Epithelial & Neuroendocrine Neoplasia Flashcards
What are the characteristics of epithelial neoplasms?
- readily exfoliate
- cohesive clusters & sheets
- Distinct cytoplasmic borders
- oval/polygonal cells
- Acinar formation
What two epithelial tumors require histopathology for evaluation of malignancy?
mammary tumors
hepatocellular tumors
Via which route do epithelial cells metastasize?
lymphatics
Benign or malignant?
Tumor type?
benign
sebaceous epithelioma
What is the most common cutaneous tumor of the dog and cat?
Basal cell tumors aka cutaneous adnexal tumors
What two basal cell tumors are malignant?
Malignant trichoepithelioma
Malignant pilomatricoma
Benign or malignant?
Tumor type?
Characteristics of tumor type?
Benign
Basal cell tumor
highly basophilic cytoplasm, tightly adhered clumps, high N:C ratio
What type of epithelial differentiation is seen with this slide?
follicular (keratin production)
Most apocrine gland tumors are benign T/F?
True
Breed predisposition for ceruminous gland adenoma vs. carcinoma?
Cocker spaniel for both
Shih Tzu for adenoma
Cats for carcinoma
Tumor type?
Sebaceous gland tumor
What are the two types of perianal neoplasms and their general appearance?
- Circumanal gland (hepatoid): epithelial
- Anal sac apocrine gland: neuroendocrine
Where are basal cell tumors most often found?
head & neck
Benign or malignant?
Tumor type?
From what structure do these arise?
What drives their development?
Benign
Perianal neoplasm
modified sebaceous glands in dogs
Androgens
Describe the characteristics of this circumanal gland tumor?
Clusters hepatoid polyhedral cells
Basophilic cytoplasm with pink hue
Round/oval nucleus w/ clumped chromatin & 1/2 nucleoli
Low N:C ratio
Reserve cells w/ higher N:C ratio
An 8-year-old male intact GSH presented for a mass on his prepuce.
Tumor type?
Benign perianal gland neoplasm
What recommendation should be made for an intact male dog with a perianal gland adenoma for treatment?
surgical excision and neuter, otherwise reoccurrence is common
Describe the characteristics of an Anal sac apocrine gland adenocarcinoma seen in this image?
high N:C
nuclei fairly uniform
Clumps/sheets of cells
INDISTINCT cellular borders
What sequelae of an anal sac apocrine gland adenocarcinoma is commonly seen?
hyperCa
In which species are mammary tumors 3rd most common?
felines & canines
In regards to mammary neoplasms, which type do rats vs. mice typically get?
Rats: fibroadenoma
Mice: adenocarcinomas
What is the most common malignant tumor of the oral cavity?
SCC
What are the common sites for SCC in the horse?
penile/vulvar
Cornea
What are the cytologic features of SCC seen in this image?
- angular cytoplasmic borders
- asynchrony of maturation (keratinization)
- small, perinuclear vacuoles (keratohyalin)
- Loss of cohesion
What characteristic of SCC is shown here?
small, perinuclear punctate vacoules
Benign or malignant?
Tumor type?
malignant
SCC
(punctate vacoules, keratinization, anuglar borders)
Which locations of SCC are more likely to metastasize?
tongue, tonsils, digits
A 10 year old female DSH presents with this lesion on the nose. Why would an FNA be preferred over an impression smear?
FNA will sample portion of mass not inflamed and ulcerated
Benign or malignant?
Tumor type?
malignant
SCC
[deep blue cytoplasm, open chromatin, pleomorphism, anisokaryosis, high N:C]
Where is transitional cell carcinoma typically located?
trigone of the bladder
A male, intact pitbull presented for his annual exam. On rectal, you palpate a symmetrically enlarged, non-painful prostate. The image below shows the cytology results.
Benign or malignant?
Tumor type?
Benign prostatic hyperplasia
A 12-year-old golden retriever presents for hematuria. On rectal exam, you palpated a nodular, asymmetrically enlarged prostate that is painful on palpation. The image shows that cytology results.
