Feline progressive histiocytosis treatment

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Feline Progressive Histiocytosis Feline progressive histiocytosis (FPH) is a disease of middle-aged to older cats, the age ranged from 7 to 17 years (Vet Pathol. 2006;43(5):646-655). The initial presentation of FPH many be a solitary skin nodule, although usually multiple papules, nodules or plaques develop, measuring up to 1.5 cm in diameter Vet Pathol 43:5, 2006 Feline Progressive Histiocytosis 647 and as previously described. 11 Amino-9-ethyl-carbazole (Sigma Chemicals Co, St. Louis, MO) was used a Feline progressive histiocytosis has been increasingly reported since 1995. The disease appears to be most closely related to multiple persistent histiocytomas or Langerhans' cell histiocytosis in dogs. Affected cats usually have multiple nodules which are firm, non-pruritic and non-painful Monoclonal antibodies (MABs) used for immunophenotyping of 25 cats with feline progressive histiocytosis: fresh, snap-frozen tissue from 16 cats, formalin-fixed tissues from 9 cats. ∗ Table 2 Etiology of progressive dendritic cell histiocytosis is not known. Feline histiocytic sarcoma. Clinical presentation--Histiocytic sarcomas do occur in cats, but less frequently than in dogs. Some of the progressive dendritic cell histiocytosis eventually become very anaplastic and have features of histiocytic sarcoma

An indolent form of localized HS, progressive histiocytosis, originates in the skin of cats. Hemophagocytic HS originates in splenic red pulp and bone marrow macrophages in dogs and cats. In dogs, histiocytes in hemophagocytic HS express CD11d/CD18, which is a leuko-integrin highly expressed by macrophages in splenic red pulp and bone marrow Lomustine (CCNU) is an antineoplastic drug that is used for the dog's histiocytic disease and may be used in the cat as well at a dosage of 40-60 mg/m2 every 3-6 weeks Surgical removal of lumps is the first line of treatment if possible. Microbiological investigation of underlying causes of histiocytosis should, in theory, be next but can be expensive, is complex, and may not assist in diagnosis. Serology (looking for antibodies) for Leishmaniasis is helpful in endemic areas

Welcome to the Histiocytosis Site. This site was developed to provide a current information source for pet owners, clinical veterinarians and pathologists who wrestle dissecting the intricacies of diagnosis, prognosis and treatment of the spectrum of histiocytic proliferative diseases in dogs and cats Treatment with chemotherapeutics or immunosuppressive and immunomodulatory drugs was not successful. The etiology of FPH remains unknown. FPH is best considered an initially indolent cutaneous neoplasm, which is mostly slowly progressive and may spread beyond the skin in the terminal stage A more widespread form of cutaneous histiocytosis that may involve the eyes, nasal mucosa, and lymph nodes in addition to skin is called systemic histiocytosis (SH). Systemic histiocytosis is more commonly seen in young to middle aged Bernese Mountain dogs, Irish wolfhounds, Rottweilers and Labradors; however any breed may develop the disease Feline progressive dendritic cell histiocytosis (FPDCH) resembles Langerhans cell histiocytosis in humans and is divided into two subgroups, epitheliotropic and nonepitheliotropic. 1 In epitheliotropic form, the cellular infiltrate extends from the dermis up to the basement membrane, with single or clusters of cells located within the epidermis.

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  1. Feline progressive histiocytosis (FPH) is a rare proliferative disorder of cats characterized by solitary or multiple firm dermal nodules. The neoplastic nodules are indolent and non-pruritic. The.
  2. Histiocytic Sarcoma in Cats and Dogs. Histiocytoma (benign tumor) Histiocytomas are common benign (noncancerous) tumors that occur in dogs younger than 3 years old. They are usually. solitary (single lesions) but multiple histiocytomas can occur in some pets, especially shar-pei dogs. Under the
  3. Malignant histiocytosis (MH) is a systemic neoplastic proliferation of macrophages and their precursors. The disease is well characterized but uncommon in dogs and has been rarely reported in cats.1-4 In dogs, MH is a rapidly progressive, fatal disease characterized by anorexia, weight loss, dyspnea, and fever. Lymphadenopathy, marke
  4. Five cases of feline progressive histiocytosis (FPH), eight histiocytic sarcomas (HS) and two haemophagocytic histiocytic sarcomas (HaeHS) were confirmed. PDGFRβ was variably positive in most histiocytic cases, while KIT was negative in all. Clinical presentation, treatment and outcome were also evaluated
  5. Neoplastic histiocytic tumors originating at a single site in the body are referred to as localized histiocytic sarcomas (LHS). They can arise within many different organs of the body but are more commonly found in the skin, spleen, lymph nodes, lung, bone marrow, brain, and the tissue surrounding the joints of the limbs
  6. ated 4,7-10,14.
Feline Progressive Histiocytic Disease – Vets on theHistiocytoses – Overview | Perri Dermatology

