General Questions Flashcards
What is the most common site for canine chondrosarcoma?
Nasal cavity
Is canine gastrointestinal lymphoma more commonly T or B cell?
T-cell (63% vs. 37% B-cell)
Which exons are typically mutated with c-kit in feline mast cell tumors?
Exon 8 and 9 (extracellular domain)
65% of cats will carry this mutation (most were 8, more common with splenic MCT).
Which gene was recently associated with MCT development in Golden Retrievers?
GNAI2- associated with hyaluronic acid synthesis
How many dogs with MCT present with multiple tumors?
11 - 14%
In dogs, c-kit mutations appear to be associated with _____% of intermediate and high grade MCT.
25 - 30%
How many dogs with MCTs located in the muzzle present with regional metastasis?
50 - 60%
This does not necessarily indicate a worse long-term prognosis, as the MST for dogs with metastatic disease was 14 months.
What is the reported MST for poorly differentiated MCT with the presence of LN metastasis?
194d.
VS. 503d for dogs with no metastasis.
What is the incidence of bone marrow involvement in canine MCT?
2.8%
Which parasite has been associated with development of sarcoma in dogs?
Spirocerca lupi
What is the most common paraneoplastic syndrome associated with thymoma in the cat?
Exfoliative dermatitis
What 3 abnormalities characterize a syndrome associated with mutation in the canine Birt-Hogg-Dube (BHD) gene in German Shepherd dogs?
1) Multiple uterine leiomyomas
2) Bilateral renal cystadenocarcinomas
3) Nodular dermatofibrosis
Mutation in FLCN- tumor suppressor gene coding for protein folliculin. Also seen in Alsatians.
Which gene expression is common in canine gastric carcinoma?
exon 11 of c-kit gene, HER-2 (58%)
Which testicular tumor is most often associated with hyperestrogenism?
Sertoli cell tumor
Which characteristics predict a worse outcome for dogs diagnosed with B cell lymphoma?
Large cell, low levels of class II MHC expression
What is the most common location of feline appendicular osteosarcoma?
Distal femur and proximal tibia
Which tumor location is most suitable for limb sparing surgery in dogs affected by OSA?
Distal radius or ulna
Which protein is necessary for metastasis in murine models of osteosarcoma and associated with shorter DFI in dogs with osteosarcoma?
Ezrin
Which breed is predisposed to bile duct carcinoma?
Labrador Retrievers
Sex predilection for females.
Which monoclonal antibody targets HER-2 positive tumors in humans?
Trastuzumab
What percentage of HSA occur primarily in the liver?
4 - 6%
Which virus is associated with HCC In humans?
Hepatitis viruses B and C
Which cells do carcinoid cells arise from?
Neuroendocrine cells
Contain secretory granules that may contain substances such as 5-hydroxytryptamine (serotonin), secretin, somatostatin, and gastrin, among others. IHC for cytokeratin and serotonin may be positive.
What histopathologic factors are associated with worse prognosis for canine SQ MCT?
Mitotic index > 4
Multinucleation
Invasiveness
What is the MST for dogs with perianal adenocarcinoma with LN or distant metastasis
7 months (however aggressive treatment was not attempted in 5/6 dogs)
What is the RR of AGASAC to Palladia?
25% PR, 63% SD, total clinical benefit rate = 88%
What is the MST of dogs with nasal carcinoma without treatment?
95 days (3 months)
What is the MST of cats with lymphoma without treatment?
53d
What % of cats treated with SRT for Functional Pituitary Adenoma developed hypothyroidism?
14%
Which tumors are known to express ABCB1?
Canine lymphoma, mammary tumors, feline primary pulmonary carcinoma
What % of dogs with testicular tumors have bilateral tumors?
50%
What % of dogs with sertoli cell tumors will present with signs of hyperestrogenism?
50%
What % of dogs will have > 1 testicular tumor type?
4 - 20%
What percentage of dogs with prostate tumors, when treated with a total prostatectomy, will experience permanent urinary incontinence?
35%
MST = 231 days (shorter in dogs with extracapsular invasion compared to intracapsular tumors)
What % of prostatic carcinomas had COX-2 expression in dogs?
75-88%
What is the MST of dogs with PCA treated with NSAID alone?
6.9 months
What % of dogs with PCA will have skeletal mets?
22 - 42%
What % of dogs with iUC are reported to have urethral involvement?
56%
What is the MST of cats with iUC treated with a variety of treatments?
261
11 cats treated with meloxicam = 311d. More than half were away from the trigone.
What % of dogs with iUC are reported to have prostatic involvement?
29%
What is the MST of dogs with renal HSA in a retrospective of 14 dogs?
278
In a phase 1 clinical trial of intravesical mitomycin C, what were the most significant complications?
Marked myelosuppression and GI upset- indicating there was some systemic absorption occurring.
Although neoplastic cells are often indistinguishable from reactive epithelial cells in the urine of dogs with TCC, neoplastic cells may be present in the urine in up to ___% of cases
30%
What % of cats with meningioma present with multiple tumors?
17%
Withrow pg. 583
What is the most common type of glioma in dogs?
Oligodendroglioma (previously reported to be astrocytoma)
New Withrow
What is the MST for dogs with CNS lymphoma treated with a variety of treatments?
171d
What is the MST for dogs with presumptive glioma treated with CCNU?
178d
What is the reported MST for cats with cerebral meningiomas treated surgically?
23 - 37 months.
685 days in another study (2 years)
What proportion of cerebral meningiomas in cats will recur following surgical treatment?
20.6 - 25% (median TTR 285 days)
What is the MST of dogs with meningioma treated surgically with conventional techniques?
7 mo.
What % of feline brain tumors detected incidentally?
20%
What is the most common location for spinal meningiomas and malignant nerve sheath tumors? Options are: A) Extradural B) Intradural/extramedullary C) Intramedullary D) Mixed
B) Intradural/extramedullary
Which breeds of dog are predisposed to spinal nephroblastoma at a young age?
GSD and Golden Retrievers
Which spinal cord segments do Nephroblastomas arise from?
