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CFT I > Final Exam - Tumors of the Respiratory System > Flashcards

Final Exam - Tumors of the Respiratory System Flashcards

1
Q

what are 3 potential risk factors for dogs developing nasal tumors?

A

dolichocephalic breeds (collies)

urban environment

exposure to environmental tobacco smoke

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2
Q

what is the most common nasal tumor in dogs? what accounts for the others?

A

carcinomas - accounts for 2/3 of all intranasal tumors

adenocarcinomas
squamous cell carcinoma & undifferentiated carcinoma

SARCOMAS

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3
Q

T/F: nasal tumors in dogs are locally very aggressive but have a low metastatic rate at the time of diagnosis

A

true

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4
Q

what is the approximate duration of clinical signs in patients prior to presentation?

A

2-3 months

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5
Q

what are the clinical signs associated with nasal tumors in dogs?

A

unilateral epistaxis that progresses to bilateral in later stages +/- mucopurulent discharge

facial deformity

unwillingness to open mouth

sneezing/dyspnea/stertor

exophthalmus/ocular discharge

neuro signs (rare)

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6
Q

T/F: if facial deformity is present, the diagnosis is almost always cancer

A

true

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7
Q

what is on your differential list for nasal tumors?

A

fungal/bacterial rhinitis (aspergillus)

idiopathic non-specific rhinitis (lymphoplasmacytic)

nasal parasites

bleeding disorders

hypertension

foreign body/trauma

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8
Q

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

A

true

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9
Q

how are nasal tumors diagnosed using imaging?

A

CT or MRI scan

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10
Q

what may be seen on CT/MRI for an animal with a nasal tumor?

A

bone destruction, abnormal soft tissue, nasopharyngeal invasion, & patchy areas of increased density within abnormal soft tissue opacity

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11
Q

how are nasal tumors diagnosed definitively?

A

histopathology - guided rhinoscopy

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12
Q

why is a punch/wedge biopsy not indicated in patients with facial deformity?

A

radiation

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13
Q

how are nasal tumors staged?

A

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

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14
Q

what is stage 1 of a nasal tumor using the modified adams staging?

A

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

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15
Q

what is stage 2 of a nasal tumor using the modified adams staging?

A

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

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16
Q

what is stage 3 of a nasal tumor using the modified adams staging?

A

orbit involved, or nasopharyngeal/subcutaneous/submucosal mass

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17
Q

what is stage 4 of a nasal tumor using the modified adams staging?

A

tumor causing lysis of the cribiform plate

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18
Q

what are some negative prognostic factors of nasal tumors in dogs?

A

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

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19
Q

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

A

radiation therapy

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20
Q

why is surgery not an option for a nasal tumor?

A

curative surgery is impossible - significant morbidity without extension of life

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21
Q

what is the median survival time of a nasal tumor treated with radiation therapy? 1 year survival? 2 year survival?

A

8 to 19,7 months

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

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22
Q

what is the total dose of radiation therapy given for nasal tumors? how many treatments are received?

A

42 to 54 Gy

treatment delivered in 10 to 18 fractions (3 to 4.2 Gy a fraction)

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23
Q

what is course fractionated radiation therapy used for palliative care for a dog with a nasal tumor?

A

treatment delivered weekly - improvement in clinical signs reported in 66-100% of dogs

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24
Q

what is the goal of course fractionated radiation therapy used for palliative care in dogs with nasal tumors?

A

improve the quality of life without aiming to maximize tumor sterilization

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25
Q

what is the median duration of improvement seen with course fractionated radiation therapy used for palliative care in dogs with nasal tumors?

A

130-300 days

26
Q

what can be used as supportive care for palliative treatment of nasal tumors in dogs?

A

unilateral/bilateral carotid artery ligation, NSAIDS< antibiotics, & analgesia

27
Q

what is the clinical response seen with chemotherapy in dogs with a nasal tumor?

A

27-75%

28
Q

what is the median survival time seen with chemotherapy used as palliative care in dogs with nasal tumors?

A

5 months

29
Q

what is the most common nasal tumor in cats? what is the 2nd most common?

