From:
"mokicapi"
Date: 2006-12-09 07:41:28 UTC
Subject: [ferrethealth] Diagnosis of Lymphoma from abdominal fluid sample?
To: ferrethealth@yahoogroups.com
I apologize for the length. I am trying to be thorough. Moki is a
3yr 3mo. Neutered sable male weighs 3.5 normally.=20
A few weeks ago he
started putting on what we thought was his normal winter weight.=20
Last Sunday I noticed his belly was larger than it should be and
started monitoring how much he was eating. His eating was normal and
the only change in his behavior was a slight slowing down. I watched
him closely for the next 2 days and realized his belly was growing
bigger quickly. It was very hard and very large.
Took him to Vet #1
who did x-rays. X-rays as (described to me) showed slightly
enlarged round shaped heart with a slight bulge on the right
ventricle, a small amount of fluid in the lungs and chest cavity and
a large amount of ascites (not completely opaque) in the abdomen.=20
Temp. 102.2 and normal heart rate with arrhythmia (beat-beat-beat-
stop). Doctor thought everything showed signs of possible heart
disease. Doctor suggested doing ultrasound the following week and
pretty much refused any of my requests for bloodwork, tapping the
fluid, diuretic therapy.=20
The next day I went to Vet#2 who reviewed
the X-rays. He notices an opaque patch in the abdominal area that he
thinks is a mass. Palpation done by him and another colleague agree
with this assessment. They feel a small mass in his abdomen. They
also see what appears to be a bladder stone.
Many symptoms are suddenly appearing the last 3 days, eating less,
lethargy, and upon waking, he has greater than normal urgency, he
passes a =BD size stool and normal urine=85runs around for a couple of
minutes then urgently finds a corner again. He does this 5 or 6
times sometimes passing a small amount of mucous and sometimes stool
and sometimes nothing. He does not seem to strain or be in pain but
he is very urgent. (He did this same thing 3 months ago with no
other symptoms=85at that time xray and cbc normal and he was back to
normal BM's in a week.)=20
Also, his breathing (during sleep only) is
very heavy and raspy sounding. No coughing, no vomiting, loose
smallish stool but no true diarrhea and he is very alert and will eat
well when coaxed. He has gained weight but in fluid only as we can
feel muscle loss in his back and shoulders.
He is on 1.25 mg
prednisone 2x/day, 3mg lasix 2x/day and .5ml clavamox 2x/day. Dr.
tells me to give all at the same time. Does this all sound right?
=20
Is the aspirating of the fluid from the abdomen the same as
aspirating from lymph node or spleen? Is this enough to comfirm
lymphoma and if so where should I go from here to pinpoint location?=20
Does the location of the lymphoma change the course of therapy?
Thank you for taking the time!
CBC
Hemoglobin 15.4
Hematocrit 43.9
WBC 5.9
RBC 9.22
MCV 48
MCH 16.7
MCHC 35.1
Platelet Count 576
Platelet Estimate Increased
Differential Absolute %
Neutrophils 3422 58
Bands 0 0
Lymphocytes 1888 32
Monocytes 354 6
Eosinophils 236 4
Basophils 0 0
Spherocytes none seen
Blood Parasites none seen
Mammalian Comprehensive Chemistries
Glucose 85
Urea Nitrogen 35
Creatinine 0.8
Total Protein 5.1
Albumin 2.4
Total Bilirubin 0.2
Alkaline Phosphatase 72
ALT (SGPT) 57
AST (SGOT) 72
Cholesterol 138
Calcium 8.0
Phosphorus 4.7
Sodium 149
Potassium 4.8
Chloride 118
Globulin 2.7
CPK 0
Fluid removed from Abdominal cavity with a syringe=85..tests that were
run on this fluid.
WBC (fluid) 0.7 THSD/CMM
RBC <0.001
Protein (fluid) 2.5
Color of fluid Straw
Appearance of fluid Cloudy
Specific Gravity 1.019
Cytology
Microscopic description: Abdominal fluid: cytospin preparation
examined. The sample is adequately cellular with mild hemodilution
and a background of a few lymphoglandular bodies. It consists of a
majority of lymphoblasts with rare small to intermediate
lymphocytes. The lymphoblasts are large and round with scant, deeply
basophilic cytoplasm and large round to indented to cleaved nuclei.=20
Nuclei contain stippled chromatin patterns and multiple, deeply
basophilic nucleoli. Few mitotic figures are seen.
Microscopic Findings: Lymphoma
Comment: consider immunophenotyping or biopsy and histropathology
with immunohistochemistry to determine the type of lymphoma.
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