T9 - L2
Which is the most common spinal nerve root affected by PNST?
Caudal cervical region (C6 - T2)
What is the most common tumor of the canine conjunctiva?
Melanoma.
Older, female, Weimaraner and possibly GSD/large breed dogs may be predisposed.
What is the most common tumor of the third eyelid in dogs and cats?
Adenocarcinoma (85%)
What is the average latency period for cats to develop ocular posttraumatic sarcoma?
5 years
67% are males or neutered males.
In cats with orbital neoplasia, what % had radiographic signs of orbital bone lesion?
59%
–> 15% had pulmonary metastasis
What percentage of canine anterior uveal melanomas demonstrate metastasis?
25%
What % of conjunctival melanoma recur following excision?
55%
at least 17% of the dogs experienced orbital invasion or spread to the regional lymph nodes or lung
What percentage of dogs with large B-cell lymphoma will have normal CBCs but exhibit bone marrow involvement when assessed via flow cytometry?
15%
What is the characteristic marker for T-zone lymphoma?
CD45-
What was the MST of T-zone lymphoma in Seelig et. al 2014?
657d
What % of normal canine lymphocytes in peripheral circulation are T cell and B cell respectively?
T cell = 80%
B cell = 15%
NK and double negative T cell = 5%
In retrospective study by Childress et. al, what were the 4 negative prognostic factors identified in dogs with DLBCL undergoing CHOP chemotherapy?
1) Thrombocytopenia
2) Greater age at diagnosis
3) Higher neutrophil count
4) Higher serum globulin concentration
What is the sensitivity and specificity of US for detection of hepatic involvement of lymphoma?
Sensitivity = 73% Specificity = 81%
What is the sensitivity and specificity of US for detection of splenic involvement of lymphoma?
Sensitivity = 100% Specificty = 23%
Which breed has been described to have lymphocytic-plasmacytic inflammatory bowel disease that progressed to GI lymphoma?
Basenji
Which dog breeds may be overrepresented in cases of alimentary lymphoma?
Boxers and Shar-pei
What % of dogs with lymphoma present with hypercalcemia?
10 - 40%
What is the name of the syndrome of cutaneous T-cell epitheliotropic lymphoma progressing to circulating malignant cells in humans?
Sezary syndrome
What chromosomal aberration has been detected in dogs with naturally occurring lymphoma and appears to hold prognostic significance?
Chromosome 13
Gains of canine chromosomes 13 and 31 and loss of chromosome 14 have been documented as the most common aberrations in a group of 25 cases analyzed.
→ prognostic advantage in dogs with trisomy chromosome 13 has been identified.
What % of dogs with multicentric lymphoma have diffuse pulmonary infiltration?
27 - 34%
What percentage of dogs with multicentric lymphoma are expected to go into complete remission when treated with single agent doxorubicin as a first line therapy?
50 - 75%
MST 6 - 8 months
For dogs that have completed the CHOP chemotherapy protocol for lymphoma, what percentage of dogs will successfully be reinduced by the same protocol >2 months after completion of treatment?
80 - 90%
What is the most common lymphoma-related paraneoplastic syndrome?
Anemia
What % of dogs with lymphoma will have ocular involvement/uveitis?
33 - 50%
What % of dogs with lymphoma are reported to have monoclonal gammopathies? Which type of lymphoma?
6%
Usually B-cell lymphoma
What are the B-cell markers?
CD79a, CD20, CD21, Pax5
–> Although dogs with TZL can express CD21
What are the T-cell markers?
CD3 (pan), CD4 (helper), CD8 (cytotoxic)
What classifies as a LARGE lymphocyte?
> 2x an RBC or larger than a neutrophil
Intermediate = 1.5-2x RBC, same size as neutrophil
What percent of dogs with multicentric lymphoma exhibit radiographic evidence of a cranial mediastinal lymphadenopathy at the time of diagnosis?
20%
What percentage of dogs with hypercalcemic lymphoma will have mediastinal involvement?
43%
What is the overall response rate for DTIC when used in the rescue setting for canine multicentric lymphoma?
35% (response duration of 43d)
PARR sensitivity and specificity for canine lymphoma?
70 - 90% sensitivity, 5% false positive rate (95% specificity). False positives occur in some infectious diseases (ehrlichiosis and leishmania)
What is the name of the monoclonal antibody against CD20 used in humans with B-cell NHL?
Rituximab
What is the MST for colorectal lymphoma in dogs receiving chemotherapy and what is the dominant immunophenotype?
MST = 1845 - 2352
B-cell
What is the reported MST of dogs with low grade GI lymphoma treated with chlorambucil and prednisone?
1.5 - 2 years
What is the response rate for cutaneous lymphoma to chemotherapy?
40 - 80%. Median remission duration = 3 - 6 months.
What percentage of senior Golden Retrievers without evidence of lymphoproliferative disease have TZ cells (CD45- T cells) in peripheral blood when analyzed by flow cytometry?
31%
Approximately what percentage of dogs with T-zone lymphoma have been reported to be Golden Retrievers?
40%
What is the median PFI and Overall ST for canine nodal marginal zone lymphoma?
PFI = 5 months
Overall ST = 8.5 months
What is the median PFS for cutaneous lymphoma treated with Tanovea?
38d
What is the response rate and median remission duration for cutaneous lymphoma treated with CCNU?
80%, median remission duration = 3 months
What is the concordance rate of pre-treatment bx STS to final dx?
59%
29% underestimate, 12% overestimate
What was the MST for dogs treated with surgery and adjuvant carbo for oral melanoma (+/- RT)?
MST = 440d PFI = 259d
What percentage of dogs with chronic lymphocytic leukemia were reported to develop Richter’s syndrome?
5%
Median survival = 41d
Normalization of lymphocyte counts occur in what % of treated CLL cases?
70%
In a study of metastatic cancer of unknown primary, what % were diagnosed as carcinoma?
57%
MST = 30 days
Primary site not identified on full body CT in 95% of dogs
What proportion of telangiectatic OSA were reclassified as HSA of bone when stained with VWIII-related antigen or VWf?
