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Onco Board Review > Endocrine, GI, oral, nasal, MGT > Flashcards

Endocrine, GI, oral, nasal, MGT Flashcards

1
Q

Do canine and feline pancreatic acinar cell carcinomas harbor KRAS mutatins?

A

No

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2
Q

A single pancreatic nodule >__?__cm is suggestive of neoplasia

A

2cm

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3
Q

What is the most common gastric tumor in dogs?

A

Gastric ACA - 70-80%

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4
Q

The carbohydrate antigen c2-O-sLex is upregulated in which canine tumor?

A

Gastric carcinoma - esp poorly differentiated

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5
Q

Are tumors with KRAS mutations more or less likely to respond to EGFR inhibition?

A

less likely - KRAS mutation represents downstream activation

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6
Q

Which is more sensitive for gastric neoplasia: ultrasound or endoscopy?

A

Endoscopy -95%

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7
Q

What is the most common Helicobacter species detected in cats, and which GI disease is it associated with?

A

H. heilmannii, associated with lymphoblastic lymphoma

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8
Q

Did use of adjuvant gemcitabine for canine HCC result in improved survival over historical controls undergoing liver lobectomy alone?

A

No

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9
Q

In canine GISTS, activating mutations occur in exon __?__ of c-kit.

A

Exon 11

**mutational status not found to correlate with staining pattern

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10
Q

What impact did the addition of adjuvant carboplatin have on outcome of dogs with surgically excised AGASACA (Wouda et al 2016)?

A

No improvement in survival in dogs tx’d with carbo vs surgery alone
Potanas et al 2015 reported DECREASED survival in pts treated with platinum drugs

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11
Q

For advanced (stage 3b) anal sac carcinoma, does surgery or hypofractionated RT result in better outcome (Meier et al 2016)?

A

RT – McQuown et al reported 38% PR, 63% improved clinical signs

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12
Q

FNA, FNI, and impression smear cytology were shown to have >90% diagnostic accuracy for oral lesions in cats and dogs. Which of these had the highest agreement (kappa) with histopath?

A

FNA/FNI = highest agreement in both dogs and cats

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13
Q

What was the strongest predictor of positive outcome in a retrospective case series of canine oral fibrosarcoma (Garder et al 2013)?

A

Combination of surgery + RT = best outcomes

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14
Q

In human SCC, p16/CDKN2A staining can be used to demonstrate papillomaviral origin. Did p16 staining support a role for PV in the development of canine OSCC? In feline OSCC?

A

No, no p16 was detected in canine OSCC

No PV DNA could be amplified from feline OSCC

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15
Q

What histological features is associated with increased risk of death in dogs with surgically treated OSCC?

A

Tumor-associated inflammation = increased risk of death (Fulton et al 2013)

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16
Q

In the most recent case series of 12 dogs with oral papillary SCC, were the majority of dogs > or <6yrs old? (Nemec et al 2014)

A

Majority (75%) were > 6yrs old

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17
Q

What impact does the presence of α-SMA-expressing fibroblasts have on survival in cats with OSCC?

A

α-SMA fibroblasts = cancer associated fibroblasts = decreased survival in feline OSCC.

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18
Q

Bmi-1 is an oncogene that suppresses cell cycle inhibitors. What impact did its expression have on outcome in feline OSCC?

A

High Bmi-1 expression = negative prognostic factor

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19
Q

18F-FDG PET/CT is likely to be most useful in defining tumor extent in feline OSCC with what characteristics?

A

Soft tissue invasive tumors

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20
Q

In cats undergoing SRT for OSCC, did increased keratinization impart improved or worse outcome?

A

More keratinized = worse

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21
Q

What is the prevalence of lymph node metastasis in feline OSCC, and is this prognostic for survival.

A

30% LN mets, 10% pulmonary mets, not prx for survival.

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22
Q

In dogs with histiocytic sarcoma, what two findings are associated with decreased survival (<1mo)?

A

Hypoalbuminema, thromboytopenia

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23
Q

Which of the following may serve as biomarkers for BMD with histiocytic sarcoma:

1) C-reactive protein
2) Fibrinogen
3) Monocyte chemotactic protein-1

A

All of the above (CRP, fibrinogen, and MCP-1)

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24
Q

Which IHC markers are expressed by feline progressive histiocytosis?

