GI Flashcards by Bushra Zaidi

Blackwood et al. 2018. External beam radiotherapy for the treatment of feline salivary gland carcinoma: six new cases and review of the literature

5 tx with surgery but 4 had gross disease (primary or metastatic) at time of starting RT

1 cat - 766 days

3 cats - 55 days, 258 days, 570 days

2 cats PD - 206 and 549 days

No cats died of distant metastatic disease

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Cray et al. 2019. Salivary neoplasia in dogs and cats: 1996-2017

56 dogs and 24 cats with salivary neoplasia

What was the incidence of salivary neoplasia?

Risk associated with sez or neuter status?

Feline breed predisposition?

Canine breed predisposition?

15.3 per 100,000 in dogs and 26.3 per 100,000 in cats

None

Poodles (toy and standard) compared to mixed breeds

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Arnell et al. 2012. Persistent regurgitatioon in 4 dogs with caudal esophageal neoplasia

All dogs presented with what clinial sign?

How many dogs had megaesophagus?

In all dogs, diagnostics revealed?

Regurgitation

3/4

Caudal esophageal mass casuing esophageal obstruction and all lesions were neoplastic

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Kirberger et al. 2015. Triple phase dynamic CT perfusion characteristics of spirocercosis induced esophageal nodules in non-neoplastic versus neoplastic canine cases

CT would be better to discrimitae non-neoplasitc and neoplastic nodules

Non-neoplastic nodule appearnce?

Perfusion of nodules?

What phases was the most difference noted?

Smooth and non-mineralized with higher proportion of hypoattenuating necropurulent cavities compared to neoplasitc

More irrgular with 93% minearlized and rare hypoattenuating pockets

Non-neoplastic more perfused

Early and late arterial phases

Hypoperfusion of esophageal sarcomas

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Shipov et al. 2015. Long-term outcome of transendosopic esophageal mass ablation in dogs with spirocerca lupi-associated esophageal sarcoma

15 dogs included

Median tumor size?

Median procedure time?

Success?

Complications?

MST?

5 cm

75 mins

12/15 (80%)

Esophageal damage (2), esophageal perforation (1), focal thermal damage (1)

202 days - 4 survived >6 months and 3 >1year

Comparable long term survival, lower mobidity, and short hospitalization - alternative to open-chest surgery

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Marolf et al. Comparison of endoscopy and sonography findings in dgos and cats with histologically confirmed gastric neoplasia

17 dogs and 5 cats

Identification on US and endoscopy?

Most common missed tumor on US?

Agreement between US and endoscopy?

Animals with sonographically normal SI had greater probability of?

Diagnosis in cats?

50% US and 95% endoscopy

LSA

36% cases

Gastric neoplasia

LSA

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Riondato et al. 2014. Diagnosis of canine gastric adenocarcinoma using squash preparation cytology

Determine if cytology might be useful for diagnosis of gastric ACA

Squash preparation from 94 dogs

4 cytologic features associated with diagnosis?

2 features associayed with excellent reults for diagnosis?

Signet rings, microvacuolation, cellular pleomorphism and single cell distribution were associated with diagnosis

Signet ring cells and microvacuolation

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Seim-Wikse et al. 2014. Tumor gastrin expression and serum gastrin concentrations in dogs with gastric carcinoma are poor diagnostic indicators

Hypergastrinemia occurs in human patients and is associated with atrophic gastritis and H. pylori infection - predisposes to gastric tumors

64 dogs with carcinoma and 7 healthy dogs, gastrin expression noted by IHC

Expression in tumor tissue?

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Gustafson et al. 2014. A retrospective study of feline gastric LSA in 16 chemotherapy treated cats

What % experienced remission?

First remission duration?

What was prognostic?

What else was noted to be prognostic?

75%

108 days

Response to treatment as with other LSAs

Sex and treatment with rescue protocol were prognostic in castrated males having longer survivals than spayed females

Cats that received rescue therapy has shorter first remission durations that those that did not

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Pellegrino et al. 2018. Canine GI spindle cell tumors efficiently diagnosed by tissue microarray-based IHC

What the specificity and sensitivity of TMA for a-SMA?

Desmin?

CD117?

100% and 94%

100% and 80%

100% and 100%

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Tanaka et al. 2018. Contrast-enhanced CT may be helpful for characterizing gastric tumors

16 dogs

CT attenuation for LSA?

Lymphadenopathy for LSA, ACA, leiomyoma?

LN measurements for LSA versus ACA?

