Oncology SDL

Question 1

What are the 3 main types of tumour groupings?

Answer 1

1) epithelial
2) round
3) mesenchymal

Question 2

What should you call benign and malignant tumours of these tissues?

Answer 2

Question 3

Via what route do carcinomas predominately metastasise (via blood or lymphatics)?

Answer 3

lymphatics

Question 4

Via what route do sarcomas predominately metastasise (via blood or lymphatics)?

Answer 4

blood

Question 5

What are the 3 methods for biopsying a mass?

Answer 5

1) FNA
2) incisional
3) excisional

Question 6

What is the definition of tumour grade?

Answer 6

• how abnormal are the cells

Question 7

Please name 4 features expected to be seen in a high grade tumour?

Answer 7

1) disorganised
2) abnormal cells
3) fast growing
4) invasive

Question 8

What features are assessed in the grading of mast cell tumours (Kiupel system)?

Answer 8

1) 7 mitotic figures in 10 high-power fields (HPF)
2) multinucleated cells (at least 3 nuclei) in 10 HPF
3) bizarre nuclei in 10 HPF
4) Karyomegaly (nuclear diameters vary by at least twofold in ≥10% of cells)

Question 9

What features are assessed in the grading of soft tissue sarcomas

Answer 9

1) tumour differentiation
2) mitotic count
3) tumour necrosis

Question 10

What is the definition of tumour stage

Answer 10

• size of the tumour and how far it has spread form its origin

Question 11

What 3 features are needed for assessing tumour stage

Answer 11

1) tumour
2) node involvement
3) metastases

Question 12

You are presented with a dog that has an oral melanoma affecting the mandible.

Q1) What initial clinical signs would you expect to see?

Q2) What clinical signs would you expect to see as the disease progresses?

Answer 12

A1) pain, difficulty eating and drinking, bad breath, drooling, presence of a tumour, bleeding
A2) weight loss, anorexia, lethargy, saliva staining

Question 13

What clinical signs would you expect to see in a dog with a splenic haemangiosarcoma?

Answer 13

Lethargy, decreased appetite, weight loss, acute collapse, pale to white mucous membranes and/or swelling in their abdomen

Question 14

What are the most common neoplastic causes of pericardial effusions in dogs?

Answer 14

1) heart base tumours
2) haemangiosarcoma

Question 15

What neoplastic processes can cause paraneoplastic hypercalcemia?

Answer 15

1) lymphoma
2) anal sac carcinomas

Question 16

What is the most common neoplastic process that causes hyperviscosity via excessive globulin production?

Answer 16

Multiple myeloma and leukemia

Question 17

Name 2 clinical signs you could see in a male dog with hyperoestrogenism?

Answer 17

1) alopecia
2) hyperpigmentation, lichenification

Question 18

Which neoplasia is most commonly associated with the development of paraneoplastic myasthenia gravis?

Answer 18

• thymoma

Question 19

Define maximum tolerated dose chemotherapy?

Answer 19

• maximum dose not causing irreversible toxicity of any type and causing less than grade 4 toxicity in any organ
• not causing unacceptable side effects

Question 20

Define metronomic chemotherapy?

Answer 20

• anti cancer drugs administered at lower doses repeatedly over a long period so as to have less side effects

Question 21

Which immunophenotype of lymphoma is more commonly seen in dogs?

Answer 21

CD4+ T cell lymphoma (TCL)

Question 22

What would you expect to be more commonly affected in a feline patient with lymphoma, lymph nodes or organs?

Answer 22

organs

Question 23

You are presented with a 5 year old male neutered Boxer with multiple enlarged lymph nodes (mandibular, prescapular and popliteal) with a recent history of tachypnoea. Radiographs identify a thoracic mass?

Q1) What test would you perform to confirm diagnosis of lymphoma?

Q2) What test can you perform to immunophenotype this patient?

Answer 23

A1) FNA of his lymph nodes
A2) flow cytometry

Question 24

You are presented with a 7 year old female neutered Labrador with a 2cm mass on her left thoracic flank. Fine Needle aspirates of this mass have been performed and cytology of this mass is consistent with a mast cell tumour.

Q1) What other organs need to be measured/sampled for this tumour to be staged?

Q2) If no spread is identified in these organs, what is this animal’s stage?

Answer 24

A)1 lymph nodes FNA or lung xray for metastases
A2) stage 1

Question 25

You are presented with a 10 year male entire Staffordshire Bull Terrier with a 5cm ulcerated subcutaneous mass wrapping around his left thoracic limb, located just proximal to his carpus.

Q1) What would your first option for biopsying this mass?

Q2) Your results have shown this to be a soft tissue sarcoma, what stage is this dog?

Q3) What is more important prognostically for this dog, grade or stage?

Answer 25

A1) FNA
A2) 1
A3) stage

Question 26

You are presented with a 12 year old male neutered Cocker spaniel with a 2cm mass affecting his right anal sac. Cytology of this mass has come back as an apocrine gland anal sac adenocarcinoma.

Q1) What organs do you need to assess/sample for staging of this dog?

Q2) This dog has a 2cm enlarged medial iliac lymph node, which is confirmed as metastatic on cytology but no other evidence of spread. What is the stage of this dog?

Answer 26

A1) lymph node, liver, spleen and lungs
A2) 3a

Question 27

You are presented with a 10 year old female entire Scottish Terrier with a 4cm black oral mass arising from her left mandible. She has normal sized mandibular lymph nodes?

Q1) Given the normal size of her lymph nodes do you still need to consider sampling them?

Q) What percentage of normal sized lymph nodes are metastatic on cytology with oral melanoma

Q) If this dog also has metastatic disease in her lungs on CT scan of her thorax, what is her stage?

Answer 27

A1) yes
A2) up to 40%
A3) IV

Question 28

What chemotherapy agents are midly or not myelosuppressive?

Answer 28

• glucocorticoids
• asparaginase

Question 29

Why do you need to be careful giving steroids to newly diagnosed patients with lymphoma?

Answer 29

• chemotherapy fails because the cells will pump out the chemotherapy before it is able to work