and inguinal regions.
- Clinical signs include weight loss, decreased appetite, polyuria (PU) and polydipsia (PD), lethargy, enlarged liver and spleen
- Diagnostic tools include physical examination, laboratory evaluation, and bone marrow evaluation.
- Lymphoma treatment involves chemotherapy, with remission occurring in about 90% of cases.
Chronic Lymphocytic Leukemia (CLL)
- Most dogs with CLL have lymphadenopathy and splenomegaly, pale mucous membranes, and fever.
- Clinical signs are often non-specific, including lethargy, PU, PD, intermittent lameness, episodes of collapse, bleeding gums, and epistaxis.
- Common clinical pathology findings include normocytic, normochromic, nonregenerative anemia and thrombocytopenia, with one-third of patients experiencing hyperproteinemia with monoclonal gammopathies.
- Treatment is recommended only in symptomatic patients, and typically involves prednisone and chlorambucil.
- Cats with CLL are FeLV negative.
- The prognosis for CLL is better than that for lymphoma.
Plasmacytoma
- Rare, solitary plasmacytoma has a tendency to progress to multiple myeloma.
- Treatment involves surgery, radiation therapy, or a combination of melphalan and prednisone in cases of systemic involvement.
- Oral or cutaneous extramedullary plasmacytomas are usually benign.
- GI extramedullary plasmacytoma behaves like a malignancy, with excision being the preferred treatment option if localized.
Soft Tissue Sarcomas
- Cause is unknown.
- Osteosarcoma (OSA) is usually aggressive and often found in metastatic form.
- Most common location of OSA is the diaphysis of long bones, with the radius being the most frequently affected site.
- Large and giant breeds may be predisposed.
- In cats, OSA is less aggressive, and the hindlimb is more commonly affected.
- Treatment involves amputation and chemotherapy.
Mammary Gland Neoplasia
- Cause is unknown, but genetics or a virus may play a role.
- Dogs spayed before the first estrus have a significantly reduced risk of mammary gland tumors.
- Mammary tumors commonly metastasize to the lungs.
- Diagnostic imaging should include evaluation of the iliac lymph nodes using radiographs or ultrasound.
- Cytology can help differentiate a tumor from mastitis, and regional lymph nodes should be removed for histopathology.
- Treatment involves surgery in most cases, with wide excision being essential.
- Medical therapy has been used in conjunction with surgery for the treatment of metastases, although its efficacy has not been established.
Papillomas
- Benign epithelial tumor with a tendency to regress in young dogs.
- Occur predominantly in the oral cavity and skin.
- Some papillomas in older dogs can transform into squamous cell carcinoma.
- Surgical removal is recommended if the papilloma does not regress spontaneously.
Sebaceous gland tumors
- Benign epithelial tumors.
- Usually well-circumscribed.
- Surgery is typically the treatment of choice.
