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Onco Board Review 2 > Histiocytic > Flashcards

Histiocytic Flashcards

1
Q

IHC markers for cutaneous histiocytoma?

A

E-cadherin

CD1a+, CD11c+, MHCII+. CD4-, Thy1/CD90-, Ecad+
Langerhans cells

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2
Q

IHC markers for histiocytic sarcoma?

A

CD1+, CD11c+, MHCII+, CD4-, Thy1-, Ecad-
Differentiate from histiocytoma because Ecad-
Also Iba1
(Interstitial DC)

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3
Q

IHC markers for cutaneous histiocytosis?

A

CD1+, CD11c+, MHCII+, CD4+, Thy1+

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4
Q

IHC markers for systemic histiocytosis?

A

CD1-, CD11c+, MHCII+, CD4+, Thy1+

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5
Q

IHC markers for hemophagocytic histiocytic sarcoma?

A

CD1 (low), CD11c-, CD11d+, MHCII+

Unique one is the CD11d+

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6
Q

What cell type mediates regression in histiocytomas?

A

CD8+ αβ T-cells

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7
Q

Signalment typical for histiocytoma?

A

Often dogs <3 yrs, cranial portion of body; often spontaneously regress in 1-2 months

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8
Q

What is the general outcome for dogs with LN metastatic histiocytoma treated with surgery?

A

Favorable - can spontaneously regress even if metastatic

Faller JSAP 2016

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9
Q

What is the major differentiating factor between the two reactive histiocytoses?

A

cutaneous histiocytosis - Limited to skin and SQ;
systemic histiocytosis - dermal, SQ, LN, BM, spleen, liver, lung, MM can be involved (nasal/ocular)
Both are CD4+ (differentiates from histiocytomas and HS)

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10
Q

How do outcomes for the two reactive histiocytoses vary?

A

Cutaneous - responds to immunosuppressive therapy (steroids)

Systemic - often prolonged but refractory to tx, most dogs euthanized due to relapse or failure to respond

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11
Q

What is the MST for PAHS treated with amputation alone? Metastatic rate for PAHS?

A

MST 6 months, metastatic rate 91%

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12
Q

What is the ORR of canine HS to CCNU? Does pred improve response?

A

46% RR with gross dz
remission duration 85d, MST for responders 172d
pred does not improve response

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13
Q

What is the ORR of canine HS to DOX/CCNU?

A

58% (Cannon JSAP paper)

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14
Q

What are 3 negative prognostic factors for HS?

A
  1. localized vs. disseminated (PAHS may be better)
  2. hemophagocytic variant more aggressive
  3. anemia, thrombocytopenia
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15
Q

What 3 genes are differentially expressed in visceral vs. soft tissue HS in flat coat retrievers? (Boerkamp 2014)

A

C6 unregulated in visceral vs. soft tissue form
CLEC12A down regulated in visceral
CCL5 down regulated in visceral

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16
Q

What medical intervention is associated with DECREASED risk of HS in Berners? (Ruple 2016)

A

Prescribe anti-inflammatory meds for orthopedic dz

orthopedic conditions –> more likely to develop HS

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17
Q

What are the unique MRI characteristics of histiocytic sarcoma in the brain? (Tamura 2009)

A

Tamura - can be confused for meningioma (dural tail, broad base) or encephalitis; doesn’t appear to have unique features

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18
Q

Which bisphosphonate/chemo combinations may be beneficial in canine HS? (Hafeman 2011)

A

Zoledronate + DOX enhanced cell kill (zoledronate increased cell uptake of DOX)
Clodronate + vincristine synergistic cell kill

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19
Q

What is the cell of origin of hemophagocytic HS?

A

Macrophage

- more aggressive form, invariably involves spleen and can also involve liver, BM, LN, and/or lung

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20
Q

What are most common hematologic findings in dogs with hemophagocytic HS?

A

regenerative anemia, thrombocytopenia, hypoalbuminemia, hypocholesterolemia

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21
Q

What is the cell of origin in histiocytoma?