Feline progressive histiocytosis - PubMe

  1. Kraje A C, Patton C S & Edwards D F (2001) Malignant histiocytosis in 3 cats. JVIM 15 (3), 252-256 PubMed. Freeman L, Stevens J, Loughman C et al (1995) Clinical vignette - malignant histiocytosis in a cat. JVIM 9 (3), 171-173 PubMed. Court E A, Earnest-Koons K A, Barr S C et al (1993) Malignant histiocytosis in a cat. JAVMA 203 (9), 1300-1302.
  2. Cutaneous histiocytosis is characterized by waxing and waning lesions that can spontaneously regress. Treatment options include corticosteroids, tetracycline, and, if necessary, aggressive immunosuppressive therapy
  3. Unfortunately, we have not identified a highly effective treatment for malignant histiocytosis. Current protocols include doxorubicin and prednisone. The CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) protocol is commonly used. A drug with high expectations is Doxil (liposome-encapsulated doxorubicin)
  4. Histiocytic disorders that are diagnosed in veterinary medicine at this time include the following: canine cutaneous histiocytoma, canine LC histiocytosis, canine cutaneous and systemic histiocytosis, feline pulmonary LC histiocytosis, feline progressive histiocytosis, dendritic cell leukemia in the dog, and histiocytic sarcoma and.
  5. al.

The Langerhans cells are immune cells that function to provide protective immunity to the tissues that are in contact with the outer environment -- the nose, stomach, intestines and lungs, but mainly the skin's surface. These cells are also referred to as dendritic cells, and histiocytes. A histiocytoma is a benign skin tumor that originates in the Langerhans cells Cutaneous histiocytosis is a benign form of histiocytosis in which there are small skin lesions around the head and neck which may come and go, and may or may not respond to treatment. Dogs with systemic histiocytosis also have head and neck lesions, with lymph nodes affected as well. In malignant histiocytosis, skin masses are uncommon. Discussion: Progressive histiocytosis of feline dendritic cells, in both epitheliotropic and non-epitheliotropic forms, is considered a clinically progressive and rare disorder. There are reports which include cytological, clinical, histological and immunohistochemical examinations, but the diagnostic characteristics regarding the non. Feline progressive histiocytosis: a retrospective investigation of 26 cases and preliminary study of Ki67 as a prognostic marker. Coste M , Prata D , Castiglioni V , Minoli L , Etienne-Raffestin CL , Boulouha L , Moreau S , Lagadic

In cats, there are limited descriptions of clinical syndromes and there are no uniformly accepted classifications of feline histiocytic disorders, nor standardized staging or treatment protocols. Feline progressive histiocytosis (FPH) is the form most commonly described in the literature.1,2 Affected cats present with solitary or multiple. The disorder is rapidly progressive and does not wax and wane as does systemic histiocytosis. Few dogs survive >6 mo. Various chemotherapeutic regimens mentioned above have been used to treat both forms; hopefully, masitinib and other tyrosine kinase inhibitors used in combination with vincristine or other combinations of antineoplastic drugs.