20%
In a study of 40 dogs with systemic mastocytosis, which chemotherapy protocol provided the best outcome?
Lomustine + Vinblastine + Pred MST = 227d
Palladia MST = 118d
What was the MST for feline large granular lymphoma receiving a variety of treatments?
MST = 21d small subset (7.3%) survived > 6 months. MST was significantly shorter in the case of substage b, circulating neoplastic cells, lack of chemotherapy administration, and lack of treatment response.
Which chemotherapeutic drugs are inhibitors of ribonucleotide reductase?
Gemcitabine, Cytarabine, Hydroxyurea –> reason for radiation sensitivity?
What % of cats with renal transplant receiving cyclosporine developed neoplasia in Wormser et. al 2014?
22.5% (56% of which were lymphoma–> 10 - 13%)
Compared to the control population, renal transplant cats have a _____ times higher odds of developing malignant neoplasia and a _____ times higher odds of developing lymphoma.
- 6x neoplasia
6. 7x lymphoma
What % of cats with T-cell GI lymphoma exhibit epitheliotropism?
40%
What % of cats with lymphoma have pulmonary involvement?
12.8%
- 2% had no gross abnormalities. (peribronchial-vascular invasion most common histo abnormality)
- 5% were B-cell vs. T-cell
- 5% + FeLV
What is the immunophenotypic classification for Hodgkin’s like lymphoma in cats?
T-cell rich B-cell lymphoma
Nasal lymphoma in cats are primarily what phenotype?
68% B-cell (20% T-cell, 12% mixed)
Renal lymphoma in cats in Australia are primarily what phenotype?
B-cell
What % of cats with renal lymphoma will have extension to the CNS?
40 - 50%
What % of CNS lymphoma in cats are part of a multicentric disease?
80%
What % of CNS lymphoma are FeLV + antigenemic?
17 - 50%
Which area of the spine most commonly affected by CNS lymphoma
thoracolumbar
What % of hypercalcemic cats are diagnosed with lymphoma?
10%
What is the reported sensitivity of PARR for feline lymphoma?
80%
Specificity has not been established.
What % of cats with LGL (6/8 were treated with CHOP) were reported to live longer than 6 months?
7.3%
What is the reported MST of cats with LGL treated with chemotherapy?
63d (2 months)
Methylation of the promoter region of p16 has been identified in ___% of feline B-cell lymphoid tumors
33%
What is the reported sensitivity and specificity of splenic ultrasonographic appearance (i.e., a moth-eaten parenchyma) for the diagnosis of feline malignancies?
Sensitivity = 13.2%
Specificity = 84.8%
Splenic mass >1cm sens = 21%, spec = 94.7%
Post-chemotherapy bowel perforation has been reported in cats with high grade gastrointestinal lymphoma. Which variable was associated with increased risk of perforation?
Magnitude of weight loss within 15 - 28 days of diagnosis
What is the increased risk associated with FeLV cats in developing lymphoma?
62x
FIV infection associated with 5x risk
Mast cells can be seen in up to ___% of aspirations from thymoma?
50%
What % of renal lymphoma will be bilateral?
> 80%
What % of renal lymphoma will have US evidence of other organ involvement?
33%
What % of cats who relapsed following COP based protocol subsequently responded to single agent DOX?
22%
What was the response rate for cats with lymphoma treated with L-Spar?
30%
Much shorter asparagin-depleting effect in cats (lost by 7 days)
A bone marrow aspirate with greater than ____% abnormal blast cells is sufficient to make the diagnosis of acute leukemia in cats.
30%
27% CR to COP based protocol
In cats with suspected CLL, infiltration of the bone marrow with more than ____% mature lymphocytes helps confirm the diagnosis.
20%
Most are of T-cell lineage and most are FeLV negative.
ALL in cats is primarily what phenotype?
T-cell
About 60 - 80% FeLV positive
What phenotype is most common with Mediastinal Lymphoma?
T-cell
Nasal = B-cell
What is the reported MST of 20 cats with high-grade GI LSA when treated with surgical resection and CHOP-based chemotherapy?
420d
Nasal lymphoma immunophenotype?
3/4 B-cell
What is the median survival time for FeLV-positive cats with mediastinal lymphoma?
2-3 months
Young FeLV-negative Siamese cats with mediastinal lymphoma had durable responses of ~9 months
What % of cats with lymphoma will respond to L-asparaginase?
30%
Missense mutations in what genes have been identified in dogs with AML?
FLT3, C-KIT, RAS
What is the tendency for the myeloid:erythroid ratio to be in Polycythemia vera?
Normal
What are the markers for megakaryocyte lineage in dogs and cats?
Acetylcholinesterase, vWF/fVIII, platelet glycoprotein, CD41
What are the markers for neutrophils?
peroxidase, Sudan Black B, chloracetate esterase
What are the markers for monocytes?
Nonspecific esterases (alpha-naphthyl acetate esterase or alpha-naphthyl butyrate esterase), especially if they are inhibited by sodium fluoride
What is the marker for basophils?
Omega exonuclease, + for chloracetate esterase activity.
What are the markers for myeloid cells?
MPO and CD11b
What is the most common type of DNMT3L (methylation) mutation identified in dogs with AML?
Missense mutation in exon 7
What disorders are known to cause secondary thrombocytosis?
Iron deficiency anemia, chronic inflammatory diseases, recovery from severe hemorrhage, rebound from ITp, and absence of a spleen.
You are treating a dog with chronic myelogenous leukemia. After inducing with hydroxyurea (20mg/kg twice daily), what hematologic parameter is used to gauge your dose reduction?
Leukocyte count falls to 15,000 - 20,000 cells/uL
Philadelphia chromosome or BCR-ABL translocation between chromosomes 9 and 22 in humans with CML. What are the equivalent chromosomes in dogs with CML?
Chromosomes 9 and 26
What % of dogs with MM will have abnormal PT/PTT?
50%
HVS occurs in what % of dogs with MM. Which immunoglobulin is most frequently associated with this?