What is your top differential?
What the likely locations for metastasis?
Prostatic carcinoma
local L.N., other organs, axial skeleton*
Why do we rely on histopathology to determine malignancy and biological behavior of neuroendocrine tumors?
Cytologically, they appear as uniform populations with minimal atypia
What are the characteristics of neuroendocrine tumors?
Tumors of chemoreceptors & endocrine glands
exfoliate well
free nuclei in the background- lysed cells (fragile)
Which breeds are predisposed to thyroid tumors?
golden retriever
boxer
beagle
Benign or malignant?
Tumor type?
Distinguishing characteristics?
Need histopathology to determine biologic behavior
Neuroendocrine, thyroid neoplasm
pink material= colloid, black dot arrow points to=tyrosine granule
Tumor type?
Neuroendocrine, thyroid neoplasm
A 10 year old female DSH present to your clinic with a >5 cm mass on the ventral neck. The FNA of the mass suggests what tumor type and what characteristics is more commonly seen? Should you FNA the local L.N.? Would you expect clinical signs in this animal of hyperthyroidism?
Neuroendocrine, thyroid neoplasm & free nuclei in the background of cytoplasm with few distinct borders, colloid present
Typically these neoplasms are benign (adenomas) and do not metastasize, so FNA of local L.N. not needed.
Yes, clinical signs common since the tumor is functional
On cytology you diagnose a thyroid neoplasm in a canine. Would you expect the canine to be clinical for hyperthyroidism? What will you tell the owner about prognosis if the mass is >5 cm?
NO, not clinical for hyperthyroidism
Malignant with 40% chance of metastasis
An equine presents with a mass on the ventral neck that has been slowly growing in size. Based on the FNA image, what is the tumor type? Are you concerned for malignancy & will the horse be clinical for hyperthyroidism?
Neuroendocrine, thyroid neoplasm (tyrosine granules)
Most likely benign
usually non-functional
What are the changes on a chemistry that will be seen with a parathyroid neoplasm? Are these more likely malignant or benign?
HyperCa, HypoP, normal to high PTH
Majority are benign
An impression smear of a liver mass in a 10-year-old dog that had an episode of acute collapse and seizures from hypoglycemia. DDX?
Insulinoma (neuroendocrine)
most likely malignant
numerous cytoplasmic vacuoles
Which species is insulinoma common in?
ferrets
A 7 year old brachycephalic breed dog present on emergency for pericardial effusion & C.S. of RHF. You take radiographs and see a mass at the heart base. The FNA sample is shown below. DDX? Is this mass typically aggressive and fast growing or slow growing?
Chemodectoma (aortic body tumor), Neuroendocrine
Characteristics: highly cellular, round nuclei, neuroendocrine appearance
slow growing
Which species do we typically see adrenal cortical neoplasms?
dogs (rare in cat)
ferrets
A 10 year old canine presents for alopecia on ventrum and enlarged abdomen plus PU/PD. After your workup, you diagnose him with a functional adrenal cortical adenocarcinoma. What is the concern when surgically resecting this tumor and where would you want to check for mets? The cytology of the tumor is shown below. What is the defining characteristic?
Local invasion into the CVC & renal v. could result in significant hemorrhage and inability to remove all of the mass. Could also metastasize to the liver.
Cytoplasmic vacuoles (similar to insulinoma)
In the dog, are pheochromocytomas typically malignant or benign? Where do they typically met to?
malignant
local invasion into CVC
Distant mets to liver & lung
Pheochromocytomas are very common, especially in dogs and they are typically the only neoplasm found at diagnosis. T/F?
FALSE
very rare
>50% occurrence of concurrent neoplasms
From what cells are pheochromocytomas derived?
Cytologic characteristics?
chromaffin cells
Neuroendocrine appearance, variable anaplasia (less differentiated), may see multinucleated cells
Paroxysmal catecholamine release occurs 50% of the time with pheochromocytomas and >10% exhibit hyperadrenocorticism. They are typically found incidentally. T/F?
True
50% asymptomatic