A

CD1a/c, CD18, MHC Class II

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25
Q

E-cadherin is expressed by what class of dendritic cells?

A

Langerhans cells

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26
Q

Interdigitating DC are present where?

A

Lymph nodes, spleen

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27
Q

Which breeds have the highest rate of homozygous mutant MDR1?

A

Collies (70%)
Australian shepherds, mini Aussies (50%)
Long-haired whippet (60%)
Other: McNab, silken windhound, sheltie, English shepherd, GSD, herding breed x, Old english sheepdog

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28
Q

What is the response rate of canine lymphoma to first line treatment with prednisone and lomustine?

A

CR: 35%, ORR: 52%

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29
Q

What is the response rate of relapsed canine lymphoma to L-spar, CCNU, and pred?

A

CR: 52%, ORR 87%

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30
Q

Does addition of Cytosar to CHOP-based protocols affect survival in patients with stage V lymphoma?

A

Yes, addition of Cytosar improved survival.

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31
Q

What is the response rate of relapsed lymphoma to to single-agent DTIC?

A

35%

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32
Q

What is the response rate of relapsed lymphoma to to DMAC?

A

65%

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33
Q

What is the expression of the following markers in feline Hodgkin’s-like lymphoma?
CD40L
CD3
CD79a

A
  • will have both CD3+ and CD79a+ cells

- Reed-Sternberg cells do not stain with any typical markers, but are positive for BLA36

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34
Q

Name 3 factors associated with poor prognosis in canine multiple myeloma.

A

Hypercalcemia
Bence-Jones proteinuria
Extensive bony lesions (ie path frac)
Azotemia

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35
Q

What is the most common M component in feline myeloma?

A

IgG

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36
Q

Name 3 negative prognostic factors in feline myeloma.

A

Pathologic fracture
Anemia
Bence-Jones proteinuria
Azotemia

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37
Q

Name two prognostic factors for lingual hemangiosarcoma.

A 
Tumor size (smaller = better)
Lack of clinical signs = better
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38
Q

What are the two most common tumors of the canine tongue?

A

SCC

Melanoma

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39
Q

What proportion of dogs with oral mucosal mast cell tumors have evidence of local lymph node metastasis at diagnosis?

A

55%

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40
Q

What is the most notable difference between extramedullary plasmacytoma in humans and dogs?

A

Humans - 1/3-1/2 have associated hypergammaglobulinemia or convert to MM
Dogs - rarely associated with systemic signs or MM

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41
Q

What impact did EGFR expression have on survival in feline OSCC?

A

Decreased survival in one study (no effect in other studies)

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42
Q

Which histologic subtypes of canine nasal tumor are associated with an unfavorable prognosis?

A

Carcinoma, esp squamous or undifferentiated

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43
Q

Which biopsy technique (blind, image-guided, or rhinoscopy) is most likely to give a diagnosis of nasal neoplasia?

A

All - proportion of diagnostic biopsies was not different between all 3 techniques

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44
Q

What is the rate of acute and late toxicity following SRS for nasal tumors in dogs?

A

Acute: 23%
Late: 40%

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45
Q

Tumor type was the only prognostic variable in a study evaluating SRS for nasal tumors. Which tumor type was associated with significantly decreased survival?

A

OSA - decreased survival following SRS

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46
Q

COX-2 expression has been demonstrated in __?__% of canine nasal tumors. Did addition of firocoxib to radiation therapy result in significantly increased survival?

A

71-95% COX-2 +

No difference in DFI/survival when firocoxib added to RT, but QoL measures improved

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47
Q

What was the clinical ORR of dogs with nasal tumors treated with a 5x4Gy daily protocol? What proportion of these constituted clinical CR?

A 
ORR = 95%
CCR = 78%
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48
Q

In dogs re-irradiated with a hypofractionated protocol following PRT, what was the clinical response rate to the second course of RT?

A

70%

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49
Q

Belshaw et al demonstrated positive immunostaining for COX2 in 90% of canine nasal tumors. How did COX2 expression correlate with survival?

A

COX2 expression had no impact on survival

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50
Q

In reviewing 140 cases of feline nasal neoplasia with IHC, Nagata et al calculated an initial diagnostic error rate of 6.5%. Was lymphoma or carcinoma more likely to be underdiagnosed?