20 - 40% (IgM)
What % of dogs with MM develop Bence Jones proteinuria?
25 - 40%
What are the known negative prognostic factors in dogs with MM?
Hypercalcemia
Bence Jones proteinuria
Extensive bony lysis
Which IHC stains are typically used for EMP?
MUM-1, IRF-4, thioflavin T
When is staging most important for EMP?
Cutaneous plasmacytosis, SOP, GI EMP (higher risk of metastasis)
Less important for cutaneous, oral, and colorectal plasmacytoma
What % of cases with cutaneous plasmacytosis had LN or abdominal visceral involvement?
30%
What is the recurrence and metastatic rate for solitary cutaneous and oral plasmacytomas following surgery?
5% and 2% respectively
What is the MST for colorectal plasmacytoma treated with surgery +/- chemo?
15 months
What is the MST for Waldestroms macrogammaglobulinemia (IgM) treated with chlorambucil?
11 months, 77% RR
What % of dogs had concurrent splenic and right atrial HSA on echocardiogram in one study?
8.7%.
Previous necropsy studies suggest about 25%
What are the IHC markers for hemangiosarcoma?
VWf/fVIII-related antigen or CD31/platelet endothelial cell-adhesion molecule
What % of grossly abnormal livers in dogs with confirmed splenic HSA were confirmed to contain HSA metastasis in one study?
50%
What is the MST for primary renal HSA?
9 months
What is the MST for retroperitoneal HSA?
37.5d
What is the MST for dogs treated with Splenectomy + AC + L-MTP-PE?
273d (9 months)
What % of dogs with HS have clinicopathologic changes consistent with DIC?
50%
What % of dogs with Thymoma are reported to have paraneoplastic syndromes?
67%
–> 40% ME with associated aspiration pneumonia
What % of dogs will have a concurrent 2nd tumor with Thymoma?
27%
Hypofractionated radiation therapy has been described as a treatment for non-resectable canine thymoma. What was the reported median time to response following treatment initiation?
22d
What is the % of perioperative mortality in dogs and cats undergoing excision of thymic epithelial tumors?
Dogs = 20% Cats = 22%
Which histologic factors were more common with atypical thymoma and thymic carcinoma compared to thymomas?
Pleomorphism, mitotic figures, capsular invasion, and higher stage disease.
IHC (GLUT-1, CD5, CD117, CK8/18) was not useful.
With TVT if regression is going to occur, at what time is this typically seen?
Within 3 - 9 months
What % of TVT metastasize?
5 - 17%, to regional LN or elsewhere.
What are the IHC markers for TVT?
1) Vimentin
2) Lysozyme
3) Alpha-1-antitrypsin (AAT)
4) Macrophage-specific ACM1
Oncogenesis of TVT involves which 2 genes?
LINE-c-myc and p53
What is a reported paraneoplastic syndrome of TVT?
Erythrocytosis
What is the reported metastatic rate for TVT?
<15% (but might be higher as many are not staged)
What is the response rate of TVT to vincristine chemotherapy?
90 - 95%
What is the recurrence rate of TVT following surgical removal?
30 - 75% (marginal surgical excision not effective)
TVT’s are unlikely to spontaneously regress after how many months?
9 months
Which tumor suppressor genes are inactivated with mesothelioma?
cyclin-dependent kinase inhibitor 2A (CDKN2A), BRCA1 associated protein 1 (BAP1), and neurofibromin 2 (NF2)
Sclerosing mesothelioma is associated with what signalment?
Male German Shepherds
Which gene is mutated with renal cystadenocarcinoma and nodular dermatofibrosis?
Birt-Hogg-Dube (BHD) gene.
The BHD gene codes for the tumor suppressor protein folliculin and mutations in this gene are thought to lead to loss of function. This disease is primarily seen in German Shepherd dogs. Also see uterine leiomyomas.
Which mutation is most common with Chronic Myelogenous Leukemia in humans?
Philadelphia chromosome or BCR-ABL translocation between chromosomes 9 and 22. The analogous chromosomes in dogs are chromosomes 9 and 26, and BCR-ABL translocation, termed “Raleigh chromosome,” has been reported in several cases of CML in dogs.
Most common mutation in canine and feline SCC
p53
Which of the following has been shown to be a negative prognostic factor for canine HS?
Palliative therapy, disseminated HS, and concurrent use of corticosteroids
(Dervisis et. Al, 2016, VCO)
Which drugs have been associated with radiation recall?
doxorubicin, taxanes, gemcitabine
In the 2016 paper by Giuffrida et. al, what % of tumors were reclassified on the basis of FVII-RAg/vWF immunoreactivity, from an original diagnosis of telangiectatic OSA to HSA?
20%
What is the most common phenotype for Canine CLL?
T cell origin (CD3+, CD21-)
CD3+, CD4-, CD8+ (73% in one study, 91% in another)
What percentage of cats with acromegaly were male in SRT paper for feline acromegaly? (Wormhoudt et al. 2018)
80%
In a recent study on IHC for nasal carcinoma and lymphoma in cats, what % of samples required IHC to differentiate carcinoma from lymphoma?
7%
Markers for Feline progressive histiocytosis?
CD1a, CD11c/CD18, CD5, Iba-1, CD204
Which IHC markers are used to distinguish pheochromocytoma from adrenocortical carcinoma?
chromogranin A and synaptophysin
GIST IHC markers?
CD117, Dog-1, CD34, and SMA (+/-).
Desmin and S-100 NEGATIVE
Which IHC markers are positive with hemangiosacoma?
Factor VIII (vWF), CD31/PECAM-1
Which IHC marker can confirm a diagnosis of hemophagocytic histiocytic sarcoma?
CD11d
Which IHC stain can differentiate between canine urinary bladder transitional cell carcinoma and other carcinomas?
Uroplakin III- expressed in more than 90% of canine TCC.
IHC markers for MCT?
