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Client Library Article
GASTROINTESTINAL LYMPHOSARCOMA
| About
Lymphosarcoma |
| Alimentary lymphosarcoma is a common malignant
cancer affecting the lymphnodes in the abdomen and the walls of the stomach
and intestine. Though this type of cancer is most common in older cats that
are often negative for feline leukemia, it can also show up in young cats,
dogs, and ferrets. The cancer usually originates in the lymph nodes
located in the mesentery (next to the intestines), or in the aggregates of
lymphoid cells within the walls of the intestines. The cancer will
present as either a diffuse thickening of the walls of the intestines or as
large masses being the cancerous lymph nodes found within the abdominal
cavity (belly) or intestinal wall masses. If left untreated, eventually the
patient becomes debilitated as the cancer spreads loosing weight and
developing diarrhea and vomiting, and when the masses grow very large, they
can rupture leading quickly to peritonitis and death. If caught early
enough, small masses can be removed surgically, and the patient can be
treated with chemotherapy with good success for remission. |
| Symptoms |
- Rapid weight loss
- Vomiting
- Diarrhea
- Lethargy
- Anorexia (loss of appetite)
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Diagnosis
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Lymphosarcoma can be confirmed only with a
biopsy specimen- where a piece of the tumor is collected and then examined
under the microscope by a veterinary pathologist. Occasionally, a diagnosis
can be made by looking at cells that have been aspirated or extracted from
the mass using a long needle introduced through the skin into the suspected
mass. However, in some cases, the clinical signs are so consistent with
lymphoma, many owners elect not to confirm lymphoma through these methods.
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Physical exam-the veterinarian can often palpate
or feel abdominal masses or intestinal thickening in cats and ferrets, but
dogs are much more difficult to feel.
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Blood work is generally normal although elevations in
liver and kidney enzymes can be elevated if the lymphoma has spread to those
organs.
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Radiographs (x-rays) can show thickening of the
intestinal loops and/or a discrete mass, however, in some cases, the
radiographs can look normal.
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Ultrasound exam of the abdomen is the most accurate
diagnostic method second only to biopsy for diagnosing lymphosarcoma.
Ultrasound images clearly show the presence of thickened intestinal loops,
masses,
and/or enlarged cancerous lymph nodes. Ultrasound is also very useful in
guiding needle aspirates and needle biopsy collections.
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| Treatment- Chemotherapy
+/- surgery |
| Lymphosarcoma has been successfully treated
using chemotherapy or a combination of surgery to remove large masses
followed by chemotherapy. Surgery is indicated for large solitary masses
that are at risk for obstructing the intestine or rupturing. Remission rates
with chemotherapy can be approximately 75 % and most
patients stay in remission for anywhere from 7 – 14 months. Without treatment,
survival is often less than 6 weeks. There are several chemotherapeutic protocols
being used, usually a combination of oral prednisone given daily at home in
combination with weekly injections of anti-cancer drugs given IV (in the
vein) by the veterinarian. Animals generally tolerate the drugs well, although
some animals may become ill requiring hospitalization. Consultation is
always advised with a boarded veterinary oncologist, and more specific
prognosis can be given for individual pets. |
| Prognosis |
| Highly variable depending on the stage the lymphoma is
detected, the organs affected, and the intensity of the treatment pursued.
A veterinary oncologist should be consulted to give a prognosis for each
individual patient whose owners wish to pursue treatment. |
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