Feline progressive histiocytosis (FPH) in cats

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Feline Progressive Histiocytosis - SAGE Publications In

Cutaneous histiocytosis has a fair to good prognosis, although relapses may occur. Systemic histiocytosis is a progressive disease that eventually requires continuous immunosuppressive therapy for control. Treatment. Cutaneous histiocytosis: Large doses of steroids are generally effective in inducing remission Malignant histiocytosis in a cat - Case report. By Adriano Ramos. Malignant Histiocytosis in 3 Cats. By David Edwards. Morphological Distinction of Histiocytic Sarcoma from Other Tumor Types in Bernese Mountain Dogs and Flatcoated Retrievers. By E. Teske. CCNU for the Treatment of Dogs with Histiocytic Sarcoma non epitheliotropic progressive, histiocytosis of epi-theliotropic and others feline neoplasms derived from histiocytes, such as histiocytomas, as well as common skin tumors, mastocytomas, and sarcomas. CASE A 5-year-old male, crossbreed, feline presen-ted with a nodule at the base of the left auricle that was characterized by slow and.

Histiocytic disease - Ca

  1. Langerhans cell histiocytosis (LCH) treatment may include observation alone, surgery, radiation therapy, or oral, topical, and intravenous medication. Treatment depends on the site and extent of disease. Get detailed treatment information for LCH in this summary for clinicians
  2. Their conclusion: feline progressive dendritic cell histiocytosis. It's not at all common. Something similar apparently happens more often in dogs and in dogs apparently the lumps go away of their own accord
  3. Investigation of subclinical bacteriuria in cats with dermatologic disease receiving long-term glucocorticoids and/or ciclosporin - Accepted for publication in Veterinary Dermatology et al-Feline Progressive dendritic cell histiocytosis in domestic long hair feline - (published in Veterinary Records Case Reports) demodicosis.
  4. Histiocytosis in dogs symptoms; Histiocytic sarcoma cat; Feline progressive histiocytosis prognosis; Symptoms of malignant histiocytosis in dogs; Feline progressive histiocytosis cytology; Reactive histiocytosis humans; Systemic histiocytosis humans; Malignant histiocytosis Bernese Mountain dogs symptoms; Recent Search. sids statistics uk 202
  5. Systemic histiocytosis is a chronic, debilitating disease usually in young Bernese Mountain Dogs. It has a fluctuating course with lumps affecting the skin, lymph nodes, eyes and other tissues. It is rarely fatal although progressive. Benign and malignant forms are probably extremes of a single disease

Feline Progressive Histiocytosis - V

Canine histiocytic proliferative diseases represent a range of disorders with different pathologic features as well as clinical behavior.1,2 At least three well-defined syndromes have been reported in dogs that arise from histiocyte proliferation, including cutaneous histiocytoma, reactive histiocytosis (cutaneous and systemic), and histiocytic sarcoma (localized and disseminated).3 Malignant. Canine reactive cutaneous histiocytosis 417. Canine systemic histiocytosis 417. Feline progressive histiocytosis 417. Canine cutaneous langerhans cell histiocytosis 418. Collagenous hamartoma 418. Calcinosis circumscripta 418. Transmissible venereal tumor 419. Feline lung‐digit syndrome 419. 20 Dermatology formulary 453. Table 20.1 Systemic. Malignant histiocytosis (6,11). (termed MH) is used for the disseminated form of histiocytic sarcoma (1,2,7,10). It is the most aggressive Case report syndrome of all histiocytic neoplasms, with the most unclear origin (4). The disease is characterized by A 14-year-old, male, crossbreed cat was presented progressive and invasive multisystemic. Histiocytosis. Transmission/cause: Reactive histiocytosis is due to an immune-mediated proliferation of a type of white blood cell called histiocytic or dendritic cells which normally occur in the skin.These cells are integral to the normal function of the immune system, and reactive histiocytosis is considered to be an aberrant immune response to an unknown stimulation of the immune system Histiocytic proliferative diseases in cats are less frequent and with narrower clinical and pathologic spectrum compared to dogs, lacking entities clearly equivalent to canine cutaneous histiocytoma and reactive histiocytoses (Moore and Affolter 2009).The most common feline histiocytic disorder is the so-called feline progressive histiocytosis, a unique feline entity that originates from the.