Vimentin (+)
Tryptase and CD117 (KIT) (+)
+/- chymase, MCP-1, and IL-8 (+)
IHC marker for Thyroid carcinoma (c-cell)
Synaptophysin (+) chromogranin (+) thyroglobulin (-)
IHC marker for Thyroid carcinoma (epithelial)
Thyroglobulin (+)
What are the IHC markers for Melanoma?
Melan-A, PNL2, Tyrosinase-related protein (TRP)-1 and TRP-2 +/- S-100, human melanoma black 45 (HMB45)
Feline cutaneous MCT response to Lomustine?
20 cats: 2 CR, 8 PR = 50% ORR
Which anthracycline may be administered orally?
Idarubicin
What toxicity is associated with 5-FU in cats?
Fatal CNS toxicity
Why is cyclophosphamide relatively platelet sparing?
High levels of aldehyde dehydrogenase in the bone marrow (which deactivates cyclophosphamide)
Which chemotherapy drugs are severe vesicants?
Doxorubicin, vinca alkaloids, mechlorethamine, actinomycin D
What is the active metabolite of cyclophosphamide?
Phosphoramide mustard
Which drugs are radiation sensitizers?
Carboplatin/cisplatin, actinomycin D, gemcitabine, 5-FU, etanidazole, metronidazole (+- Dox)
What are the solvents used for paclitaxel and docetaxel respectively that allow for IV administration?
Paclitaxel = Cremophor EL Docetaxel = Polysorbate 80
Which enzyme functions in alkylator-induced DNA repair (eg. Temozolomide)
MGMT (O6 methylguanine DNA methyltransferase)
Removes adducts from the O-6 position of guanine and transfers the alkyl group to a specific cysteine residue (acceptor site) on the enzyme–> renders it inactive
What is the reported MST for dogs with stage IV MCT?
Pizzoni et. al VCO 2018
110 days
Tumor diameter >3cm and more than 2 metastatic sites, BM infiltration, and lack of tumor control at primary site were negative px factors.
Which breed is predisposed to Cutaneous Langerhans Cell Histiocytosis?
Shar-Pei (35%)
- Onset of regression can take up to 10 months
- 50% euthanized due to lack of regression
- LN metastasis–> no regression
What are the markers for reactive histiocytosis?
CD1a, CD11c, MHC class II, Thy-1 (CD90), and CD4 but NEGATIVE for E-cadherin.
Histiocytoma is NEGATIVE for Thy-1 and CD4 but POSITIVE for E-cadherin
CD1a, CD11b, CD11c, MHC class II can only be done on fresh smears or snap-frozen tissues.
What cell type or cytokine is thought to mediate the regression of cutaneous histiocytoma?
CD8+ T-cells
Which Tumor Suppressor gene most commonly mutated with HS?
CDKN2A/B
Also RB1 and PTEN
Why is p53 often present in high concentrations in tumors that carry mutant, defective p53 alleles?
Mutant p53 loses its transcription activating powers, unable to induce Mdm2 transcription. In the absence of Mdm2, p53 escapes degradation and accumulates.
Genetic instability in patients with hereditary nonpolyposis colon cancer occurs because of a deficiency in which DNA damage repair pathway?
Mismatch repair (MMR)
What is the definition of Linear Energy Transfer?
The average energy lost by a particle over a given track length.
What % of dogs with MCT had GI ulceration on necropys?
35 - 83%
Prognosis for dogs with MCT with bone marrow involvement?
43d
What are the markers for MCT?
vimentin (+), CD117+, chymase, MCP-1, IL-8
What % of tissue shrinkage will occur for cutaneous tumors following formalin fixation?
30%
What is the ORR for Paccal Vet for canine MCT?
59%
Negative prognostic indicators for feline splenic MCT?
Anorexia, significant weight loss, and male gender.
What are the top 3 most common intestinal tumors in the cat?
1) Lymphoma
2) Adenocarcinoma
3) Mast cell tumor
Tumor cells located further than approximately ___um from vessels experience “diffusion-limited” hypoxia as oxygen is consumed by the tumor cells more proximal to the vessels.
100um
Tannock pg. 278 (5th edition, newer edition says 150um)
What are some of the markers of Cancer stem cells?
CD34 - AML
CD44 - Breast Cancer
CD133 - Glioma
Dogs with MM caudal to PM3 are ____ times more likely to die from tumor related causes compared to dogs with tumors rostral to PM3.
4.3
Dogs with incomplete histo margins 3.6 x more likely to die of tumor-related causes.
What percentage of dogs with digital melanoma are reported to have metastasis at the time of diagnosis?
30 - 40%
What is the MST of dogs with melanoma of the digit without lymph node or distant metastasis treated with digit amputation?
12 months
What % of dogs with oral malignant melanoma will experience a complete remission when treated with RT?
51 - 69% (up to 70% according to new Withrow)
ORR = 82 - 94%
Dogs with tumors <5cm^3 were more likely to achieve a CR
What % of dogs with normal size lymph nodes and OMM had LN mets?
40%
What % of dogs with oral melanoma treated with RT will develop bone necrosis?
8%
What is the local recurrence rate of dogs with microscopic disease of oral melanoma after incomplete surgical resection and radiation therapy?
26%
vs. 45% for those treated with RT in macroscopic disease setting.
What are the local recurrence rates for mandibulectomy and maxillectomy of OMM respectively?
22% = mandibulectomy
48% = maxillectomy
MST with surgery alone = 150 - 318d, with 1-year survival <35%
Melanoma typically is considered to have a high or low alpha beta ratio?
LOW- higher dose/fraction
Tumors that may have a lower a/B ratio include melanoma, prostatic tumors, STS, TCC, and OSA.
Withrow pg. 183 (2013)
In a study of 5 cats treated with RT for oral melanoma, what was the ORR and MST?
ORR = 60%, MST = 146d
One cat treated with carbo, one with carbo + mito, one with melanoma vaccine.
What is the sensitivity and specificity for Ki67 >19.5% to identify tumor related death due to OMM at 1- year?
