10 yr old MN Golden Retriever presented with generalized lymphadenopathy. Past relevant history included having spleen removed due to trauma; also possible allergies (generalized pruritus with variable response to antihistamines).
Workup:
-CBC (mild anemia, likely secondary to splenectomy), Chem, T4 normal.
-FNA submandibular node- intermediate to large lymphocytes, dense chromatin pattern
-3 view chest rads, no evidence of mets
- prescap lymph node biopsy confirmed Lymphoma, intermediate grade
-UA normal
- Abdominal ultrasound- enlarged mesenteric and sublumbar nodes. Liver appears normal.
- FNA of mesenteric lymph nodes appears same cytologically as submandib lymph node aspirate.
- FNA of liver pending
- Immunohistochemistry pending.
- no staging bone marrow biopsy done (can use as discussion point)
Dog develops hot spot over prescap biopsy site.
Treatment: What are your recommendations? What is your prognosis?
A Member has submitted this additional information and follow up regarding this case:
- The liver FNA came back as strongly suggestive of lymphoma.
- Immunophenotype results came back as B cell.
- Dog is doing very well. We just completed vincristine week 3 today. Dog is in complete remission. CBCs have been normal except for chronic mild anemia.
- Ultrasound images can be viewed here: http://www.vetvine.com/albums/view/47
Uh oh.. I am using a CHOP 19 week protocol, so 4 cycles of:
week 1- Vincristine
week 2- Cyclophosphamide
week 3- Vincristine
week 4- Adriamycin
week 5- off
I am not sure if there is lymphoma in the bone marrow because I never did an aspirate. Dog has no spleen, so no lymphoma there. Not seeing lymphoma elsewhere besides lymph nodes and liver.
So far, the dog is still doing clinically well. He lost weight in the first 4 weeks, but I attribute that to a homemade diet the owner started feeding. I think his metabolic energy requirement was not being met. The dog gained some weight back after she started mixing in his normal dog food.
Can you provide me with some references for the link between hepatic lymphoma prognosis on CHOP based protocols?
Thanks for your input,
Lynn