Background Feline Progressive Histiocytosis (FPH) is a cutaneous dendritic cell neoplasm characterized by slow progression and spread to internal organs in the terminal stage. FPH is often misdiagnosed as an inflammatory reaction and has not been fully characterized from a cytologic diagnostic perspective. Objectives The purpose of the study was to characterize the cytologic and. LC proliferative disorders have been best described in humans. 8 Human LC histiocytosis (LCH) covers a spectrum of disease, ranging from unifocal to rapidly progressive multifocal multisystem disease. 8 Feline histiocytic disorders of LC origin are uncommon. 8 Pulmonary LCH has been described in cats as pulmonary disease alone or with multi. Algorithm 11.2 Treatment of feline pemphigus foliaceus 270. Feline progressive histiocytosis 417. Canine cutaneous langerhans cell histiocytosis 418. Collagenous hamartoma 418. Calcinosis circumscripta 418. Transmissible venereal tumor 419. Feline lung-digit syndrome 419. 20 Dermatology formulary 453

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Histiocytic Proliferative Diseases in Dogs and Cats

FELINE PROGRESSIVE HISTIOCYTOSIS WITH PERIOCULAR INVOLVEMENT IN A DOMESTIC SHORTHAIR CAT (#95) G. Storms 1, G. Janssens 1, C. Naranjo 2, H. De Cock 3. 1 Vet practice Kleidal, Hemiksem, Belgium 2 IDEXX Laboratories, Barcelona, Spain 3 AML/Veterinary Pathology Services, Antwerp, Belgiu Blackwell's Five-Minute Veterinary Consult: Canine and Feline, 7th Edition provides up-to-date information on feline and canine disease in the familiar, popular, and trusted 5-Minute Veterinary Consult format. This reference puts all the necessary information regarding common diseases and conditions in dogs and cats at the reader's fingertips This presentation provides an overview of histiocytic diseases in dogs (histiocytoma, cutaneous Langerhans cell histiocytosis, cutaneous histiocytosis, systemic histiocytosis, histiocytic sarcoma and dendritic cell leukaemia) and in cats (progressive histiocytosis, histiocytic sarcoma and pulmonary Langerhans cell histiocytosis), including. Eosinophilic granuloma is a form of Langerhans cell histiocytosis.It is a condition of both human and veterinary pathology. Feline eosinophilic granuloma complex is synonymous with feline eosinophilic skin diseases.This is considered to be a cutaneous reaction pattern that can be the manifestation of a number of underlying infections, allergies or ectoparasite infestations Interdigital 'Cysts' (Pododermatitis) Interdigital 'cysts' are a common, recurrent and painful problem in many dogs. Treating the secondary infections will often result in only a short to medium term resolution. Recurrence is very likely unless the primary cause is detected & treated

what are the treatment options for feline lymphosarcoma. CHlorambucil and pred, MST 18-24 months Reactive process- (cutaneous histiocytosis and systemic histiocytosis) malginant processes (histiocytic sarcoma and disseminated histiocytic sarcoma (malignant histiocytosis) multiple infiltrating nodules/plaques on skin- non progressive and. The histiocytic diseases in children and adults are caused by an abnormal accumulation of cells of the mononuclear phagocytic system. Only Langerhans cell histiocytosis (LCH), a myeloid-derived dendritic cell disorder, is discussed in detail in this summary. The histiocytic diseases have been reclassified into five.. Specialties: Over the years, we have found homes for over a thousand cats The Ann Arbor Cat Clinic first opened its doors in 1987 with two exam rooms, a small reception area, 12 holding kennels and one full-time employee. Founded by co-owners Dr. Linda Griebe and Dr. Tina Kaufeld, Ann Arbor Cat Clinic was the first cats only animal hospital in Washtenaw County. We have grown to be a full.

Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon lung disease which usually affects young to middle aged smokers or former smokers. PLCH causes the formation of multiple lung cysts (air-filled pockets inside the lung tissue), which can progress over time leading to loss of lung function. While the precise cause of PLCH remains. An adult lymphoma treatment regimen of methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin (MACOP-B) was used in three patients with multisystem eosinophilic granuloma (Langerhans cell histiocytosis) and four with single-system multifocal bone eosinophilic granuloma (Langerhans cell histiocytosis) from 1995 to 2007 Start studying canine and feline hemolymphatic neoplasia. Learn vocabulary, terms, and more with flashcards, games, and other study tools