Sensitivity = 87% Specificity = 85%
White cats in California are ___ times more likely to develop SCC
13.4
When PCR is used to amplify papillomavirus DNA, up to what % of UV-protected SCC are positive?
76%
42% in SCC in regions exposed to UV radiation.
What breeds are associated with multiple digital SCC?
Large breed dogs with black skin and haircoat: Standard Poodles, Black Labradors, Giant Schnauzers, Gordon Setters, Rottweilers. +/- Dachschund, flat coat retriever.
Which breed is predisposed to digit melanoma?
Scottish Terriers
What is the reported disagreement rate between pathologists when evaluating digital masses?
20%
What % of canine SCC were positive for p53 overexpression?
30%
47.5% in feline SCC.
What mutation was found with 100% of trichoepithelioma and pilomatricomas?
B-catenin
What % of canine and feline SCC were + for cyclin A?
44% canine
90% feline
Cyclin D was rarely expressed in skin tumors of any type.
Which marker is highly specific for BCC and helps to differentiate it from SCC or cystic-solid ductular tumors in the diagnosis of BCC in humans?
BerEP4
+/- Cytokeratin 8
Which breeds are at increased risk for BCC in one study?
Cocker Spaniels, Poodles
What are the 3 histo subtypes of BCC?
Solid, keratinizing, clear cell
Which drug has been shown to be effective in treating multiple papillomas?
Azithromycin
What is the name for when SCC in situ appears in multiple sites?
Bowen’s carcinoma or
Bowenoid carcinoma in situ (BISC) OR
Multicentric papillomavirus-induced SCC.
What is the name used for SCC in situ that arises as a consequence of UV exposure?
Actinic keratosis
Occurs in lightly haired skin with UV exposure, can occur as a solitary lesion. It is typically accompanied by solar elastosis and fibrosis of the skin, consistent with the effects of chronic UV exposure.
Highly positive for p53 expression compared to BISC.
Which chromosome and gene is the effector transcription factor of hedgehog signaling cascade and has been reported to be associated with canine basal cell carcinoma?
Chromosome 10, GLI1 gene.
What % of dogs with digital SCC have bone lysis on radiographs?
80%
8.8% have metastasis at presentation, 23.2% eventually develop metastasis
What are the 2 immunosuppressive molecules expressed by T-reg cells and activated T-cells and are the targets of check point inhibitors?
CTLA-4 and PD-1
Mechanism of action of Imiquamod?
Activates TLR7
Has been used to treat BISC in 12 cats, 42% CR.
What % of grade III PNST will invade the spinal cord?
50%
What % of dogs develop recurrence following hypofractionated RT for incompletely excised STS?
21%
What histologic subtype of rhabdomyosarcoma has a predilection for the urinary bladder in young, female, large-breed dogs?
Botryoid
St. Bernard possibly overrepresented. Grapelike appearance. In humans alveolar histotype has the worst prognosis and botryoid has the best.
What % of dogs with GI leiomyosarcoma will have intestinal perforation with localized to diffuse peritonitis?
50%
50% metastatic rate.
What is the signalment and location most commonly seen with GI Leiomyoma?
Male predisposition, predilection for the stomach.
Three paraneoplastic syndromes seen with GI leiomyoma and leiomyosarcoma?
1) Hypoglycemia
2) Nephrogenic Diabetes Insipidus
3) Secondary erythrocytosis
Which histologic type of Liposarcoma has the highest metastatic rate? Options are: well-differentiated, myxoid, poorly differentiated (round cell), pleomorphic, or dedifferentiated.
Pleomorphic
What are the IHC that help differentiate Lymphnagiosarcoma from Hemangiosarcoma?
LYVE-1 and PROX-1
MST of Liposarcoma with wide excision?
1188 days
MST of Liposarcoma with marginal excision?
650 days
MST of dogs with GIST or Leiomyosarcoma with metastasis?
21.7 months (37.4mo. without)
However other reports found metastasis significantly decreases survival time to much less than 21.7 mo
MST for dogs with splenic leiomyosarcoma
8 months
In one retrospective study of dogs with incompletely resected STS who underwent re-excision, how many had histologic evidence of residual tumor?
22%
What is the recurrent rate for grade II incompletely excised STS?
34% (7% for grade 1 and 75% for grade III).
Cumulative doses higher than ____ Gy are recommended for incompletely excised STS and local tumor control is better with higher cumulative doses.
50 Gy
What is the median time to local recurrence for STS in dogs?
1 year (368 days)
In a study of 39 dogs with incompletely excised STS treated with orthovoltage and doxorubicin as a radiation sensitizer, what MI was associated with higher risk of local tumor recurrence and shorter survival time?
Mitotic rate greater than 9/10 HPF
What is the median time to metastasis for dogs with STS?
1 year (365 days)
What is the MST for dogs with STS MI > 20?
236d (5x more likely metastasis, 2.8x more likely tumor-related death.
What are some of the markers for FISS?
PDGFR, EGF, TGF-B, C-jun, p53
What % of cats with FISS will have grade 3 tumors?
60% (only 5% grade 1)
What is the bluish-gray foreign material that has been identified in the macrophages in peripheral inflammatory cell infiltrates associated with FISS?
Aluminum and oxygen
Aluminum hydroxide is one of several adjuvants used in currently available feline vaccines.
With FISS, how much does the volume of tumor increase based on contrast-enhanced CT compared to calipers on physical exam?
TWICE
What % of FISS will recur following surgery and RT?
28 - 45%
Hi-Low oral FSA tends to occur in what anatomical location?
Hard palate and maxillary arcade between the canine and carnassial teeth.
Large-breed dogs.
How much of the cortex needs to be destroyed before bone lysis is evident on radiographs?
40%
What is the overall reported metastatic rate for MTB?
58%
Which breeds is canine oral eosinophilic granuloma suspected to be heritable in?
Siberian husky and Cavalier King Charles
What is the MST of dogs with oral melanoma <2cm with no evidence of metastasis treated with surgery?
511 days
What are 3 main negative prognostic indicators for dogs with oral melanoma?