A

lymphoma

carcinoma

30
Q

what is the treatment of choice for non-lymphoproliferative neoplastic nasal tumors in cats?

A

radiation therapy!!

31
Q

what is the definitive intent radiation therapy median survival time?

A

12 months

32
Q

what is the coarse fractionated palliative radiation therapy median survival time?

A

13 months

33
Q

what is the overall response rate for cats treated for nasal pharyngeal lymphoma? what enhances overall survival?

A

70-90%

inclusion of radiation therapy

34
Q

what is the combined survival time for treatment of nasal pharyngeal lymphoma?

A

6-30 months

35
Q

what are the risk factors for pulmonary neoplasia in dogs & cats?

A

urban living/2nd hand smoke

inhalation of polluted air - anthracosis

experimental exposure to plutonium

dogs trained to smoke cigarettes in the presence or absence of asbestos exposure

36
Q

what is the pathology of pulmonary neoplasia?

A

affects the epithelium of the airways or alveolar parenchyma

37
Q

what is the most common pulmonary neoplasia in dogs?

A

bronchoalveolar carcinomas - 85%

38
Q

what is the most common pulmonary neoplasia in cats?

A

adenocarcinoma - 60-70% of tumors

39
Q

what is the metastatic rate of pulmonary neoplasia in cats?

A

76%

40
Q

what percentage of animals are diagnosed with pulmonary neoplasia with no clinical signs?

A

30%

41
Q

what is the most common clinical sign of pulmonary neoplasia?

A

coughing

others - dyspnea, lethargy, anorexia, weight loss

42
Q

what paraneoplastic syndrome is most commonly reported with primary lung tissues in the dog?

A

hypertrophic osteopathy

43
Q

what paraneoplastic syndrome is most commonly reported with primary lung tissues in the cat?

A

digit metastasis (scc & adenocarcinoma) & aortic thromboembolism

44
Q

what diagnostics are used for pulmonary neoplasia?

A

thoracic rads, ultrasound guided FNA & cytology, & CT scan

45
Q

what percentage is ultrasound guided FNA & cytology diagnostic in dogs & cats with pulmonary neoplasia?

A

dogs - 38%-90%

cats - 80-100%

46
Q

what are prognostic factors in dogs for pulmonary neoplasia?

A

metastatic disease, histologic type/grade, tumor stage, tumor size, location within lung lobe, & involvement of entire lung lobe

47
Q

what is the median survival time for a dog with a stage 3 pulmonary tumor that has invaded into adjacent tissues?

A

3 months

48
Q

what are prognostic factors in cats for pulmonary neoplasia?

A

poorly differentiated tumor on histopath - median survival time is 2.5 months

well differentiated tumor on histopathology - median survival time is 23 months

49
Q

what is the treatment of choice for pulmonary neoplasia?

A

surgery!! when possible, a complete lobectomy should be performed with the removal of local/regional lymph node

50
Q

what are 3 other options used in treating pulmonary neoplasia?

A

chemotherapy

tyrosine kinase inhibitors - used in metastatic or non-operable disease

radiofrequency ablation - electrode is placed within the tumor to generate heat resulting in necrosis

51
Q

after removing a lung tumor, why should it be submitted to histopathology even if you have already done a cytology?

A

further characterization of the tumor & assessment of margins

52
Q

when should chemotherapy be recommended for a patient with pulmonary neoplasia?

A

if the patient has poor prognostic factors - large tumor size, aggressive histopath, clinical signs, & metastatic lymph nodes

53
Q

what chemo drugs can be used in a post operative setting for pulmonary neoplasia?

A

carboplatin, doxorubicin, & vinorelbine

54
Q

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

A

UV exposure

55
Q

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

A

erythema, ulcerated, & crusted lesions

56
Q

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

A

surgery!

57
Q

what dog breed is associated with nasal planum tumors? is it UV associated?

A

dogs - no

58
Q

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

A

surgery

59
Q

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

A

it’s not effective in dogs

60
Q

T/F: multimodal approach to treatment of nasal planum tumors in dogs is likely to result in superior survival times

A

true

CFT I (30 decks)

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