Exam 2 - Tumors of the Respiratory System

Question 1

what dog breeds are potentially at risk for developing nasal tumors?

Answer 1

dolichocephalic breeds - long noses

Question 2

what environmental risks may predispose animals to nasal tumors?

Answer 2

urban environments & exposure to environmental tobacco smoke

Question 3

what is the most common nasal tumor in dogs?

Answer 3

carcinomas!!! 2/3s of all intranasal tumors

Question 4

other than carcinomas, what is the main other group of intranasal tumors in dogs?

Answer 4

sarcomas

Question 5

T/F: intranasal tumors are locally very aggressive & have a low metastatic rate at the time of diagnosis

Answer 5

true

Question 6

what is the average duration of clinical signs prior to presentation of intranasal tumors in dogs?

Answer 6

approximately 2-3 months

Question 7

what are the typical clinical signs seen with intranasal tumors in dogs?

Answer 7

unilateral epistaxis and/or mucopurulent discharge that progresses to bilateral in later stages

facial deformity, unwillingness to open mouth, sneezing, dyspnea, stertor, & rare neuro signs

Question 8

if facial deformity is present, what is almost always the diagnosis?

Answer 8

cancer

Question 9

what are some main differentials for intranasal neoplasia?

Answer 9

fungal/bacterial rhinitis - especially aspergillus

idiopathic non-specific rhinitis - lymphoplasmacytic

nasal parasites, bleeding disorders, hypertension, & foreign body/trauma

Question 10

T/F: detection of a mass is not specific for neoplasia

Answer 10

true

Question 11

how is intranasal neoplasia diagnosed?

Answer 11

CT or MRI scan to look for bone destruction, abnormal soft tissue, nasopharyngeal invasion, & patchy areas of increased density within abnormal soft tissue opacity

Question 12

what is required after imaging to confirm a diagnosis?

Answer 12

tissue - histopathology, rhinoscopy guided

Question 13

what is the most common diagnostic run at a&m for diagnosing intranasal neoplasia?

Answer 13

transnostril blind biopsy

Question 14

how is intranasal neoplasia staged?

Answer 14

thoracic rads, CT scan, & FNA of both submandibular lymph nodes (others if enlarged such as retropharyngeal)

Question 15

what is used for tumor staging on CT scan?

Answer 15

modified adams staging

Question 16

what is a stage 1 intranasal tumor using modified adams staging?

Answer 16

confined to 1 nasal passage, paranasal sinus, frontal sinus, & no bone involvement beyond turbinates

Question 17

what is a stage 2 intranasal tumor using modified adams staging?

Answer 17

any bone involvement beyond the turbinates, no evidence of orbit/subcutaneous/submucosal mass

Question 18

what is a stage 3 intranasal tumor using modified adams staging?

Answer 18

orbit is involved, or nasopharyngeal/subcutaneous/submucosal mass

Question 19

what is a stage 4 intranasal tumor using modified adams staging?

Answer 19

tumor causing lysis of the cribiform plate

Question 20

what are some negative prognostic factors for intranasal neoplasia?

Answer 20

older than 10 years, epistaxis, longer duration of clinical signs, metastatic disease, advanced stage, & failure to achieve resolution of clinical signs with treatment

Question 21

without any treatment, what is the median survival time for nasal carcinomas in dogs? what if epistaxis is present?

Answer 21

95 days

88 days instead of 224 days

Question 22

what is the treatment of choice for intranasal neoplasia in dogs?

Answer 22

radiation therapy

Question 23

T/F: surgery can cure intranasal neoplasia

Answer 23

false

Question 24

why is surgery not recommended in intranasal neoplasia for treatment?

Answer 24

significant morbidity without extension of life, median survival time only 3-6 months, & surgery isn’t curative

Question 25

what is the median survival time of intranasal neoplasia if treating the dog with a full course of radiation of definitive radiation?

Answer 25

8 to 19.7 months

Question 26

what is the treatment plan of radiation therapy in dogs for intranasal neoplasia as far as fractions & total dose?

Answer 26

10-18 fractions 42-54 Gy

Question 27

what is the 1 year survival time of dogs with intranasal neoplasia when treated with radiation therapy? what about 2 years?

Answer 27

1 year - 43-68% 2 year - 11-44%

Question 28

how is radiation therapy used palliatively for dogs with intranasal neoplasia?

Answer 28

course fractionated radiation therapy! treatment is delivered weekly

Question 29

what is the goal of palliative radiation therapy in dogs with intranasal neoplasia?

Answer 29

improve quality of life without aiming to maximize tumor sterilization - improvement of 66-100% of dogs

Question 30

what is the median duration of improvement seen in dogs receiving palliative radiation therapy for intranasal neoplasia?

Answer 30

130-300 days

Question 31

what is the median survival time of dogs with intranasal neoplasia when treated with chemo?

