Tumors Of The Thoracic Cavity

Question 1

What is the most common chest wall tumor in dogs?

Answer 1

Osteosarcoma… Followed by chondrosarcoma

Question 2

What type of biopsy would you take of a chest wall tumor for tissue diagnosis?

Answer 2

Open (wedge)
*need Lg sample - at least > 1cm*
CT scan needed for surgical planning

Question 3

What is the fancy phrase used to describe the surgery treatment of choice for chest wall tumors?

Answer 3

En bloc excision w/chest wall reconstruction (max 6 ribs)

Cranial approach: latissmus dorsi muscle flap and ext.ab.oblique mm.flap

Caudal: diaphragmatic advancement
*caudal lung lobectomy may be required to permit adequate closure w/substantial diaphragmatic advancement*

Question 4

Which chest wall tumor type is adjunctive chemotherapy generally recommended for?

Answer 4

Rib OSA!

(Not generally for CSA)

Question 5

In the surgical approach for treating chest wall resection for CSA w/diaphragmatic advancement, what margins would you use?

Answer 5

3cm!

Question 6

How do we go about diaphragmatic reconstruction following removal of a CSA tumor in the chest wall?

Answer 6

Advance cranially and suture free diaphragm to caudal aspect of cut ribs

Question 7

T or F:
The prognosis of OSA is much better when chest wall resection is performed and followed with adjunctive cytotoxic chemotherapy than without.

Answer 7

TRUE

Question 8

How are carcinoma lung tumors subclassified according to their precise anatomic location within the pulmonary system?

Answer 8

Bronchial,
Bronchoalveolar,
Alveolar

Question 9

The most common lung tumor in cats is ________; whereas the most common lung tumor in dogs is ________.

Answer 9

Bronchial ACA;

Bronchoalveolar ACA

Question 10

Which lung lobes are more commonly affected in dogs and cats with lung tumors?

Answer 10

Caudal lung lobes!

Question 11

What are the 3 main radiographic presentations in cats with lung tumors?

Answer 11

1. Mixed bronchoalveolar pattern
2. Ill-defined alveolar mass
3. Pulmonary mass w/cavitation (56%- most common!!)

Question 12

What is the gold standard for staging lung tumors?

Answer 12

CT!
Sensitive for correctly assessing TBLN status

Question 13

In treating lung tumors with surgical approaches, _________ __________ is indicated for small to medium sized tumors w/hilar LN biopsy, while _________ _________ is indicated for large tumors and inspection of other lung lobes.

Answer 13

Lateral thoracotomy (4-6th intercostal);

Median sternotomy

Question 14

What is the most important prognostic variable in feline lung tumors?

Answer 14

Histologic grade* (1,2, or 3)
1–>3 (worse prognosis)

Question 15

What unique phenomenon happens in cats with regard to lung tumors, that yields a bad prognosis?

Answer 15

Pleural effusion

Question 16

What do we use as adjunctive therapy for lung tumors?

Answer 16

Vinorelbine (vinca alkaloid)
14x increase lung concentrations compared to other vinca alkaloids!

Question 17

What is a histiocytic sarcoma?

Answer 17

Malignant tumor of antigen-presenting dendritic cell origin

*commonly metastasizes to LNs, kidneys, liver, and CNS*

Question 18

What does a dog presenting with signs consistent with Caval syndrome indicate?

Answer 18

Cranial mediastinal tumor invasion into the cranial vena cava (Edema build up in head, neck and forelimbs d/t impairment of venous return to right atrium)

Question 19

T or F: Almost 70% of thymomas are going to cause some form of a Paraneoplastic Syndrome (PNS).

Answer 19

True.

Question 20

You’re having a hard time differentiating a lymphoma from thymoma cranial mediastinal mass. You perform transthoracic US with guided FNA/cytology, which reveals neoplastic epithelial cells w/large numbers of small MATURE lymphocytes and mast cells. Which one is it?

Answer 20

Thymoma

Question 21

How can Flow Cytometry help us in the work-up and staging of thymoma?

Answer 21

Thymic lymphocytes are differentiated… if they’re CD4+CD8+, it’s thymoma