1) Non rostral location
2) Bone lysis
3) Macroscopic disease
No risk factors MST = 21 months,
1 risk factor MST = 11 months
2 risk factors MST = 5 months
All risk factors MST = 3 months
What is the most common location for Oral SCC in dogs?
Rostral mandible
What paraneoplastic syndrome has been reported with Spirocerca lupi associated esophageal sarcoma?
Hypertrophic osteopathy
Usually affects the caudal thoracic esophagus, can be associated with thoracic spondylitis, microcytic hypochromic anemia and a neutrophilia.
Which test may aid in the diagnosis of spirocerca lupi associated esophageal sarcoma?
Fecal flotation test
Loss of which protein expression is associated with pancreatic carcinoma (especially poorly differentiated)
Claudin-4 and Claudin-5
Which breeds are predisposed to gastric cancer?
Belgian shepherds
Norweigian lundehunds
Dutch Tervueren shepherds
Males more commonly affected
Which tumor has been reported to metastasize to the testes?
Gastric and intestinal adenocarcinoma
What is the reported rate of metastasis at necropsy for Gastric Adenocarcinoma?
70 - 80%
Where do gastric leiomyomas occur most commonly?
Cardia
Where do gastric adenocarcinomas most commonly occur?
Lesser curvature and Pyloric antrum
What % of dogs with HCC have additional tumors?
20%- most were benign and endocrine in origin.
Which signalment may be overrepresented for HCC?
Male, Miniature Schnauzers
What is the metastatic rate for massive HCC?
0 - 37%
What cells do neuroendocrine tumors arise from?
Neuroectodermal cells
What histochemical stain is used to differentaite neuroendocrine tumors (carcinoids) from carcinomas?
Silver stain
Withrow pg. 407
What is the most common type of primary liver sarcoma in dogs? cats?
Dogs = Leiomyosarcoma Cats = Hemangiosarcoma
Which tumor can be identified with the Grimelius histochemical stain?
Neuroendocrine tumor (Pascual’s, Grimelius, Sevier-Munger)
What % of dogs and cats undergoing liver lobectomy require blood transfusion?
Dogs = 17% Cats = 44%
Hanson et. al JAVMA 2017
Which cat breed is 8x more likely to develop intestinal adenocarcinoma?
Siamese
Most commonly reported signalment for Intestinal MCT in the dog?
Male Maltese
Which tumors are most likely to develop in the cecum?
Leiomyosarcoma or GIST
What cells do GIST arise from?
Multipotent stem cells phenotypically similar to Interstitial cells of Cajal
What % of previously diagnosed leiomyosarcomas in the dog were reclassified as GIST using IHC for CD117/KIT?
66%
and only 7% of GIST metastasized.
Where do leiomyomas most commonly occur?
Stomach
Which tumor was reported in association with paraneoplastic alopecia and Cheyletiella infection?
Intestinal carcinoma with abdominal carcinomatosis
What paraneoplastic syndrome is seen in dogs and cats with intestinal T-cell lymphoma? What is the proposed cause?
Hypereosinophilia and eosinophilic tumor infiltrates.
Suggested cause is IL-5 secretion by the neoplastic lymphocytes
Which GI tumor was associated with a paraneoplastic syndrome of erythrocytosis and erythropoietin mRNA protein production by tumor cells?
Cecal Leiomyosarcoma
What clinicopathologic abnormality is detected in up to 85% of cats with nonlymphomatous intestinal tumors?
Elevated ALP
What paraneoplastic syndrome has been reported in dogs with rectal tumors?
Neutrophilic leukocytosis
What breeds may be predisposed to perianal adenoma?
Cocker Spaniels, Beagles, Bulldogs, and Samoyeds.
Which breed may be predisposed to anal sac adenocarcinoma?
English Cocker Spaniel
In male dogs–> neutering may increase risk.
What is the rate of metastasis for Perianal Adenocarcinoma?
15%
Possibly occurs later in the course of disease?
What is the overall incidence of bilateral anal sac adenocarcinoma (either simultaneous or temporally separated)?
14%
What is the overall incidence of hypercalcemia with AGASACA?
27%
In a study of dogs with splenic mass based on body weight, which were more likely to be diagnosed with HSA?
> 27.8kg
What is the most common immunophenotype for canine chronic lymphocytic leukemia?
CD8+ T cell
What % of normal lymphocytes are CD8+ T cell?
25 - 35% (compared to 5 - 20% for B-cell)
Which bacterial infection can result in expansion of a phenotypically homogenous population of lymphocytes, making it difficult to distinguish from neoplasia?
E canis- expansion of CD8+ T cells that have LGL morphology
Anne Avery, VCP 2004, Molecular methods to distinguish reactive and neoplastic lymphocyte expansions
Which molecular test has been developed to identify differences between chromosomes in different cells by detecting amplifications or deletions of segments of DNA (eg. gains and losses in chromosome number)?
Comparative Genomic Hybridization
Which assay is most often used to identify HER2 status of breast cancers and N-myc amplification in neuroblastoma?
FISH
After a certain number of population doublings cells undergo senescence and cease dividing although generally retaining viability. This is referred to as ______?
The Hayflick Limit
What is the name of the statistical adjustment that helps alleviate the risk of detecting a difference due to chance alone (type I error) when analyzing large numbers (eg. 10,000 genes in 20 patients) by dividing the threshold p-value by the number of tests to be performed?
Bonferroni correction
What is the name of the statistical adjustment that controls the percentage of tests that will be expected to be false-positives and provides an adjusted p-value (q-value)?
False-discovery rate
What is the name for the descriptive epidemiology term that refers to the number of new cases of a disease observed in a defined population in a specific time period divided by the population size?
Incidence rate
What is the name for the descriptive epidemiology term that refers to the number of deaths caused by the disease during a specific time period divided by the population size?
Mortality rate
Which term is used to describe the number of deaths caused by a specific disease in a defined population divided by the number of individuals who have been diagnosed with that particular disease, in a fixed time interval?
Case fatality rate
What is the term used to describe the proportion of a population that has a disease at a specific time point, (cases divided by population size) where cases include both new cases of disease and the number of previously diagnosed cases who are still alive in a population?