Lymphoma
- Bone marrow aspirate may show neoplastic lymphocytes or bone marrow/blood involvement
- Hypercalcemia is seen in about 20% of those with lymphoma
- Increased blood urea nitrogen and creatinine may be seen with kidney involvement
- If there is liver involvement, liver enzymes may be increased
- Most cats with mediastinal or multicentric lymphoma are FeLV positive
TNM Classification
- Substage A: Without clinical signs of disease
- Substage B: With clinical signs of disease
Feline Lymphoma by Anatomic Site
- Alimentary: 50-70%, 10-14 year old, high T-cell association, low FeLV positive
- Multicentric: 10-25%, age depends on FeLV status, T-cell association depends on FeLV status, approximately one third are FeLV positive
- Mediastinal/thymic: 10-20%, young, high T-cell association, high FeLV positive
- Nasal: approximately 10%, aged, low T-cell association, low FeLV positive
- Renal: 5-10%, middle-aged, low to moderate T-cell association, low to moderate FeLV positive
- Other: 5-25%, mixed, mixed, mixed
Diagnostic Imaging
- Neoplasias, granulomatous disease, hypereosinophilic syndrome
- Differentials for mediastinal lymphoma include: thyroid tumors, heart base tumors, thymoma, and pulmonary granulomatosis
- Differentials for cutaneous lymphoma include: pyoderma, immune-mediated disorders, parasitic skin disorders, and other cutaneous neoplasia
Treatment
- Requires chemotherapy
- Without treatment, most only live 4-6 weeks after diagnosis
- With chemotherapy, up to 90% of dogs and 70% of cats enter remission with a median survival of 1 year
- Cures are uncommon
- Cats have fewer adverse effects unless treated with doxorubicin
- Do not give doxorubicin to cats with renal disease
- Combination protocols tend to be more effective with longer survival times
- Surgery combined with radiation and chemotherapy can be beneficial in CNS lymphoma
- Cutaneous lymphoma is resistant to chemotherapy, surgery and radiotherapy may be beneficial
Prognosis
- Dogs: Stage V (or substage b) are associated with shorter remission and survival times
- Dogs: T-cell lymphoma has a shorter remission and survival time
- Dogs: Female dogs may have a longer survival time
- Dogs: Hypercalcemia is associated with T-cell lymphoma and a worse prognosis
- Dogs: GI lymphoma, disseminated cutaneous, or leukemic forms have a poorer prognosis
- Cats: The higher the clinical stage, the poorer the prognosis
- Cats: FeLV positive cats have a poorer prognosis
- Cats: Genetics may play a role in some breeds (Boxers, German Shepherd Dogs, Great Danes, Saint Bernards, Golden Retrievers, Basset Hounds, Flat-coated Retrievers)
Plasma Cell Neoplasia
Multiple Myeloma
- Occurs in older dogs; no sex predilection
- Nonspecific clinical signs (anorexia, lethargy, PU, PD)
- Most have lameness secondary to bone pain
- Epistaxis and gingival bleeding due to hyperviscosity syndrome occurs in about 50% of cases
- About 75% of dogs have a monoclonal gammopathy, usually immunoglobulin G or immunoglobulin A
- Bence Jones proteins may be present in the urine (cannot be detected by urine dipstick)
- May have a nonregenerative, normocytic, normochromic anemia
- Thrombocytopenia occurs in about 30%; 10% have circulating abnormal plasmacytes
- About 20% have hypercalcemia secondary to bone resorption
Mast Cell Tumors
- Most common cutaneous neoplasia in dogs
- Surgical excision is the treatment of choice
- Mast cells release histamine
- Give an antihistamine before surgery
- If the tumor cannot be completely excised, a combination of radiation therapy or chemotherapy can be attempted
- Chemotherapy is recommended in systemic mastocytosis: vinblastine, cyclophosphamide, or lomustine in combination are used
- Give histamine type 2 (H2)- antagonists (famotidine, ranitidine, cimetidine) to reduce gastric acid secretion. Give H-1 antagonists (diphenhydramine) to reduce inflammation associated with histamine
- In cats, splenectomy may increase survival even if other organs are involved
- Chemotherapy has not been well evaluated in cats
Skeletal Neoplasias
- Osteosarcoma (OSA): Approximately 85% of primary bone tumors in dogs are OSAs
- Carcinomas are more likely to metastasize to bone
- Metastasis to bone usually causes tumors in the diaphysis; primary tumors are usually in the metaphysic
- Prostatic carcinomas, transitional cell carcinomas, and mammary cell carcinomas tend to metastasize to bone
Mammary Gland Neoplasias
- Unknown cause
- Genetics or a virus may play a role
- Dogs spayed before the first estrus have a greatly reduced risk
- Risk increases after 6 years of age
- Sporting breeds, poodles, Boston Terriers, and Dachshunds are at increased risk
- In cats, most occur in intact females; Siamese have an increased risk
- A mass is usually noted by the owner, or it may be an incidental finding
- Most often occur in the caudal mammary glands
- Inflammatory tumors have diffuse swelling, which may look like mastitis
- Lymph nodes may be enlarged (superficial)
- Most mammary gland tumors are malignant
- In cats, inflammatory mammary carcinoma occurs in 25%-50% of cases
- Inflammatory mammary carcinoma: highly malignant, rapidly fatal, rarely metastasizes to regional lymph nodes, may metastasize to internal organs, usually occurs in older cats.