Lower than other gastric tumors in the early and delayed phase

Widespread in LSA and regional in ACA, none with leiomyoma

Larger for LSA

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Maeda et al. 2016. Changes in Foxp3-regulatory T cell number in the intestine of Dogs with Idiopathic IBD and intestinal LSA

IBD 48 dogs and LSA in 46 dogs, 25 healthy dogs

Expression of Foxp3 positive lamina propria cells and IL-10 mRNA?

Foxp3-positive intraepithelial cells?

Which cells were noted to express Foxp3?

Overall survival with regards to Treg density in dogs with small cell intestinal LSA?

Significantly lower in dogs with IBD than in healthy dogs and dogs with LSA

Higher in dogs with small cell intestinal LSA

CD3+ and granzyme B negative helper T cells

Overall survival in dogs with high Treg density was worse than dogs with normal density

Treg contributes to pathogensis of canine IBD and intestinal LSA by disrupting mucosal tolerance and suppressing antitumor immunity

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Carrasco et al. 2015. Distinguising intestinal LSA from inflammatory bowel disease in canine duodenal endocopic biopsy samples

Endoscopic biopsies from 32 dogs with severe IBD or intestinal LSA

Was EATL-1 (large cell) or EATL-2 (small cell) more common?

ki67 expression?

6/8 were EATL-1, EATL was uncommon

Higher in EATL-1 than EATL-2 or IBD

Stepwise approach using histology as first step, tthen immunophenotyping and determine Ki67 index finally PCR for clonality improves accuracy for distinguishing intestinal LSA from IBD in dogs

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Ohmura et al. 2017. Detection of monoclonality in intestinal LSA with PCR for antigen receptor gene rearrnagement to differentiate from enteritis in dogs

Assessed clonality in 29 canine intestinal LSA, 14 enteritis, 15 healthy control cases using PARR

Monocloncal rearragements in intestinal LSA?

Polycloncal rearrangement?

Phenotype?

22/29 (76%)

100% in enteritis and healthy control

T-cell phenotype predominated compared to B (85%)

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Maeda et al. 2017. Endoscopic cytology for the diagnosis of chronic enteritis and intestinal LSA in dogs

167 dogs with chronic GI disease

What was the agreement between cytology and histology?

What was the sensitivity and specificity associated with endoscopic cytology? PPV? NPV?

Results of cytology predicted the prognosis

81%

98.6% and 73.5%, 72.3% and 98.6%

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Aberdein et al. 2012. Widespread mismatch repair expression in feline small intestinal LSA

MLH1, MSH2, and MSH6 were detected in noeplastic lymphocytes in all tumors

No difference in expression in younger cats or older cats

Inherited germline MMR defects are not a cause of feline small cell intestinal LSA

Swanson et al. 2012. Expression of the Bcl-2 apoptotic marker in cats diagnosed with IBD and gastrointestinal LSA

Bcl-2 degree of expression in cats with GI LSA vs. IBD?

Higher expression in cats with LSA (90%) than IBD (60%)

Positive immunolabeling tended to be high in both

Bcl-2 may be a therapeutic target for IBD and GI LSA

Lalor et al. 2014. Cats with IBD and intestinal small cell LSA have low serum concentrations of 25-hydroxyvitamin D

23 healthy group, 41 hospitalized ill group, 20 in IBD/intestinal small cell LSA

Serum 25(OH)D concentrations?

Significantly lower in cast with IBD and ISCL compared to healthy cats ans hospitalized ill cats

In the IBD/ISCL there was significant moderate positive correlation between serum albumin and 25(OH)D concentrations

Sabattini et al. 2016. Feline intestinal mast cell tumors: clinicopathological characterisation and KIT mutation analysis

10 tumors in small intestine, 2 ileocaecolic junction, and 5 large intestine

Survival times?

6 well differentiated, 6 moderately, and 3 poorly

Which had higher mitotic index and ki67 indexes?

What was associated with survival time?

12 cases had kit expression - kit pattern?

3-538 days

Poorly differentiated

Tumor degree of differentiation and mitotic index were signifcantly assciated with decreased survival time

Membranous (33%), focal paranuclear (33.3%), and diffuse cytoplasmic (13.3%)

Jugan et al. 2017. Serum cobalamin concentrations and small intestinal ultrasound changes in 75 cats with clinical signs of GI disease: a retropsective study

Small intestinal US changes noted in?

4 abnormalities noted on US?

Serum cobalamin <500ng/l?

Difference in cobalamin concentrations?

Difference between cobalamin concentrastions and US abnormalities?

