Test 3 - Case Studies Flashcards
Benign or malignant?
What is the effect on the host?
Benign - growing by expansion
Deviating the central septum
Pushing down on hard palate
Outcome is the same as malignant due to the location
Benign or malignant?
Benign - compressing tumor
Common in cats
Tumor of meninges (you can see that it is adhered)
Depending on where it is present, you may be able to do surgery
Benign of Malignant?
Malignant
Multiple places
You can ignore the sizes. It may have started somewhere else. What is important is that you are seeing multiple lesions.
High DDx: melanoma or hemangiosarcoma
What kind of tumor do you suspect if this is seen?
This is the typical presentation of metastatic tumors in the lungs
Each one of these lesions have been seeded from a primary tumor from somewhere else
Look for primary tumor elsewhere
What is this?
Liver, spleen lungs
Liver, spleen, lungs - top sites for secondary spread
What is this?
Tumor spreading by kissing or seeding. In humans in ovarian cancer, can kiss off of the peritoneum.
Multiple tumors growing from primary melanoma.
This is just a nother way to spread.
Neoplastic, melanoma cells growing
Melanocytes produce melanin. This does not always mean that they are always dark. There is variation in differentiation. Not every cell is exactly like its parent.
A dog presents with this lesion. It is growing rapidly and ulcerating. Would this be benign or malignant? How would you know?
If it was 12 years of age, would it be malignant or benign? Malignant
This was from from a 4 month old dog, it is a histiosarcoma
What are the different categories of Mast cells present here?
Big cells: Mast cells - big cells with lots of granules
Well differentiated mast cell: one full of pigment so you cant see its nucleus
Poorly differentiated: you cant see them
When you see poorly differentiated creeping into the well differentiated cells, then you would think it is malignant
Mast cells have a chemotactic agent that bring in Eosinophils. What would appear to be mostly lymphocytes in mast cell tumor would be eosinophils.
Mast cell tumors are graded from well differentiated to poor differentiated then go to a book and get prognosis. E.g. if you completely excise a well differentatated then you have gotten rid of the problem. Or if you have excised a poorly differentiated tumor, it will probably come back. So you categorize the tumor based on your data and get the prognosis based on historical dataa.
What kind of cells are present in this mast cell tumor? How do you know?
When you look more closely (pink cells), they are not lymphocytes because you can see the multi-lobed nuclei and so these are the eosinophils that get dragged in with a mast cell tumor.
You can see granules leaving the eosinophils.
Complete excision would be curative.
Animal presents with painful and swollen carpus, and severe lameness.
What is your initial thought for a cause?
What are the steps you will take to confirm this?
Initial thoughts: Since it is a big/clumsy animal, the idea would be that they banged their leg.
- X-Ray
- Biopsy
- Chest X-ray (Normally we would skip the previous steps and go directly to the Chest X-Ray) - looking for metastatic tumors in the lungs)
This is the X-Ray of our pooch with the swollen carpus..
Describe this radiograph.
What are you thinking?
hows that there is significant damage to the bone. We have lost the cortices and there is a ‘fluffy appearance’ –> typical of a neoplasm.
This is the histology from our pup with the swollen carpus.
What is significant about this?
What are you thinking??!
When a pathologist gets a biopsy from a tumor, what broad category will they put it? Patterns - epithelial or CT. Talk about sarcomas, carcinomas. CT - I think the nuclei are bit plump, rather than spindle.
Do they look similar or is there variation? there is variation - nuclear/cellular pleomorphism - pushes you towards malignant.
It is also mitotically active - there are a few mitotic figures
Cell death will also happen during cancer as well (usually through apoptosis)
Prevalence of mitosis = malignant.
Not well differentiated. You can’t tell what they are.
*You see some CT- which would be separating cells in smaller groups. Cartilage or bone - osteoid cells are trapped in lacunae.
In this area they have the ability to produce osteoid so by definition, the origin is bone cells.
Dx: osteosarcoma: malignant tumor of bone origin
This is our chest x-ray of our pooch with the swollen carpus.
Que PASA???!
Golf ball size metastasis in the lungs from osteosarcoma.
Poor prognosis
What do you see?
Bizarre Mitotic Figures –> MALIGNANT.
What are some things you can do to figure out cells of origin?
Analyze the cytoplasm. Use immunohistochemistry?
