Dear Brandi:
 
>About three weeks ago during giving her a bath, I noticed a disturbingly
>large lump under her neck.  She has been to the vet and it was determined
>that it was her = lymph node that was enlarged.  The vet aspirated the
>lymph node and sent the sample to a pathologist were they deemed it wasn't
>cancerous.  Lilli = was put on antibiotics for two weeks because we were
>hoping the node was enlarged due to infection.  It was not reduced during
>this time.  After going off the antibiotics, Lilli began to have trouble
>eating and was having diarrhea.  I took her immediately back to the vet
>and they now = think that she has lymphoma and the pathology results were
>incorrect.  She is = now on prednisone and the antiobiotic and is doing
>well (3 days later) but = the lymph node is still very enlarged.
 
My recommendation at this time is to go back in and remove that lymph node
and send it off for biopsy.  Biopsy yields far more information on a lymph
node than aspirate, beause you can evaluate the architecture of the whole
node rather than individual cells.
 
Older ferrets commonly have lymphomas in which the cells are very mature,
and differ very little from normal lymphocytes.  Soemtimes, the only way
that you can tell whether lymphoma is presence is to see whether these
cells respect the typical lymph node architecture.  If they maintain normal
architecture, you probably are dealing with a reactive chane from local
inflammation in the area.  However, if they overrun the architecture,
extend into the surrounding tissue, and what you have is a large sheet of
apparently normal lymphocytes rather than something which you can identify
as a lymph node, then you have a lymphoma.
 
In some of these cancerous nodes, the cells look so much like normal that
when you suck some out with a needle and spread them on a slide (which is
what an aspirate is) - you can't tell there is anything wrong (unless you
see other cells that don't belong in normal nodes, such as neutrophils -
which indicate local infection.
 
With no response to anitibiotics, and no obvious infection in this area -
it's time to remove the node and make absolutely sure whether you are
dealing with lymphoma or not.  Cases in which multiple nodes are enlarged
are easy - it's these cases where only one node is enlarged that can be
tough.
 
Most important - until you come back with a definite diagnosis of lymphoma
- don't start any treatment for it.  Too many non-lymphoma cases get chemo
based on suspicious signs.  Get the diagnosis first.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3245]