Clinical Approach to Skin Nodules and Tumors

Question 1

what is tumor?

Answer 1

general term for any mass, benign or malignant

Question 2

what are the most common inflammatory infiltrates?

Answer 2

pyogranulomatous
granulomatous

Question 3

what are the epidermal neoplasias?

Answer 3

squamous cell carcinoma
papilloma

Question 4

what can FNA cytology be useful for?

Answer 4

neoplastic vs non-neoplastic growth
type of neoplasia/inflammation
benign vs malignant neoplasia
occasionally, type of neoplasia

Question 5

what information does histopathology provide?

Answer 5

neoplastic or non-neoplastic growth
type of neoplasia
benign or malignant
grade of malignancy
surgical borders: clean or dirty

Question 6

what are the common mesenchymal skin neoplasms?

Answer 6

lipoma
fibroma
dermatofibroma
fibrosarcoma/osteosarcoma/liposarcoma/spindle cell sarcoma
mast cell tumor

Question 7

where is sebaceous gland hyperplasia usually seen?

Answer 7

head (eyelids)
trunk

Question 8

who is at increased risk of sublingual/digital squamous cell carcinoma?

Answer 8

large breeds with black coat

Question 9

who is predisposed to subcutaneous lipoma?

Answer 9

old dogs
obese female dogs

Question 10

who usually gets fibrosarcoma?

Answer 10

old dogs/cats
some are injection-site in young cats

Question 11

what is the treatment of choice for feline injection-site sarcoma?

Answer 11

surgery

Question 12

which dogs are predisposed to mast cell tumors?

Answer 12

8 year olds
boxers
boston terriers
bulldogs

Question 13

what is the distribution of mast cell tumors?

Answer 13

trunk 50%
limbs 40%
head 10%

Question 14

what is darier’s sign?

Answer 14

erythema and wheal formation after manipulation
mast cell tumors
results from release of vasoactive amines

Question 15

who commonly gets cutaneous plasmacytoma?

Answer 15

dogs
rare in cats

Question 16

what is cutaneous reactive histiocytosis?

Answer 16

reactive proliferation of dermal dendritic cells
unknown etiology of suspected immunoregulatory deficit

Question 17

when do skin lesions develop in paraneoplastic syndrome?

Answer 17

after development of malignant tumor

Question 18

what is pyogranulomatous inflammation?

Answer 18

macrophages and neutrophils

Question 19

what is immunohistochemistry used for?

Answer 19

leishmania

Question 20

how can you treat a sterile inflammatory nodule?

Answer 20

glucocorticoids
calcineurin inhibitors: cyclosporine, tacrolimus
azathioprine
tetracyclines and niacinamide
mycophenolate mofetil
chlorambucil
JAK inhibitors: oclacitinib

Question 21

when is the highest chance to cure a skin neoplastic disorder?

Answer 21

in first treatment attempt

Question 22

what are some epidermal-dermal neoplasias?

Answer 22

melanoma
histiocytoma

Question 23

what are some dermal neoplasias?

Answer 23

mast cell tumor
dermatofibroma

Question 24

what diagnostic tests can be done on a nodule?

Answer 24

cytology- FNA
histopathologic examination
phenotyping, cell lineage
ancillary diagnostic tests

Question 25

what are the types of cutaneous neoplasia in FNA cytology?

Answer 25

epithelial neoplasia: large cells in clusters mesenchymal neoplasia: isolated spindle cells round cell neoplasia

Question 26

when is histopathology usually done?

Answer 26

after surgical excision of tumor or nodule

Question 27

what are the most common epithelial neoplasms?

Answer 27

squamous cell carcinoma melanoma/melanocytoma sebaceous gland tumors

Question 28

what are the most common mesenchymal skin neoplasms?

Answer 28

lipoma fibrosarcoma/osteosarcoma/liposarcoma/spindle cell sarcoma mast cell tumor

Question 29

what type of neoplasia is feline-injection site sarcoma?

Answer 29

fibrosarcoma can also be other soft tissue sarcomas

Question 30

what does cutaneous plasmacytoma look like?

Answer 30

solitary lesionss: well-circumscribed, raised, smooth, dermal haired skin, mucocutaneous junctions

Question 31

which histiocytic diseases arise from macrophages?

Answer 31

hemophagocytic histiocytic sarcoma dogs and cats

Question 32

how can you treat cutaneous reactive histiocytosis?

Answer 32

cyclosporine