A

Lymphoma was more commonly misdiagnosed as carcinoma.

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51
Q

What was the recurrence rate of feline nasal planum SCC treated with curettage and diathermy?

A

<10%

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52
Q

What complications of full thickness GI biopsies can be expected in cats with alimentary lymphoma?

A

Anorexia, hyperthermia, pancreatitis, constipation

**even when albumin <2.5, no leak or dehiscence was noted

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53
Q

What proportion of cats developed neoplasia following renal transplantation?

A

22% - lymphoma most common

6.6X increased risk of neoplasia
ST did not differ between cats that developed neoplasia and those who did not

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54
Q

What are the diagnostic features of myelodysplastic syndrome?

A

<30% blasts

Dysplastic changes in 1 or more cell lines

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55
Q

What was the ORR and PFS for dogs with measurable MCT treated with toceranib, prednisone, and hypofractionated RT?

A

75%, PFS 300d

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56
Q

What criteria define a high-grade MCT in the two-tiered grading scheme (Kiupel)?

A

At least 7 mitotic figures/10hpf
At least 3 multinucleated cells/10hpf
At least 3 bizzare nuclei/10hpf
Karyomegaly

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57
Q

Name 3 histopathologic features associated with a worse prognosis in canine subcutaneous MCT.

A

MI >4
Infiltrative growth pattern
Presence of multinucleation

Also: Age at dx

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58
Q

What is the survival time for canine appendicular chondrosarcoma with amputation alone?

A

2.5 yrs (979d)

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59
Q 
Expression of which of the following was prognostic for survival in canine osteosarcoma:
Ezrin
Met 
VEGF
COX2
A

Ezrin

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60
Q

In dogs with osteosarcoma, what impact does a decreased circulating CD8:Treg ratio have on survival?

A

Decreased CD8/Treg ratio = decreased survival

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61
Q

What is the MST for parosteal OSA?

a) 3mo
b) 1 yrs
b) 33mo

A

33mo

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62
Q

What is the 3-year control rate for STS treated with surgery and hypofractionated RT?

a) 30%
b) 50%
c) 70%
d) 90%

A

70% control at 3 yrs

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63
Q

Which of the following is prognostic for outcome in canine pituitary tumors treated with RT?

a) tumor size
b) ACTH
c) baseline cortisol
d) brachycephalic breed

A

Tumor size - pituitary to brain height ratio and pituitary to brain area ratio

64
Q

What clinical factor was most predictive of complications following stent placement for urogenital tumors?

A

Duration of stranguria prior to stenting

65
Q

Which of the following has the highest reported response rate in treating canine TCC?

a) piroxicam
b) deracoxib
c) firocoxib

A

Firocoxib - 20% PR

***but, piroxicam has a 6% CR rate + 12% PR rate

66
Q

__?__% of renal tumors are bilateral at diagnosis.

A

4% of renal tumors are bilateral at diagnosis

67
Q

What is the MST following surgery for renal cell carcinoma?

A

16mo

68
Q

What two factors have a positive impact on survival for canine inflammatory mammary carcinoma?

A
  • lack of coagulopathy

- medical treatment

69
Q

What criteria are used to grade canine mammary carcinomas?

A

Tumor type, nuclear/cellular pleomorphishm, MI, necrosis, lymphatic invasion, and LN metastasis

70
Q

What is the response of canine MLO or osteosarcoma of the skull to treatment with 153-Samarium?

A

20%

71
Q

What are the most common bloodwork abnormalities seen with hypertrophic osteopathy?

A

Anemia, neutrophilia, elevated ALP

72
Q

What labwork findings are expected in cases of ATLS?

A 
Hypocalcemia
Metabolic acidosis
Hyperphosphatemia
Hyperkalemia
Decreased bicarb
73
Q

RT for ameloblastoma resulted in sarcoma in __?__% of dogs treated.

A

3.5%

74
Q

Tonsilar SCC is associated with living in what kind of environment?

A

Tonsillar SCC- urban environoment

75
Q

What impact does Wnt/B-catenin signaling have on telomerase?

A

Wnt/B-catinine regulates telomerase by increasing TERT subunit; without B-catenin telomeres are shorter

76
Q

True/False: Mice have longer telomeres than humans.