65%

Thickening, loss of layering, echogenicity alterations, discrete masses

Observed in inflammatory disease, neoplasia, infectious disease and normal histopathology

Significantly lower in cats with LSA or inflammatory disease than with other GI neoplasia

None were found

Sabattini et al. 2016. Differentiating feline IBD from alimentary LSA in duodenal endoscopic biopsies

4 different diagnostic methods (cytology, histology, IHC, clonality) applied to 77 cases of feline chronic enteropathy

On mutivariable analysis, which diagnostic method was associated with poor survival?

By comparing the other tests of clonality, what was the specificity and sensitivity for cytology, histology, and IHC?

Accuracy for cytology, histology, and IHC?

Clonality

specificty 87-97% and sensitivity 36% for cytology, 39.5% for histology, and 63.2% for IHC

62.3, 68.8%, 80.5%

Hoehne et al. 2017. Identification of mucos-invading and intravscular bacteria in feline small intestinal LSA

Mucosa invasive bacteria were more frequent in?

Intravascular bacteria were observed in?

Serosal colonization?

Cats with large cell LSA (82%) than small cell LSA (18%)

Solely in larger cell LSA (29%)

More common in large cell LSA (57%) than small cell LSA (11%)

High frequency of invasive bacteria with large cell LSA may account for sepsis related cimplication

Berger et al. 2018. Retrospective evaluation of toceranib phosphate use in treatment of GIST tumors in dogs

27 dogs

Clinical benefit in 7 dogs with gross disease?

Median PFI in dogs with gross disease

Median PFI in dogs with microscopic disease

What was associated with shorter PFI?

5/7 (71% 3CR, 1PR, 1SD)

110 weeks

67 weeks

Metastasis at diganosis and high mitotic index

Ohta et al. 2013. Expression of CD4+ T cell cytokine genes in the colorectal mucosa of inflammatory colorectal polyps (ICRPs) in miniature daschunds

Major cause of large bowel diarrhea in Japan

10 dogs with ICRPs and 14 control dogs

What was increased in large polyps compared to small polyps and controls?

IFNg and IL-10 mRNA

IL-4 mRNA

IL-17A mRNA

Significantly higher in larger polyps compared to controls

No difference in 3 groups

IL-17A is though to play role in pathogenesis of ICRP. IL-10 could oppose the proinflammatory function of IL-17A

***Nucci et al.* Complication and outcomes following rectal pull through surgery in dogs with rectal masses: 74 cases** How many developed post-surgical complication? Most commmon complication and incidence? How may developed permanent incontinence? Other complication? Rectal tumor recurred? MST for all dogs and dogs with malignant tumor? The 2 most common malignant tumors? MST

58%, fecal incontinence (56.8%) 54.8% diarrhea (32), tenesmus (23), stricture (16), rectal bleeding (8) constipation (7) dehiscence (6), infection (4) 10 dogs 1150 days (3 yr) for all dogs and 726 days (2 yr) for dogs with malignant tumor Rectal carcinoma and rectal carcinoma in situ - 696 (1.9 yr) and 1006 (2.7 yr) days

***Tamura et al. 2013.* Markedly increased expression of IL-8 in the colorectal mucosa of inflammatory colorectal polyps in miniature daschunds** Which cytokine was upregulated in large polyps? Protein expression of the upregulated cytokine? Where was it localized?

IL-8 mRNA Increased in large polyps and serum of dogs with ICRP Localized in macrophages but not mucosal epithelial cells or neutrophils IL-8 positive macrophages were increased in larger polyps compared to controls **Suggest IL-8 is produced mainly by macrophaes and may induce neutrophil infiltration in colorectal area of ICRP dogs**

***Igarashi et al. 2014.* Expression profiling of pattern recognition receptors and selected cytokines in miniature daschunds** TLR1, 2, 4, 6, 7, 8, 9, 10, NOD2 and all cytokines were elevated in polyps compared to controls Significant decrease in TLR3 and NOD1 in polyps tissue May play a role in pathogenesis of disease

***Arteaga et al. 2012.* A review of 18 cases of feline colonic ACA treated with subtotal colectomies and adjuvant carboplatin** 18 cats Median carbo dose 200 mg/m2 4wk with median of 5 doses/cat Toxicities? Positive prognostic factors? Negative prognostic factor? Median DFI? MST?

