Intro to Vet Oncology Flashcards
What questions should be asked when looking at a mass?
- How long has it been present, is it growing, how fast
- trauma?
- is it hot, erythematous or painful? indicates inflammatory lesion, though still could be a tumour
- solid or fluid filled? fluid could be abscess, cyst, seroma, haematoma or necrotic centred tumour
- well defined or ill defined? fixed to underlying tissues?
What 2 samples can be taken to further inestigate a mass? uses/pros and cons of each?
> FNA for cytology
-distinguish inflammaotry [neutrphils and mixed cell population] and neoplastic [one cell type predominates] lesions
-cell morphology can determine benign or malignant masses
-also good for bone marrow and effusions
-cytology NOT useful for tissue architecture, mitotic index, invasion or grading
Biopsy for histopathology (incisional, excisional, puch biopsy, tru-cut, Jamshid core biopsy)
- gold standard
- but expensive and requires sedation or GA
- decide whether malignant and give tumour a grade
What are the 3 possible cells of origin of a tumour?
- epithelial
- mesenchymal (=spindle cell = structural cells bone, cartilage, endothelium)
- round cell
WHat is tumour grade?
- assigned by PATHOLOGIST
- assessment of mitotic index, cellular differentation, invasion of tissues, necrosis etc.
- categorised as LOW, MEDIUM or HIGH
- low grade likely to be benign
- high grade likely to be malignant
What are the 2 numerical grading systems for describing mast cell tumours?
> Patnaik 1-3
> KIupel low or high (make people decide)
What is tumour staging?
- Performed by the CLINICIAN
- extent of the disease in the patient
- looking at primary tumour, lymph nodes and distant distant metastatic disease
What system is usually used for staging and what does each descriptor mean?
TNM
> Primary tumour
- size, mobility, relationship to surrounding tissues, ulceration and erythema
- may require imaging and endoscopy
> Draining lymph nodes
- size, mobility, relationship to surrounding tissues, texture, consistency
- imaging might be required
- FNA to assess as small nodes can be malignant and larger ones just hyperplastic
> Distant metastasis
- history and PE can give clues eg. coughing
- imaging: radiography or CT, ultraound, , MRI, scintigraphy
- lungs most common site of metastasis
- FNA/biopsy to confirm dx
- liver, spleen, kidneys, heart, skin, bones, CNS may also be site sof metastasis
How may the TNM system be refined?
Numerical grading
T1: 5cm
N0: no metastasis to regional LNs N1: LNs metastasis
M0: no distant metastasis M1: distant metastasis present
How does lymphoma grading systemdiffer to normal?
WHO staging system for canine lymphoma
1: single LN or lymphoid tissue in single organ exlcuding BM
2: more than 1 LN in a regional area +- tonsils
3: generalised LN involvement both side of diaphragm
4: liver +- spleen +- stage 3
5: blood bonemarrow or other organ systems +- stages 1-4
> sunstage a= without systemic sounds
b = with systemic signs
What is paraneoplastic syndrome?
systemic effects of a tumour, occouring at sites distant to the tumour
- result of a secretion of a hormone or hormone-like subsance, enzyme, cytokine, immune mediated mechanisms
What 4 baseline tests can be used to assess the cancer patient?
- haemotology/blood count
- Biochem
- Urinalysis
- COaglation parameters (when indicated)
WHat can haemotology/complete blood count show?
- general health status
- baseline before starting chdemo
- check for
> anaemia
> cytopenia
> abnormal cells in circulatin
What can biochemistry show?
- general health status
- organ damage and function esp prior to GA and chemo
- liver and kidney parameters
3 common paraneoplastic effects
- Hypercalceamia due to tumour production of PTH-rp -> renal damage
- Hypoglyceamia due to secretion of insulin or insulin like growth factor
- Hyperglobulinaemia due to excessive AB production
What does urinalysis show?
- underlying renal and other diseases
- do dipstick, sediment and SG
Clinical signs associated with hypercalcaemia?
- PUPD
- depression
- anorexia
- weakness
- bradycardia