A

True - mice telomeres are 5-10x longer

77
Q

What is the TRAP assay?

A

Telomeric Repeat Amplification Protocol

Detects telomerase activity using a primer and amplification; 92% sensitivity for malignant tumors in dogs

78
Q

What are the cellular features of senescent cells?

A

Senescent cells are larger and more morphologically diverse
B-galactosidase is a commonly used marker
p16INK4a also a marker

79
Q

What is considered the most important histologic predictor of outcome in human and canine mammary carcinoma?

A

LN status

80
Q 
Which of the following was shown to be prognostic for survival in canine mammary carcinomas (Diessler et al)?
Histologic Grade
LN status
Vascular Invasion
PCNA
MVD
VEGFR2
A

LN status
Vascular invasion

trend towards shorter survival in high-VEGFR2 tumors

81
Q

What does a CD44+/CD24- phenotype in canine mammary tumor cells imply?

A

CD44+/CD24- = cancer stem cell

Associated with higher grade of malignancy

82
Q

What is unique about the sensitivity of CD44+/CD24- canine mammary tumor cells to metformin?

A

CD44+/CD24- = cancer stem cell

Highly resistant to DOX but susceptible to metformin

83
Q

Compare the degree of malignancy, frequency of vascular invasion, and age of onset in canine mammary carcinoma in overweight/obese dogs versus those in good body condition.

A

Obese dogs had higher degree of malignancy, more frequent vascular invasion, and younger age of onset than those in good body condtion

84
Q

In canine mammary carcinoma, frequency of copy number aberrations and LOH increase or decreases with histologic grade of malignancy?

A

frequency of copy number aberrations and l.o.h. INCREASES with histologic grade of malignancy

85
Q

In canine mammary carcinoma, which of the following copy number aberrations was more common: amplification or deletion?

A

Deletion

86
Q

Copy number aberrations frequently identified in canine mammary carcinoma include gain/loss of:

1) MYC
2) PTEN

A

MYC - frequently increased

PTEN - frequently lost

87
Q

What is the significance of detection of MAC387+ cells in canine mammary tumor samples?

A

MAC387 = tumor-associated macrophage marker

TAMs were associated with decreased survival, malignant > benign tumors, VEGF+ tumors, presence of infiltrative growth and LN mets

88
Q

How are tumor-associated macrophages thought to contribute to angiogenesis?

A

Production of VEGF

89
Q

FOXP3 expression in canine mammary tumors correlates with…?

A

Decreased survival

Negative FOXP3 expression was correlated with positive ER and PR expression

90
Q

Is expression of phospho-mTPR considered a prognostic factor in dogs with mammary carcinoma?

A

No, p-mTOR expression did not correlate with survival or histologic grade in Delgado et al 2015

91
Q

What impact do VEGFR-2 and VEGF expression have on survival in canine MGTs?

A

Both VEGFR-2 and VEGF expression correlated with decreased survival in canine mammary tumors

92
Q

High expression of COX2 and EGFR in canine mammary carcinoma corresponds to what clinicopathologic features

A

COX2 and EGFR co-expression in canine MGTS ==> higher histologic grade, presence of LN metastasis

93
Q

Name two circulating antigens investigated as potential biomarkers in canine mammary carcinoma.

A

Carcinoembryonic antigen (CEA) and cancer antigen (CA 15-3)

CA 15-3 was more sensitive for detecting disease

94
Q

Certain haplotypes/SNPs of what three gene have been associated with increased risk of mammary carcinoma in both humans and dogs?

A

ESR1 (estrogen receptor)

BRCA1 & BRCA2

95
Q

A female dog presents with two mammary tumors. One is biopsied as benign. Is the other more likely to be malignant or benign, or is the chance equal?

A

More likely to be benign

Gunnes et al 2015: Simultaneous tumours within dogs more often had equal diagnoses and neoplastic level (benign or malignant) than would be expected by chance alone.

96
Q

What is the risk of mammary tumor in dogs spayed before their first, second, and third heat cycles, respectively

A

0.05% before 1st heat
8% before 2nd heat
26% before 3rd heat

97
Q

Dogs with BRCA1 and BRCA2 mutations have a _?_X higher risk of mammary tumor development.