Limited Weight loss as presenting signs nodal and distant metastasis 251 days (8.3 mo) , 269 days (9 mo)

***Youmans et al. 2012.* Frequent alteration of the tumor suppressor gene APC in sporadic canine colorectal tumors** Sporadic canine clorectal cancers (CRCs) make models for studying human cancers APC (adenomatous polyposis coli) was significantly mutated gene in both canine adenomas and ACAs among 11 genes Large deletions of \>10 bases and single to 2 base deletions in 70% canine tumors Suggests APC is aletered in sporadic colorectal tumors

***Adamovich-Rippe et al. 2017.* Colonoscopic and histologic features of rectal masses in dogs: 82 cases** Rectal masses that underwent colonoscopy Multiple masses observe in? Diagnosis? Complication?

6 of 82 dogs, no lesions visualized orad to the colorectal junctions Epithelial neoplasia in 58/64 - 71% benign adenoma or polyp and 29% ACAs 3/82 dogs **Multiple lesions are uncommon in dogs**

***Van den Steen et al. 2012.* Rectal LSA in 11 dogs: a retrospective study** Chemotherapy treatment consisted of either low dose COP (4 dogs) or 6-week CHOP protocol (4 dogs) Difference in survival between dogs that got chemo and didnt? MST? Mean survival? Immunophenotype?

2352 (6.4 yr) vs. 70 days (2.3 mo) Not reached, 1697 days (4.6 yr) B cell in 10 that had IHC performed, 1 didnt have IHC

***Saito et al. 2018.* Histopathologic feactures of colorectal adenoma and ACA developing between inflammatory polyps in Miniature Daschund** Number of beta-catenin positive nuclei was higher in adenoma (46%) and ACA (75%) compared to inflammatory polyp (6%) Normal epithelial cells and hyperplastic goblet cells in inflammatory polyp showed homogenoeus positive cytoplasmic reactivity for APC antigen Aberration in beta-catenin and APC may be involved in tumor development

***Frances et al. 2013.* Sonographic features of GI LSA in 15 dogs** How many exhibited no abnormalities? What were the abnormalities when noted on US? Clinical signs? Intestinal obstruction?

4/15 (26.7%) Intestinal wall thickening, absence of wall layering Not realiable markers of GI LSA with weight loss, vomiting, diarrhea being uncommon presenting complaints Not present in any case

***Hobbs et al. 2015.* Ultrasonographic features of canine GIST compared to other GI spindle cell tumors** 37 dogs - 19 GISTs, 8 leiomyosarcoma, 6 leiomyomas, 4 unspecified sarcomas GISTs were significantly associated with? Location of GIST?

Abdominal effusion - suspect due to septic peritonitis Cecum most common location

***Gress et al. 2016.* Characterization of the T-cell receptor gamma chain gene rearrangements as an adjunct tool in the diagnosis of T cell LSA in GI tract of cats** Improved quantity and quality of extracted DNA

***Barrett et al. 2017.* Outcome following treatment of feline GI MCTs** 31 cats Mean age? Diagnosis made how? Metastatic sites? Most commonly used drugs? Overall MST?

12.9 years Cytology (15), histopath (13), both (3) Abdominal LN (10), abdominal viscera (4), both (2) Lomustine (15) and chlorambucil (12) 531 days Surgical and medical tx (including prednisolone) were associated with prolonged survival times

***Hayes et al. 2013.* Classification of canine nonangiogenic, nonlymphogenic, gastrointestinal sarcomas based on microscopic immunohistochemical and molecular characteristics** Eighteen (45%) were classified as GISTS based on positive KIT. All were positive for vimentin, (78%) were positive for S-100. and 6 (32%) for SMA Occured mainly in small intestine (67%) but commonly metastasized (5/18) liver, LN, omentum 6 had an activated KIT mutation exon 11 Leiomyosarcomas positive for SMA and negative for KIT - poorly differentiated strong vimentin and well diffentiated weak to negative for vimentin None metastasize

**Dailey et al. 2015. DOG1 is a sensitive and specific immunohistochemical marker for diagnosis of canine GIST** \_\_\_% were diagnosed as GIST based on KIT or DOG1 \_\_\_% of GIST had similar staining patter for both KIT and DOG1 DOG1 has improved specificity and sensitivity to that of KIT

60% 97%

***Takanosu et al. 2016.* Analysis of c-kit exon 11 mutations in canine GIST** Mutations detected in exon 11 of c-kit by PCR? Mutations detected in exon 11 of c-kit by RT-PCR? 10 different mutation, inclusing deletion, internal tandem duplication and point mutations KIT staining was detcted in 70% and partial or stippled cytoplasmic staining of KIT was observed (30%) - Neither pattern was associated with c-KIT exon 11 mutation status

32. 6% 73. 9%