Exam 2 - Tumors of the Respiratory System Flashcards

1
Q

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

A

dolichocephalic breeds - long noses

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2
Q

what environmental risks may predispose animals to nasal tumors?

A

urban environments & exposure to environmental tobacco smoke

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3
Q

what is the most common nasal tumor in dogs?

A

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

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4
Q

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

A

sarcomas

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5
Q

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

A

true

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6
Q

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

A

approximately 2-3 months

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7
Q

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

A

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

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8
Q

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

A

cancer

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9
Q

what are some main differentials for intranasal neoplasia?

A

fungal/bacterial rhinitis - especially aspergillus

idiopathic non-specific rhinitis - lymphoplasmacytic

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

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10
Q

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

A

true

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11
Q

how is intranasal neoplasia diagnosed?

A

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

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12
Q

what is required after imaging to confirm a diagnosis?

A

tissue - histopathology, rhinoscopy guided

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13
Q

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

A

transnostril blind biopsy

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14
Q

how is intranasal neoplasia staged?

A

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

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15
Q

what is used for tumor staging on CT scan?

A

modified adams staging

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16
Q

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

A

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

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17
Q

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

A

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

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18
Q

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

A

orbit is involved, or nasopharyngeal/subcutaneous/submucosal mass

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19
Q

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

A

tumor causing lysis of the cribiform plate

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20
Q

what are some negative prognostic factors for intranasal neoplasia?

A

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

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21
Q

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

A

95 days

88 days instead of 224 days

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22
Q

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

A

radiation therapy

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23
Q

T/F: surgery can cure intranasal neoplasia

A

false

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24
Q

why is surgery not recommended in intranasal neoplasia for treatment?

A

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

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25
Q

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

A

8 to 19.7 months

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26
Q

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

A

10-18 fractions

42-54 Gy

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27
Q

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

A

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

28
Q

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

A

course fractionated radiation therapy!

treatment is delivered weekly

29
Q

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

A

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

30
Q

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

A

130-300 days

31
Q

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

A

5 months

32
Q

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

A

supportive care - NSAIDS, analgesia, antibiotics

unilateral or bilateral carotid artery ligation

33
Q

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

A

lymphoma

carcinoma

34
Q

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

A

radiation therapy is the treatment of choice

35
Q

what is the treatment for nasal pharyngeal lymphoma in cats?

A

radiation therapy

36
Q

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

A

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

37
Q

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

A

13 months - 1 year survival 63%

38
Q

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

A

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

39
Q

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

A

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

40
Q

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

A

bronchoalveolar tumors - 85%

23%

41
Q

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

A

adenocarcinoma - 60-70%

76%

42
Q

what is the pathology of pulmonary neoplasia?

A

tumors affecting the airways or alveolar parenchyma

43
Q

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

A

coughing

44
Q

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

A

true

45
Q

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

A

hypertrophic osteodystrophy

46
Q

what is this condition? what causes it?

A

hypertrophic osteodystrophy - dogs with paraneoplastic syndrome/primary lung tumor

47
Q

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

A

digit metastasis (SCC, adenocarcinoma) & aortic thromboembolism

48
Q

what diagnostics are used for pulmonary neoplasia?

A

CBC/chemistry/ultrasound

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

49
Q

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

A

2.5 months

50
Q

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

A

23 months

51
Q

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

A

330 days

52
Q

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

A

T1 - solitary, MST 26 months

T2 - multiple lesions, MST 7 months

T3 - invasion into adjacent tissues, MST 3 months

53
Q

what is the treatment of choice for pulmonary neoplasia?

A

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

54
Q

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

A

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

55
Q

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

A

histopathology

56
Q

when will chemo be recommended for pulmonary neoplasia patients?

A

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

57
Q

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

A

true

58
Q

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

A

UV exposure

59
Q

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

A

erythema, ulcerated, & crusted appearance

60
Q

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

A

surgery

61
Q

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

A

labs & goldens

62
Q

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

A

false

63
Q

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

A

surgery

64
Q

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

A

not effective

65
Q

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

A

false - extremely aggressive