Answer 31

5 months

Question 32

other than course fractionated radiation therapy & chemo, what other treatments are used in palliative therapy for intranasal neoplasia in dogs?

Answer 32

supportive care - NSAIDS, analgesia, antibiotics unilateral or bilateral carotid artery ligation

Question 33

what is the most common nasal tumor in cats? what is the second?

Answer 33

lymphoma carcinoma

Question 34

what is the treatment for non-lymphoproliferative intranasal neoplasia in cats?

Answer 34

radiation therapy is the treatment of choice

Question 35

what is the treatment for nasal pharyngeal lymphoma in cats?

Answer 35

radiation therapy

Question 36

what is the median survival time for non-proliferative neoplasia using definitive intent radiation therapy?

Answer 36

12 months - 1 year survival 44% & 2 year survival 16%

Question 37

what is the median survival time for non-proliferative neoplasia using course fractionated radiation therapy?

Answer 37

13 months - 1 year survival 63%

Question 38

what is the median survival time for non-proliferative neoplasia radiation therapy?

Answer 38

6 to 30 months, overall response rate of 70-90%

Question 39

what are risk factors for dogs & cats regarding pulmonary neoplasia?

Answer 39

urban living, second hand smoke, experimental exposure to plutonium, anthracosis, & inhalation of polluted air

Question 40

what is the most common pulmonary neoplasia in dogs? metastatic rate?

Answer 40

bronchoalveolar tumors - 85% 23%

Question 41

what is the most common pulmonary neoplasia in cats? metastatic rate?

Answer 41

adenocarcinoma - 60-70% 76%

Question 42

what is the pathology of pulmonary neoplasia?

Answer 42

tumors affecting the airways or alveolar parenchyma

Question 43

what is the most common clinical sign seen with pulmonary neoplasia?

Answer 43

coughing

Question 44

T/F: pulmonary neoplasia is often diagnosed incidentally as 30% of animals diagnosed may not show clinical signs

Answer 44

true

Question 45

what paraneoplastic syndrome in dogs is associated with primary lung tumors?

Answer 45

hypertrophic osteodystrophy

Question 46

what is this condition? what causes it?

Answer 46

hypertrophic osteodystrophy - dogs with paraneoplastic syndrome/primary lung tumor

Question 47

what paraneoplastic syndrome in cats is associated with primary lung tumors?

Answer 47

digit metastasis (SCC, adenocarcinoma) & aortic thromboembolism

Question 48

what diagnostics are used for pulmonary neoplasia?

Answer 48

CBC/chemistry/ultrasound thoracic rads, thoracocentesis if pleural effusion is present, BAL & TTW, ultrasound guided FNA & cytology, & CT scans

Question 49

what is the median survival time for cats with pulmonary neoplasia that is poorly differentiated on histopathology?

Answer 49

2.5 months

Question 50

what is the median survival time for cats with pulmonary neoplasia that is well-differentiated on histopathology?

Answer 50

23 months

Question 51

what is the median survival time of complete surgical excision of pulmonary neoplasia in dogs?

Answer 51

330 days

Question 52

what are the different tumor stages of pulmonary neoplasia in dogs?

Answer 52

T1 - solitary, MST 26 months T2 - multiple lesions, MST 7 months T3 - invasion into adjacent tissues, MST 3 months

Question 53

what is the treatment of choice for pulmonary neoplasia?

Answer 53

surgery - when possible, complete lobectomy & removal of local lymph nodes

Question 54

along with surgical treatment, what other options do you have for treatment for pulmonary neoplasia?

Answer 54

chemo therapy, tyrosine kinase inhibitors in the setting of metastatic or non-operable disease, & radiofrequency ablation

Question 55

after surgical excision of the tumor is done, what should be done for further characterization & margin assessment?

Answer 55

histopathology

Question 56

when will chemo be recommended for pulmonary neoplasia patients?

Answer 56

if the patient has poor prognostic factors such as: large tumor size, aggressive histopathology, clinical signs, & metastasis

Question 57

T/F: there is no standard of care for using chemo in pulmonary neoplasia

Answer 57

true

Question 58

what is the perceived cause of nasal planum tumors in cats?

Answer 58

UV exposure

Question 59

what is the typical clinical presentation of cats with nasal planum tumors?

Answer 59

erythema, ulcerated, & crusted appearance

Question 60

what is the treatment of choice for nasal planum tumors in cats?

Answer 60

surgery

Question 61

what dog breeds are associated with tumors of the nasal planum?

Answer 61

labs & goldens

Question 62

T/F: in dogs, UV exposure is thought to cause nasal planum tumors

Answer 62

false

Question 63

what is the treatment of choice for nasal planum tumors in dogs?

Answer 63

surgery

Question 64

why is radiation & chemo not used in dogs with nasal planum tumors?

Answer 64

not effective

Question 65

T/F: nasal planum tumors in dogs are not very aggressive

Answer 65

false - extremely aggressive