A

4X higher

98
Q

What percentage of HAC cases are PDH?

A

85%

99
Q

What were the two most prevalent dopamine and somatostatin receptor subtypes expressed in canine pituitary adenomas?

A

Type 2

D2 + SST2

100
Q

What percentage of pituitary tumors in dogs are adenocarcinomas?

A

6%

Differentiated by presence of metastasis, not infiltration

101
Q

Plasma levels of ___?____ may help select PDH patients for brain imaging, as they can be correlated with tumor size.

A

Pro-opiomelanocortin

Pro-ACTH

102
Q

Which of the following adrenal tumors is most common in cats?

  • Adrenocortical tumors
  • Pheochromocytoma
  • Metastatic lesions
A

Metastatic lesions

next most common = adrenocortical

103
Q

The most common metastatic adrenal neoplasia in both dogs and cats is:

A

lymphoma

104
Q

What is the sensitivity and specificity of abdominal ultrasound and contrast-enhanced CT for the detection of vena cava invasion?

A

AUS - 80-100% sensitive, 90% specific

CT - 92% sensitive, 100% specific

105
Q

Adrenal tumors larger than ___cm are more likely to be carcinomas than adenomas.

A

> 2cm

106
Q

What % of adrenal tumors locally invade the phrenicoabdominal vein?

A

20%

107
Q

How is Conn’s syndrome diagnosed?

A

Plasma aldosterone:renin ratio

108
Q

Pheochromocytoma has a metastatic rate of ____% and vascular invasion is observed in ____%

A

40% met, 82% invade

109
Q

Which IHC marker most accurately identifies medullary thyroid carcinoma?

A

Calcitonin

110
Q
  1. Which of the following is the most sensitive for detection & localization of canine insulinoma?
    a. Abdominal ultrasound
    b. CT
    c. SPECT with 111‑In-DTPA-D-Phe1-octreotid
    d. 111‑Indium penetreotide scintigraphy
A

SPECT with 111‑In-DTPA-D-Phe1-octreotid

111
Q

What is the response rate of dogs with insulinoma to diazoxide therapy?

A

70%

Diazoxide is a nondiuretic benzothiadizine that supresses insulin release from B cells and stimulates gluconeogenesis

112
Q

What is the response rate of dogs with insulinoma to octreotide?

A

~50%

113
Q

Besides gastrinoma, what conditions can lead to elevation of gastrin levels?

A

renal, hepatic, and gastric disease; tx with antacids

114
Q

Activating mutations of which of the following genes were detected in canine adrenocortical tumors?

a. PI3K
b. GNAS
c. MC2R

A

GNAS - activating mutations

there was evidence of increased PI3K/AKT signaling, but no mutations identified

115
Q

What was the accuracy of cytology in differentiating adrenocortical vs. medullary tumors?

A

90-100%

116
Q

Is hisotpathology a reliable determinant of behavior in adrenocortical tumors?

A

No, although lymphovascular invasion and ki67 may predict malignancy

117
Q

Is serum inhibin concentration higher in patients with adrenocortical or medullary tumors?

A

Inhibin is higher in cortical tumors

118
Q

What is the preferred method for differentiation of pheochromocytoma?

a. Urine epinephrine:creatinine ratio
b. Urine normetanephrine:creatinine ratio
c. Plasma free normetanephrine
d. Plasma total metanephrine

A

Urine normetanephrine:creatinine ratio

119
Q

What was the most imported predictor of short term survival in dogs undergoing adrenalectomy?

A

Extent of vena caval invasion/thrombus

120
Q

Does extent of caval invasion influence long-term survival in dogs with adrenocortical tumors?

A

No, only short term survival

Only tumor type was predictive of longterm survival

121
Q

Are metastatic or primary tumors more common in the kidney?

A

Metastatic

122
Q

Renal cell carcinoma accounts for ____% of primary renal tumors in dogs.

A

50-60%

123
Q

Which of the following renal tumors has the highest metastatic rate: carcinoma, sarcoma, nephroblastoma

A

Sarcoma - 88%

Nephroblastoma - 75%
Carcinoma - 69%

124
Q

What is the most significant histological predictor of survival in canine renal cell carcinoma?