A

Langerhans cells (intraepithelial dendritic cells)

22
Q

What is the prognosis for PAHS vs. synovial cell?

A

PAHS 9-12 mos (~300d)

Synovial cell 3-4 mos

23
Q

Which breed is over-represented for cutaneous Langerhans Cell Histiocytosis

24
Q

What dog breeds were overrepresented with CNS HS? What was the MST in this study? (Mariani 2015)

A

Retrievers and Pembroke welsh corgis
MST 3 days
(all in this study had histopath CNS diagnosis)

25
Are PDGFRbeta and c-KIT expressed in feline histiocytic diseases? (Treggiari 2015)
PDGFR-beta was variable, c-KIT negative in all tumors | 15 cases
26
Do feline histiocytic diseases respond to CCNU? Toceranib? (Treggiari 2015)
Partial responses were documented to each
27
What % of HS expressed CD204 in Kato 2013?
100% (all 50 samples); all other round cell tumors were negative for CD204 Also expressed CD18 and MHCII
28
Are most cases of histiocytic sarcoma in flat coated retrievers disseminated or localized? (Constatino 2011)
57% were primary limb lesions 26% were visceral - mainly spleen All expressed MHCII and CD18, spleen consistently expressed CD11d
29
What population of cells were noted to infiltrate HS lesions of flat coated retrievers? (Marcinowska 2017)
FoxP3+ (Tregs) - higher in the soft tissue lesions
30
Does e-cadherin successfully distinguish cutaneous histiocytoma from other round cell tumors? (Ramos-Vera 2011)
No
31
What breed was recently determined to be predisposed to HS based on pedigree analysis? (Lenz 2017)
Miniature schnauzers
32
What % of dogs with stifle PAHS had prior joint disease?
88.2% | Most common was CrCL rupture
33
What are Birbeck's granules?
Found in Langerhans cells
34
Does canine HS express COX-2?
No (Heller 2005)
35
What was the ORR and TTP of HS to DOX/CCNU? (Cannon 2015)
ORR 58%, TTP 185d
36
How did a survivin suppressor affect HS in a murine model?
Enhanced chemosensitivity
37
What is DFI and MST for dogs with localized HS treated with aggressive local therapy + CCNU? (Skorupski 2009)
``` DFI 248d (8.3 months) MST 568d (18 months) 50% developed mets ```
38
RR to CCNU of macroscopic HS? MST? (Skorupski 2007)
``` ORR 46% MST 106d (3.5 months) ```
39
ORR of HS to epirubicin? (Mason 2017)
29% | very messy study
40
What is the odds ratio for a dog with previous joint disease developing PAHS? (van Kuijk 2013)
5.4
41
What gene region encoding for p16 may be associated with HS development? (Ruple 2016)
CDKN2A/B
42
Berners have a ___% lifetime risk of developing HS.
25%
43
In a study evaluating primary pulmonary histiocytic sarcoma, dogs who had surgery followed by chemo had much longer PFS at ___ and OS at ___. (Marlowe 2018)
PFS 276d | OS 374d
44
IHC markers for reactive histiocytosis?
CD4, Thy-1 (CD90)
45
IHC marker for hemophagocytic HiSa?
CD11d
46
What is unique about many of the IHC stains for histiocytic diseases?
must be performed on fresh smears or snap frozen tissues
47
What was discovered regarding miRNA leg-7g in BMDs with disseminated HiSa? (Borresen VCO 2016)
significantly down-regulated in dogs with disseminated HiSa compared to healthy controls
48
MST for synovial cell sarcoma (by grade and mets vs. no mets)?
mets - <6 months, no mets 36 months Grade 1: 48 months Grade 2: 36 months Grade 3: 7 months
49
Where does hemophagyocytic HiSa originate from?
splenic red pulp and bone marrow | CD11d+
50
What two important genes have shown copy number aberrations in HiSa?
PTEN | CDKN2A

Onco Board Review 2 (20 decks)

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