Various forms of DC proliferations have been documented in humans and dogs; their etiology is largely unknown. With the exception of a few case reports, histiocytic proliferations have not been characterized in cats. This study summarizes clinical, morphologic, and immunophenotypic features of a feline progressive histiocytosis (FPH) in 30 cats Untreated, the clinical course of disseminated histiocytic sarcoma is rapid and fatal. Localized histiocytic sarcoma is sometimes more slowly progressive, but can be extremely painful and cause a poor quality of life. Overall, response rates to treatment are poor and survival times are short (3-4 months) Malignant histiocytosis (MH) is a neoplastic. proliferation of macrophages. The majority of this. tumors in cats was disseminated and characterized by. progressive and invasive multi-systemic neoplastic. proliferation of morphologically atypical histiocytes. and its precursors (5). The affected organs include

Malignant histiocytosis (MH) is a progressive systemic neoplastic proliferation of morphologically atypical histiocytes, well characterised in humans and dogs but only recently identified in the cat. In all species, liver, lung, lymph nodes, spleen and bone marrow are infiltrated by atypical histiocytes, and the disease is rapidly fatal an attempted tapering of the prednisone treatment there were more numerous dermal nodules found at a recheck examination. At an 8 month follow up visit there was continued improvement of lesions, especially of the nasal planum. References Affolter, V.K. & Moore, P.F. 2000; Canine cutaneous and systemic histiocytosis: a reactive histiocytosis o The histiocytoma is a tumor originating from what is called a Langerhans cell. This cell lives in the skin and serves as part of the immune system by processing incoming antigens and presenting them to other immunologic cells

6 Signs & Symptoms. 7 Diagnosis. 8 Treatment. 8.1 Definitive therapy. 8.2 Palliative intent therapy. 9 Prognosis. Histiocytic Sarcoma is an aggressive neoplasia originated from histiocytes. The characteristic features of the malignant proliferation of this rare histiocytic neoplasia involve morphological and immunohistochemical alterations 1 A histiocytosis is a disease in which there are too many histiocyte cells in the skin and other organs. Normal histiocyte cells are part of the immune system, alerting infection -fighting cells to the presence of foreign material such as bacteria ( antigen presentation). They also perform a waste-disposal function, getting rid of waste products. Langerhans cell histiocytosis is a type of cancer that can damage tissue or cause lesions to form in one or more places in the body. Langerhans cell histiocytosis (LCH) is a rare cancer that begins in LCH cells. LCH cells are a type of dendritic cell which fights infection. Sometimes there are mutations (changes) in LCH.. Also Known As: Mycosis Fungoides, Cutaneous lymphoma Transmission or Cause: Epitheliotropic lymphoma is a malignant cancer arising from T lymphocytes. There is some evidence that epitheliotropic lymphoma in cats may be linked to FeLV infection. Affected Animals: Epitheliotropic Lymphoma usually affects older dogs and cats (average age is 9-11 years). There is no sex or [

A review of histiocytic diseases of dogs and cat

Treatment and prognosis are similar to other sarcomas of bone. Surgical extirpation is central to control of local disease. Histiocytosis infers the presence of histiocytes - cells of the immune system located within connective tissue that engulf cellular debris and pathogens. Pain with fibrosarcoma is often rapidly progressive with. Langerhans cell histiocytosis is a type of cancer that can damage tissue or cause lesions to form in one or more places in the body. Langerhans cell histiocytosis (LCH) is a rare cancer that begins in LCH cells (a type of dendritic cell which fights infection ). Sometimes there are mutations (changes) in LCH cells as they form Treatment. Vincristine 0.7 mg/m2 IV weekly. Continue 2-3 weeks past resolution of disease. Usually 3-5 injections are required. If no response, doxorubicin 30 mg/m2 IV q3 weeks x 3 treatments. Radiation is also effective, but often reserved for those that do not respond to chemotherapy. Spay-neuter and do not allow to roa

The cat was evaluated by the referring veterinarian and treated with furosemidea (2.2 mg/kg, PO, q12 hr) for presumptive congestive heart failure. The cat subsequently developed a decreased appetite and an increase in respiratory effort and rate until presentation 7 days later. The cat was the only animal in the house and never ventured outdoors Systemic histiocytosis - seen in BMDs, Goldens, Rottweilers, Dobermans, and Saint Bernards. It could be a benign version of malignant histiocytosis. The disease involves skin (flank, muzzle, nasal plane, eyelids and scrotum), peripheral lymph nodes and less frequently episclera and conjunctiva Localized histiocytic sarcomas occur most commonly in middle-aged or older flat-coated retrievers, golden and Labrador retrievers and rottweilers. 5 Malignant histiocytosis has a predilection for Bernese mountain dogs as well as the aforementioned breeds. 5 The disease is uniformly fatal after a progressive disease course. Cytologic appearance.