A

Mitotic index (<10, 10-30, >30)

125
Q

Name 3 clinical negative prognostic factors at diagnosis for canine RCC?

A

age <6yrs
cachexia
hematuria

126
Q

What presenting complaint is more common in primary renal sarcomas compared with other primary renal tumors?

A

Pain

127
Q

What percentage of renal tumors in BHD heterozygous GSD had a mutation in the wild-type FLCN gene?

A

71% – indicates likely “second-hit” as underlying the pathogenesis of this disease

128
Q

OHE at the time of benign mammary tumor removal reduces risk of new tumor formation by ?%

A

50% reduced risk

129
Q

What is the MST for dogs with nasal tumors treated with robotic radiosurgery?

A

399d

130
Q

What is the most common laryngeal tumor in cats?

A

SCC

131
Q

Which of the following canine nasal tumor histologies is associated with a worse prognosis?
SCC
Adenocarcinoma

A

SCC

132
Q

Ki67 >____% indicates a malignant adrenal tumor.

A

Ki67 >2.4 = ACA not adenoma

133
Q

What factor is prognostic for outcome in cats undergoing adrenalectomy for tx of Conn’s syndrome?

A

Anesthetic time >4hrs

134
Q

Treatment of thyroid carcinoma in cats requires I-131 dosing ____X higher than thyroid adenoma.

A

5-10X

135
Q

Which canine breeds are predisposed to thyroid carcinoma?

A

Beagle, Husky, Golden retriever

136
Q

What % of thyroid carcinoma will lose the ability to accumulate radioactive iodine? Can these secrete thyroglobulin?

A

20-30%

Can still secrete Tg even if don’t concentrate iodine

137
Q

What impact does EGFR expression have on canine mammary CA?

A

EGFR overexpression = poor prognosis

138
Q

What was the age and neuter status of male dogs with mammary tumors?

A

Avg age = 11.5yrs

50% neutered vs intact

139
Q

What was the clinical behavior of mammary tumors in male dogs?

A

Benign - treated with surgery only

ER receptor expression high, PR expression present

140
Q

In which species is HER2 immunovaccination more likely to be useful?

A

Cats

HER2 is expressed in 95% of K9 MGTs but it is also expressed in normal tissue. Cetuximab was not successful in dogs.

141
Q

BRCA mutation has been detected in what breed?

A

English Springer Spaniel

142
Q

What is the response rate for feline nasal planum SCC treated with strontium?

A

88% RR

Recurrence - 20%

143
Q

What is the response rate of feline nasal planum SCC to PDT with 5-ALA?

A

> 95%

144
Q

What is the complication rate for intrathoracic biopsies?

A

40%

145
Q

Which tumor subtype of canine lung tumors has the longest MST?

A

Papillary adenocarcinoma - T1, Stage I = 555d survival time

146
Q

What percentage of AGASACA express PDGFRa? PDGFRb?

A

100% PDGFR-alpha

10% PDGFR-beta

147
Q

What is the MST of AGASACA following treatment with surgery, radiation, and MTX?

A

960d

148
Q

What feature of LN ultrasound is reliable for detecting AGASACA metastasis?

A

size

149
Q

What % of canine malignant melanomas expressed KIT, and what % harbored mutations?

A

100% weak to strong staining

~10% exon 11 mutation

150
Q

What % of GISTs have kit mutation?

A

35%

151
Q

What % of GISTs have PDGFR-alpha mutation?

A

0%

152
Q

What is the outcome of gastric tumors treated with gastroduodenectomy?

A

25% mortality rate

MST = 33d

153
Q

What factors are prognostic for outcome in lingual tumors?

A

Size
LN mets

tumor subtype (melanoma vs SCC) did NOT impact outcome

154
Q

What is the most likely diagnosis of a 2.5cm ulcerated mass on the ventral aspect of the tongue?

A

SCC

155
Q

What is the most important predictor of outcome in both human and canine MGT?

A

LN status

156
Q

What were the transcript levels of ATM in canine mammary CA and benign MGTs compared to normal tissue?

A

ATM was lower in benign/neoplastic tissue than normal

157
Q

What impact did loss of autophagy-related protein Beclin-1 have on behaviour of canine mammary tumors?

A

more aggressive behavior

Onco Board Review (6 decks)

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