Mast Cell Tumors Flashcards

1
Q

what is the mean age at presentation for mast cell tumors?

A

8-9 years

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2
Q

which breeds are at risk for low grade mast cell tumors?

A

bulldog descent

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3
Q

are most mast cell tumors easy to diagnose by cytology?

A

yes

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4
Q

do mast cell tumors spread to lungs in a nodular fashion?

A

no

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5
Q

what is surgery like for mast cell tumors?

A

2 cm margins
one fascial plane deep

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6
Q

what are some indicators of likely high-grade behavior?

A

rapid growth
ulceration
mucucutaneous location
inguinal or perineal location

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7
Q

where are H1 receptors located?

A

in the skin

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8
Q

what are chemotherapy drug options?

A

palladia
vinblastine
prednisone

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9
Q

what is the treatment of choice for feline cutaneous mast cell tumors?

A

surgery

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10
Q

what are mast cells like when they leave bone marrow?

A

immature

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11
Q

how long do mast cells live in the tissues?

A

40 days

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12
Q

what do mast cells contain that mediate local and systemic hypersensitivity?

A

histamine
heparin
cytokines: IL-6, TNF-alpha
chemokines
growth factors: VEGF, bFGF

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13
Q

what is the most common skin tumor of the dog?

A

cutaneous mast cell tumor

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14
Q

which dogs are at risk for high grade cutaneous mast cell tumors?

A

shar-pei

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15
Q

where do most mast cell tumors occur?

A

skin and subcutaneous

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16
Q

what is the treatment of choice for mast cell tumors?

A

surgery: 2 cm margins and one fascial plane deep

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17
Q

can mast cell tumors spread to the lymph nodes in the thorax?

A

yes

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18
Q

when should you do an abdominal ultrasound for mast cell tumors?

A

high grade
usually done after surgery, can be done before if suspect high grade

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19
Q

how should incisions be oriented?

A

follow along the tension lines of the skin
to decrease risk of dehiscence and prevent raised tissue at end of incision

20
Q

tumors greater than _______ should use 2-cm skin margins on either side of the tumor with one fascial plane deep

A

1cm

21
Q

should you mark margins of a tumor removal?

A

yes
not orange or red dye

22
Q

what is the most consistent indicator of prognosis?

A

grade

23
Q

what makes a tumor high grade with the kiupel grading system?

A

mitotic count >7
multinucleated cells >3
bizarre nuclei >3
karyomegaly >10%

24
Q

is the kiupel or patnaik grading system more clear?

A

kiupel

25
Q

what is survival for grade III/high cutaneous mast cell tumors?

A

3.5-7 months

26
Q

when is camus cytologic grading not relevant?

A

low grade

27
Q

is grade highly correlated with survival?

A

yes

28
Q

is follow-up chemotherapy needed for high grade mast cell tumors?

A

yes

29
Q

should you do an ultrasound with aspiration of the liver and spleen prior to surgery for a high grade mast cell tumor?

A

yes

30
Q

where is tyrosine kinase receptor expressed?

A

surface of normal mast cells: high levels
KIT mutation

31
Q

what should you use instead of diphenhydramine (low oral bioavailability)?

A

hydroxyzine
cetirizine
loratadine

32
Q

what can you give for H2 receptors?

A

famotidine
omeprazole

33
Q

what is radiation most useful for?

A

incompletely excised low-grade tumors
palliation of high-grade tumors

34
Q

when is chemotherapy useful?

A

high grade tumors
visible metastatic disease

35
Q

what does palladia do?

A

inhibits tyrosine kinase
specifically targets KIT mutation

36
Q

what is stelfonta/tigilanol tiglate for?

A

treatment of cutaneous non-metastatic mast cell tumors
<10 cubic cm

37
Q

what is intralesional triamcinolone?

A

long-acting corticosteroid injected directly into mast cell tumor

38
Q

what is intralesional triamcinolone recommended for?

A

low grade tumors

39
Q

who is overrepresented with feline mast cell tumors?

A

siamese breed

40
Q

what usually happens with histiocytic feline cutaneous mast cell tumors?

A

spontaneously regress

41
Q

when is there a poor prognosis with feline cutaneous mast cell tumors?

A

multiple lesions
pleomorphic phenotype
high mitotic count
survival still 500 days

42
Q

do you need wide margins for surgery for feline cutaneous mast cell tumors?

A

no

43
Q

how common is abdominal effusion with feline splenic mast cell tumors?

A

30%

44
Q

how common are circulating mast cells with feline splenic mast cell tumors?

A

35%

45
Q

what is survival for feline splenic mast cell tumors?

A

1600 days with splenectomy
780 days without

46
Q

who usually gets feline intestinal mast cell tumors?

A

older cats