Feline Progressive Histiocytic Disease - Vets on the

Langerhans cell histiocytosis is a type of cancer that can damage tissue or cause lesions to form in one or more places in the body. Family history of cancer or having a parent who was exposed to certain chemicals may increase the risk of LCH. The signs and symptoms of LCH depend on where it is in the body Lukina EA, Kuznetsov VP, Beliaev DL, et al.: [The treatment of histiocytosis X (Langerhans-cell histiocytosis) with alpha-interferon preparations] Ter Arkh 65 (11): 67-70, 1993. [PUBMED Abstract] Gadner H, Ladisch S: The treatment of Langerhans cell histiocytosis. In: Weitzman S, Egeler R M, eds.: Histiocytic Disorders of Children and Adults Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease of unknown etiology characterized by the infiltration and destruction of the walls of distal bronchioles by Langerhans cell granulomas (1-3).In patients with progressive disease and impaired lung function, extensive cystic lesions are the main finding on high-resolution computed tomography (HRCT) scans (4-6), a radiological.

Histiocytosis X is a generic term that refers to an increase in the number of histiocytes, a type of white blood cell that acts as a scavenger to remove foreign material from the blood and tissues. Research that demonstrated Langerhans cell involvement as well as histiocytes led to a proposal that the term Langerhans cell histiocytosis (LCH) be. Sources. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds): WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition) IARC: Lyon 2017. Section: Histiocytic and dendritic cell neoplasms. Pages: 473. International Classification of Diseases for Oncology, Third Edition, Second Revision. Histoplasmosis is a pulmonary and hematogenous disease caused by Histoplasma capsulatum; it is often chronic and usually follows an asymptomatic primary infection.Symptoms are those of pneumonia or of nonspecific chronic illness. Diagnosis is by identification of the organism in sputum or tissue or use of specific serum and urine antigen tests

Eosinophilic Granulomas are self-limiting benign histiocytic lesions that can occur in isolation or as a part of 2 systemic syndromes: Hand-Schuller-Christian (HSC) disease and Letterer-Siwe disease (LSD). Isolated lesions typically present with pain in the thoracic spine or long bones in patients < 20 years of age Childhood LCH. Incidence. The annual incidence of Langerhans cell histiocytosis (LCH) has been estimated to be between two and ten cases per 1 million children aged 15 years or younger.[1,2,3] The male-to-female ratio (M:F) is close to one, and the median age of presentation is 30 months.[] A 4-year survey of 251 new LCH cases in France found an annual incidence of 4.6 cases per 1 million. Langerhans cell histiocytosis (LCH) describes a group of syndromes that share the common pathologic feature of infiltration of involved tissues by Langerhans cells. Typically, the skeletal system is involved, with a characteristic lytic bone lesion form that occurs in young children or a more acute disseminated form that occurs in infants Most (50% to 70%) of the infections are subclinical. The ocular signs are the earliest manifestations of the systemic disease; they include acute, mild to severe, bilateral, serous to mucopurulent conjunctivitis, mostly with involvement of the palpebral conjunctiva. With the progression of disease, respiratory and/or gastrointestinal signs appear

Relapsing polychondritis (RP) is characterized by recurrent swelling and inflammation of cartilage and other tissues throughout the body. Cartilage is a tough but flexible tissue that covers the ends of bones at a joint and gives shape and support to other parts of the body. Symptoms of RP include swelling of the cartilage of the ear, nose, and joints. Other parts of the body that may be. Synonyms: Disease, Lymphatic; Diseases, Lymphatic; Lymphatic Disease; Lymphatic Diseases: SNOMED CT: Disorder of lymphoid system (111590001); Disorders of lymph node and lymphatics (234087005); Disorder of lymphatic system (362971004); Disorder of lymphatics (3305006); Lymphangiopathy (3305006

Cutaneous or Reactive Histiocytosis VCA Animal Hospita

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