- Surgery is the treatment of choice
- Wide excision is important
- Lumpectomy can be performed if the tumor is very small and noninvasive
- Simple mastectomy is relatively simple
- Multiple glands may be removed if the tumor is extensive
- When multiple, nonadjacent glands are involved, perform a complete unilateral mastectomy
- Medical therapy has been used in conjunction with surgery to treat metastases
Skin Neoplasias
- Papilloma: Benign, usually occur in young dogs
- Papilloma virus causes them
- Usually regress spontaneously
- May require surgical removal if they don't regress
- Sebaceous gland tumors: epithelial
- Squamous cell carcinoma: More common is older dogs, can transform from papillomas
Lymphoma
- Lymphoma is a cancer of the lymphatic system.
- It can affect dogs and cats.
- There are different types of lymphoma, including:
- Alimentary Lymphoma: Affects the gastrointestinal tract.
- Mediastinal Lymphoma: Affects the chest area.
- Cutaneous Lymphoma: Affects the skin.
- CNS Lymphoma: Affects the central nervous system.
Lymphoma Signs
- Signs of Lymphoma:
- Enlarged lymph nodes
- Weight loss
- Fever
- Lethargy
- Difficulty breathing
- Vomiting and diarrhea
- Loss of appetite
- Pale mucous membranes
Lymphoma Diagnostics
- Diagnosis of lymphoma can be made through:
- Physical examination
- Blood work
- Fine-needle aspiration of lymph nodes
- Biopsy
Lymphoma Treatment
- Treatment for lymphoma typically involves chemotherapy.
- Chemotherapy can achieve remission in up to 90% of dogs and 70% of cats.
-
Common Lymphoma Protocols:
- CHOP protocol (cyclophosphamide, hydroxydaunorubicin [doxorubicin], Oncovin [Vincristine], prednisone)
-
Other Treatments:
- Surgery
- Radiation therapy
Lymphoma Prognosis
- Prognosis depends on several factors, including:
- Stage of the disease
- Type of lymphoma
- Patient's overall health
- Prognosis for Lymphoma in Dogs:*
- Stage V and substage b are associated with shorter remission and survival times.
- T-cell lymphoma has a shorter remission and survival time.
- Female dogs may have a longer survival time.
- Hypercalcemia is associated with T-cell lymphoma and a worse prognosis.
- GI lymphoma, disseminated cutaneous, or leukemic forms have a poorer prognosis.
- Prognosis for Lymphoma in Cats:*
- The higher the clinical stage, the poorer the prognosis.
- FeLV positive cats have a poorer prognosis.
- The presence of leukemia, anemia, neutropenia, and sepsis worsen the prognosis.
- Cats that achieve remission early have a better prognosis.
Lymphocytic Leukemia
-
Acute Lymphocytic Leukemia (ALL):
- Signs include fever, abdominal pain, anorexia, splenomegaly, and pale mucous membranes.
- Most affected dogs are late middle-aged, while affected cats are younger.
- Anemia occurs in most, and 25% are thrombocytopenic.
- Diagnosis based on abnormal lymphocytes in bone marrow or blood.
- Treatment involves CHOP-based protocols, but prognosis is poor.
-
Chronic Lymphocytic Leukemia (CLL):
- Usually marked by lymphadenopathy and splenomegaly.
- Most affected dogs are late middle-aged.
- Clinical signs often nonspecific.
- Diagnosis based on abnormal lymphocytes in bone marrow or blood.
- Treatment is recommended only in symptomatic patients.
- Prednisone and chlorambucil are commonly used treatments.
- Prognosis for CLL is better than MCT or hemangiosarcoma.
Plasmacytoma
-
Solitary Plasmacytoma:
- Rare, tending to progress to multiple myeloma.
