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Lymphoma
Introduction
- Cats have a higher incidence of lymphoma than dogs (20-30% of all tumors in cats).
- Lymphoid neoplasia accounts for an incidence of 200 per 100,000 cats at risk and is 90% of all feline hemopoietic neoplasms.
- Lymphoma can originate in any organ or tissue containing lymphocytes:
- Alimentary Alimentary tract: neoplasia.
- Multicentric.
- Mediastinal Mediastinal lymphoma.
- CNS/Spinal Spinal neoplasia.
- Renal Kidney: neoplasia.
- Other:
- Nasal Nasal cavity: neoplasia.
- Cutaneous Skin: lymphocytic neoplasia.
- Ocular.
- Cause: some forms associated with FeLV infection (only 25% of cases in a recent report which represents a decrease over previous years).
- Signs: depend on form, eg malaise, weight loss, respiratory distress, vomiting, diarrhea.
- Diagnosis: cytology, histopathology.
- Treatment: cytotoxic drugs, surgery if alimentary and obstructed; radiation therapy for nasal, rapid reduction of large problematic masses such as mediastinal form and consolidation therapy following chemotherapy, surgery for ocular.
- Prognosis: Poor if no treatment. Print off the owner factsheet Feline lymphoma Feline lymphoma to give to your client.
Presenting signs
- Dyspnea/cough/regurgitation (mediastinal lymphoma Mediastinal lymphoma).
- Vomiting/diarrhea (alimentary lymphoma Alimentary tract: neoplasia).
- Lymphadenopathy Lymphadenopathy.
- Hepatosplenomegaly Abdominal organomegaly (multicentric lymphoma).
Acute presentation
- Respiratory distress due to pleural effusion Pleural effusion (mediastinal lymphoma).
- Intestinal obstruction (alimentary lymphoma).
Age predisposition
- Young (2-3 years, FeLV positive cats or >4 months, mediastinal form).
- Older animals (mean 7-8 years for FeLV negative animals and gastrointestinal form).
Breed/Species predisposition
- Siamese Siamese may be predisposed, particularly mediastinal form.
Cost considerations
- Cytotoxic agents and need for close monitoring with regular CBCs.
- Moderate costs associated with radiation therapy Radiotherapy.
Pathogenesis
Etiology
- Related to FeLV infection Feline leukemia virus disease.
- Possible development of alimentary (intestinal) lymphoma in cats with lymphocytic enteritis Lymphocytic / plasmacytic enteritis.
- Recent reports suggest that FIV infection may be implicated in some forms.
Specific
- FeLV Feline leukemia virus disease for some forms (not alimentary)
- Mediastinal 80% FeLV positive.
- Alimentary <30% FeLV positive.
- Multicentric 80% FeLV positive.
- CNS 80% FeLV positive.
- Cutaneous <10% FeLV positive.
- Renal 50% FeLV positive.
- Often occurs in households of FeLV infected cats.
Pathophysiology
- Relative incidence of different forms varies with geographical region (and therefore depends on study):
- Alimentary: 30-50% Scotland (but 15% in New York).
- Mediastinal: 25-38% England (but 18% Scotland).
- Multicentric: 20-44%.
- Renal Kidney: neoplasia.
- Spinal: rare (but most common spinal neoplasm in cat).
- Malignant proliferation of lymphoid cells arising in any area containing lymphoid tissue → focal or diffuse masses in intestine, skin, thymus or lymph nodes → progresses to extranodal sites, eg liver, spleen, bone marrow.
- Stage 1Neoplasia: TNM staging:
- Single tumor.
- Stage 2:
- Single tumor and regional lymph node involvement.
- Two single tumors on same side of diaphragm.
- Resectable gastrointestinal lesion.
- Stage 3:
- Two single tumors on opposite sides of diaphragm.
- Inoperable intra-abdominal mass.
- Spinal neoplasia.
- Stage 4:
- Stage 1-3 plus liver/spleen involvement.
- Stage 5:
- Stage 2-4 plus CNS or bone marrow involvement (leukemic).
Timecourse
- Rapidly fatal (6-8 weeks) without treatment in most cases.
- Months (nasal, cutaneous forms).
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Williams L E, Pruitt A F, Thrall D E (2010) Chemotherapy followed by abdominal cavity irradiation for feline lymphoblastic lymphoma. Vet Radiol Ultrasound 51 (6), 681-687 PubMed.
- Louwerens M, London C A, Pedersen N C et al (2005) Feline lymphoma in the post-feline leukemia virus era. J Vet Intern Med 19 (3), 329-335 PubMed.
- Brown M R, Rogers K S, Mansell K J et al (2003) Primary intratracheal lymphosarcoma in four cats. J Am Anim Hosp Assoc 39 (5), 468-472 PubMed.
- Teske E, van Straten G, van Noort R et al (2002) Chemotherapy with cyclophosphamide, vincristine, and prednisolone (COP) in cats with malignant lymphoma: new results with an old protocol. JVIM 16 (2), 179-186 PubMed.
- Kristal O, Lana S E, Ogilvie G K et al (2000) Single agent chemotherapy with doxorubicin for feline lymphoma - a retrospective study of 19 cases (1994-1997). JVIM 15 (2), 125-130 PubMed.
- Parnell N K, Powell L L, Hohenhaus A E et al (1999) Hypoadrenocorticism as the primary manifestation of lymphoma in two cats. JAVMA 214 (8), 1208-1211, 1200 PubMed.
- Gabor L J, Malik R, Canfield P J (1998) Clinical and anatomical features of lymphosarcoma in 118 cats. Aust Vet J 76 (11), 725-732 PubMed.
- Court E A, Watson A D & Peaston A E (1997) Retrospective study of 60 cases of feline lymphosarcoma. Aust Vet J 75 (6), 424-427 PubMed.
- Meleo K A (1997) The role of radiotherapy in the treatment of lymphoma and thymoma. Vet Clinics NA SAP 27 (1), 115-129 PubMed.
- Moore A S, Cotter S M, Frimberger A E et al (1996) A comparison of doxorubicin and COP for maintenance of remisssion in cats with lymphoma. JVIM 10 (6), 372-375 PubMed.
- Mahony D M, Moore A S, Cotter S M et al (1995) Alimentary lymphoma in cats 28 cases (1988-1993). JAVMA 207 (12), 1593-1598 PubMed.
- Mooney S C, Hayes A A, McEwan E G et al (1989) Treatment and prognostic factors in lymphoma in cats 103 cases (1977-1981). JAVMA 194 (5), 696-702 PubMed.
- Mooney S C, Hayes A A, Matus R E et al (1987) Renal lymphoma in cats 28 cases (1977-1984). JAVMA 191 (11), 1473-1477 PubMed.
Further Information
- The Webinar Vet - Feline lymphoma on a budget