Prevalence
Prevalence is affected by the mortality of the disease, for example: although lung cancer is one of the most common cancers, its prevalence ranks lower then that of prostate or breast cancer because lung cancer is such a lethal disease. Cancer incidence may better reflect how commonly cancer develops in a population.
What is the term used to describe the risk in a group exposed to a potential disease-related factor and compares it to the risk in a group that is not exposed (or has lower exposure) to the factor.
Relative Risk
What is the most probable cellular outcome following DNA damage?
Repair of the damage by DNA repair enzymes
During which phases of the cell cycle does Homologous End recombination work?
S and G2
In which type of DNA repair is BRCA1 and BRCA2 important?
Homologous end recombination
Which DNA repair pathway typically suppresses micro-satellite instability?
Mismatch Repair (MMR)
Mutations in MMR associated with Hereditary Nonpolyposis Colon Cancer typically causes micro-satellite instability.
Which phosphorylated protein has been shown to be a reliable surrogate marker for DNA double strand breaks (DSBs) in cells?
Histone yH2AX
RAD52 is associated with which DNA repair pathway?
Homologous recombination
KU70/80 proteins are associated with which DNA repair pathway?
Nonhomologous end joining (NHEJ)
What is the approximate agreement rate between MRI and CT for staging dogs with nasal tumors?
5/6 were in agreement (83%)
Though MRI resulted in a higher tumor volume (median 18%) in 5/6 dogs and greater likelihood of detecting meningeal involvement.
Which cytokine is believed to be involved in inducing radiation fibrosis?
TGF-B
Which 2 rare paraneoplastic diseases have been reported with nasal tumors in dogs?
Erythrocytosis and hypercalcemia
Bilateral carotid artery ligation can palliate the symptoms in dogs with nasal tumor related epistaxis for up to ____ months or longer.
> 3 months.
What % of dogs will develop late effects when treated with SRT for nasal tumors?
30 - 40%
What is the most common lung tumor in dogs?
Bronchoalveolar carcinoma (85%)
What is the most common lung tumor in cats?
Adenocarcinoma (60 - 70%)
What % of canine pulmonary malignant tumors had evidence of local vascular or lymphatic invasion?
71%
What % of dogs with pulmonary tumors have tumors found in multiple lung lobes?
37.1%
What percentage of cats with primary lung tumors show GI signs on presentation
20%
What % of cats had evidence of pulmonary metastasis of primary pulmonary tumor on CT?
53%
Which of the following chemotherapy protocols has proven to have a greater than 50% reduction in gross pulmonary adenocarcinoma in dogs?
Vindesine + cisplatin
What is the complication rate for CT guided lung biopsy?
43% (pulmonary hemorrhage and pneumothorax)
Which mutation has been identified in p53 of canine OSA?
Missense mutation of exons 4 - 8 in 25 - 47%
Which antibiotic has been shown to reduce canine OSA cell viability in vitro?
Enrofloxacin- regardless of p53 mutational status or downstream activity.
What is the metastatic rate of OSA affecting the head (mandible, maxilla, and skull)
37%
What is the MST for rib OSA following rib resection with and without chemotherapy?
Rib resection alone = 3 months
Rib resection + chemo = 8 months
What is the MST for OSA of the canine scapula treated with subtotal scapulectomy surgery and chemotherapy?
8.2 months (246 days) (DFI = 210 days)
What is the MST of OSA distal to the antebrachiocarpal or tarsocrural joints?
MST = 466 days = 15.5 months
What is the MST for vertebral OSA treated with surgery, RT and chemo?
4 months (8.7 mo. in another study)
Sx alone = 42 days
Sx + chemo = 82 days
Dixon et. al 2019 VCO
What is the MST for mammary gland OSA treated with surgery alone?
3 months. Most died of pulmonary metastasis (62.5%)
What gene mutation has been detected in BMD with histioctyic sarcoma?
PTPN11 (MAP Kinase pathway)–> 36.67%
In a study by Barrett et. al VRU 2014, what % of dogs with histiocytic sarcoma with pulmonary involvement had internal air bronchograms?
57% (12/21)
In a study by Barrett et. al VRU 2014, which lung lobes were most commonly affected by HS?
Right middle and left cranial
In a study by Marlowe et al 2018 VCO regarding primary pulmonary HS in dogs, how many were found incidentally?
25%
What are the 4 negative prognostic indicators with HS?
Anemia, thrombocytopenia, splenic involvement, hypoalbuminemia.
Which region of bone is most suitable for limb spare?
Distal radius and ulna
–> Because function following carpal arthrodesis is good
Which anatomical location for OSA is typically seen in young dogs (mean age 4.5 - 5.4 years)?
Rib
What type of fluid should be given for diuresis with cisplatin and why?
NaCL
Because in a low chloride environment such as urine, cisplatin undergoes aquation and attacks renal epithelium. Maximizing chloride content with NaCl will help reduce aquation and thereby prevent renal damage.
What is the mechanism of action of bisphosphonates?
Inhibits Farnesyl diphosphate (FPP) synthase. FPP prenylated proteins are required for osteoclast function and survival.
What is the MST for dogs with telangiectatic OSA (confirmed via IHC) undergoing surgery +/- chemotherapy?
7 months (213 days)
What percentage of telangiectactic osteosarcomas were reclassified to hemangiosarcoma after IHC with factor VIII-RA/vWF?
21%, typically from an original diagnosis of tOSA to a reclassified diagnosis of HSA (11%).
Which type of OSA carries the best prognosis?
Parosteal
Primary appendicular HSA primarily affects which bone?
Tibia
What disease is commonly associated with MCE in cats?
FeLV/FIV
What is the MST of cats with OSA treated with surgery alone?
24 - 44 months
Low metastatic rate (5 - 10%) so chemotherapy not recommended.
NF-kB is inactivated and sequestered in the cytoplasm by?
IkB
Nf-kB is made up of which 2 proteins?
RelA (p65) and p50