- Treatment involves surgery, radiation therapy, or melphalan and prednisone if systemic involvement exists.
-
Extramedullary Plasmacytoma:
- Usually benign when found in the oral cavity or skin.
- GI extramedullary plasmacytoma behaves like a malignancy.
- Excision is the treatment if the tumor is localized.
Soft Tissue Sarcomas
- Soft tissue sarcomas are malignant tumors of connective tissue.
- Several types exist, each with unique characteristics and prognoses.
Papilloma (Epithelial)
- Originates from squamous epithelium.
- Can be viral in origin.
- Looks like a cauliflower or wart-like mass.
- Common in dogs and rare in cats.
- Usually found on the head, eyelids, feet, or mouth.
- Contagious to other dogs through viral transmission.
- Treatment typically involves surgical excision.
Anal Sac/Apocrine Gland Adenocarcinoma (Epithelial)
- Originates from the apocrine glands of the anal sac.
- Can vary in size from small to large masses.
- More common in older female dogs.
- Often metastasizes to regional lymph nodes.
- Treatment includes surgical excision and chemotherapy with carboplatin or mitoxantrone.
Keratoacanthoma (Epithelial)
- Develops from epithelium between hair follicles.
- Found on the neck, dorsal thorax, legs, and ventral abdomen.
- Often produces toothpaste-like material.
- Generally benign, but can be multiple in some breeds.
- Usually treated with surgical excision.
Dermoid and Epidermal Inclusion Cyst (Epithelial)
- Inclusion cysts result from an occluded hair follicle.
- Dermoid cysts are a type of inclusion cyst.
- Treatment typically involves surgical excision.
Squamous Cell Carcinoma (Epithelial)
- Originates from squamous epithelium.
- Occurs secondary to ultraviolet light exposure.
- More frequent in white cats, often found on ear tips and nose.
- Treatment typically involves surgical excision, sometimes combined with radiation therapy or chemotherapy.
Hemangiosarcoma (Mesenchymal)
- Originates from the vascular endothelium.
- Usually solitary masses found on limbs, flanks, or neck.
- More common in German shepherd dogs and golden retrievers.
- Tumors involving subcutaneous tissue or muscle have a poorer prognosis.
- Treatment includes surgical excision, sometimes with doxorubicin.
Histiocytoma (Round Cell)
- Develops from monocyte or macrophage cells in the skin.
- Benign growths usually found on the head, small, alopecic, and pink in appearance.
- Typically occurs in young dogs (1 to 3 years old).
- Often regresses spontaneously within 4 to 8 weeks.
- Surgical removal is recommended if the growth does not regress.
Melanoma (Round Cell)
- Arises from melanocytes or melanoblasts.
- Usually pigmented nodules, brown to black, found on the face, trunk, feet, mucocutaneous regions, and nail beds.
- More common in dogs than cats.
- Skin tumors are usually benign, while mucocutaneous tumors are often malignant.
- Surgery is the primary treatment option.
- Recurrence and metastases are common.
Oncology Principles
- The patient's age, sex, breed, and species are important factors in diagnosis.
- The tumor's location, duration, and growth rate should be considered.
- A complete physical examination should be done to assess overall health.
- Regional lymph nodes and lungs should be assessed during a physical exam.
- Common lab tests for cancer assessment should be performed.
- These tests may include a complete blood cell count (CBC), serum biochemistry profile, and urinalysis.
- Perform additional laboratory tests such as an FeLV test, bone marrow aspirate, or adrenal function tests as needed.
- Radiographs of the thorax, abdomen, and skeleton are essential to evaluate for metastases.
- Ultrasound can be especially useful for visualizing the abdomen.
- Cytology can provide rapid and inexpensive diagnostic information.
- Overinterpreting cytology preparations should be avoided.
- Histopathology is often required for definitive diagnosis.
- Larger biopsy samples provide more accurate diagnoses.
- Fix tissue samples in 10% buffered formalin.
Treatment
- Surgery is most useful for localized tumors.
- When possible, resect all neoplastic tissue with wide margins.
