Cutaneous masses: workshop Flashcards
when investigating skin mass- what are generally the first diagnostic tests done
cytology- usually FNA
tissue biopsy - histopath
what is angioedema
Localised/generalised large oedematous swelling, usually involving head
Potentially fatal if involves airways
Associated with anaphylactic shock on rare occasions
Treatment for urticaria
Many cases of urticaria resolve spontaneously in 12-48h
dex IV in acute cases
adrenaline if signs of analphylaxis
avoid cause if known
Descrieb Calcinosis cutis
inappropriate deposition of calcium/phosphate in skin/subcutis - gritty white deposits, often with surrounding inflammation
List 3 causes of calcinosis cutis
dystrophic calcification
metastatic calcification
idiopathic
what do we see on cytology with a haematoma
initially cytology is same as blood smear (though no platelets). Macrophages (engulfing rbcs) +/- fibroblasts may appear with time.
describe management of haematoma
Find cause and address if necessary
Usually self-limiting- keep quiet, ?apply pressure (light bandage), and wait to resorb
Occasionally acute, severe haemorrhage – identify source UGA and ligate if possible. Antibiotic cover – risk of secondary infection.
what is a seroma
accumulation of sterile fluid (filtrate of blood) under a wound
Soft, non-painful swelling 2-5 days post-surgery (d/d infection!). No heat on palpation.
FNA: Straw-coloured/blood-tinged fluid
management of seroma
conservative unless refractory or causing wound distruption
repeasted drainage if size causing discomfort
if severe surgical debridement
what do arthropod-but granuloma look like
1cm diameter, firm, ill-defined erythematous nodule with central black mark
management of arthropod-bite granuloma
check no evidence of retained arthropod
?short course of steroids
If not resolving, consider surgical removal and submission for histopathology and tissue culture to confirm diagnosis
diagnosis of panniculitis
FNA- pyogranulomatous inflammation with background fat
Biopsy- important to rule out infection as initial step
if you can’t identify/ correct cause of panniculitis (solitary and multifocal lesion) what should you do
Solitary lesion —> surgical excision if possible
Multifocal lesion —> immunosuppressive therapy
what neoplasia can occur in younger animals
histiocytoma
T/F most canine skin tumours are malignant
False- 2/3 benign
T/F most feline skin tumours are malignant
True - 2/3
what is the most common canine skin tumour
lipoma
what is the most common feline skin tumour
fibrosarcomas
decribe what is seen on cytology with epithelial neoplasia
High yield, cells associated with one another, rafts, sheets, acini, cuboidal, columnar
what is seen on cytology with round cell tumours
High yield, discrete round cells, not adherent
what is seen on cytology with spindle/ mesenchymal cell tumour
Low yield, spindle shaped cells, usually single but may be in association/sheets, may be “matrix”
Describe Elliptical incisional biopsy
Include margin
Take from representative area
Ensure to remove whole biopsy tract when mass removed….
Describe Elliptical excisional biopsy
May cure benign, non-infiltrative neoplasms
Remove deeper tissue en bloc so can assess all margins (send untrimmed), but can never confirm 100% excision
Not if suspect infiltrative mass – look at FNA cytology first!
List the 4 rules to approaching a cancer cases
- Establish the diagnosis (type and grade of tumour)
- Establish the extent/stage of the disease
- Investigate any complications
- greatest chance of cure lies with the primary surgery