- Minimize manipulation of the tumor to prevent surgical spread of cancer cells.
- Radiation therapy is used for local or regional tumors.
- Radiation therapy can be used before surgery to shrink tumors, concurrently with chemotherapy, or postoperatively.
- Chemotherapy is most often used for regional or disseminated neoplasms.
- Some tumors are quite chemosensitive, for example, lymphoid neoplasia.
- Chemotherapy should continue after apparent remission to eliminate any microscopic residual tumor.
- Tumors can develop drug resistance, which is more likely in larger tumors.
- Patients should be reevaluated regularly after completion of therapy.
- Anorexia and cachexia are common in cancer patients.
- Anorexia can be related to side effects of treatment or tumor-produced anorexigenic substances.
- Provide enteral or parenteral feeding if animals do not eat for more than 5 days or experience an acute loss of 10% or more of body weight.
- Malnourished patients often have hypoalbuminemia, lymphopenia, and anemia.
- Malnutrition compromises the immune system, slows wound healing and cell repair, and increases morbidity and mortality.
Tumor Types
- Mast cell tumors (MCTs) can be found in the skin, subcutaneous tissue, or viscera.
- MCTs are the most common cutaneous tumor in dogs.
- MCTs can be benign, but most are malignant.
- The most common tumor located on the head and neck is MCTs.
- MCTs are usually well-defined, raised, and may be hairless or contain ulcerations.
- MCTs in the skin can be mistaken for lipomas.
- Visceral MCTs can occur in the spleen, intestine, liver, and lymphatics.
- Clinical signs of visceral MCTs include anorexia, vomiting, and diarrhea.
- Diagnosis of MCTs includes a CBC, bone marrow aspirate, abdominal radiographs, and a fine-needle aspirate of the mass.
- Treatment of MCTs involves surgical excision, radiation therapy, and chemotherapy.
- Prognosis for MCTs varies depending on the grade and tumor location.
- Treatment is typically more effective for grade I and II tumors than grade III tumors.
- Basal cell tumors originate from the basal cells of the epidermis and adnexa.
- Basal cell tumors are usually solitary, firm, well-demarcated, and pigmented.
- The most common skin tumor in cats, basal cell tumors occur anywhere, including the head, neck, and shoulders in dogs.
- A cytology evaluation will reveal basal cell tumors arranged in cords.
- Surgical excision is the main treatment for basal cell tumors, but radiation or chemotherapy is often used for cancerous tumors.
- Ceruminous gland tumors originate from the ceruminous epithelium of the ear canal.
- Ceruminous gland tumors are typically brown, produce cerumen and are small, located near the tympanic membrane.
- Ceruminous gland tumors commonly affect cats and can also be found on the external genitalia and face.
- Ceruminous gland tumors are often multiple and may be friable with ulcerations and cauliflower-like masses.
- Treatments for ceruminous gland tumors include surgery, vincristine chemotherapy, or radiation therapy.
- Lipomas originate from adipocytes.
- Lipomas are usually soft, well-circumscribed, and common in older, spayed female dogs.
- Lipomas are rare in cats.
- Liposarcomas are infiltrative, firm, poorly circumscribed, and can metastasize to the lungs and liver.
- Liposarcomas are rare.
- Treatment for lipomas includes surgical removal, although most cases are benign.
- Treatment of liposarcomas requires surgical removal and additional radiation therapy depending on the surgical margins.
- Fibrosarcomas originate from the fibrous connective tissue, from fibroblasts or fibrocytes.
- Fibrosarcomas are commonly associated with feline sarcoma virus or FeLV, at sites of vaccination or sporadically.
- Fibrosarcomas can be invasive and aggressive and can metastasize.
- Treatment for fibrosarcomas includes surgery and often radiation therapy.
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This quiz covers the essentials of lymphoma and chronic lymphocytic leukemia (CLL) in dogs and cats. It includes classifications, clinical signs, diagnostic tools, and treatment options for these hematopoietic neoplasias. Perfect for veterinary students and professionals seeking to enhance their knowledge.