Tumors of the thoracic cavity

Question 1

Chest wall tumors

Answer 1

Large dogs, middle ages (4-6)
Rare in cats
non specific CS - discomfort, weight loss, lanes, respiratory
Incidental finding

Question 2

Differential chest wall tumors

Answer 2

Osteosarcomas (73%)
Chondrosarcomas

ACT VERY DIFFERENTLY

Question 3

Chest wall tumor work up and staging

Answer 3

thoracic radiographs - underestimate
Cytology - not specific: sarcoma
Open wedge biopsy - subtype!
CT

Question 4

Chest wall tumor treatment

Answer 4

en bloc resection and reconstruction. place chest tube
max 6 ribs removed.
caudal lung lobectomy?
OSA - adjunct chemo

Question 5

Chest wall prognosis

Answer 5

OSA - much better with chemo added

CSA 5-6x better than OSA

Question 6

Chest wall tumor Prognostic factors

Answer 6

type and complete resection

5.6x recurrence w/o complete resection

Question 7

Lung tumors DOG

Answer 7

uncommon
older
boxer, doberman, irish setter, bernese MD
non productive cough, ex. into., respiratory signs

Question 8

Lung tumors CAT

Answer 8

rare.
older (persian?)
lameness!!!

Question 9

lung tumor differentials

Answer 9

CARCINOMAS: bronchial, broncho-alveolar, alveolar

Question 10

lung tumor differentials dog

Answer 10

bronchoalveolar AVA (85%)
SCC

Histiocytic sarcoma - multiple multilobutated masses

Question 11

lung tumor differentials cat

Answer 11

bronchial ACA

Question 12

Lung tumor work up and staging

Answer 12

Caudal lobes, diffuse
rads
Dog: demarcated, spherical, cavitated
Cat: 3 patterns
Transthoracic FNA/Cytology- not recommended.
Biopsies - high complications

Question 13

Cat lung tumor radiograph presentations

Answer 13

pulmonary mass w/ cavitation (56%)
Mixed bronchoalveolar pattern (33%)
Ill-defined mass (22%)

Question 14

Lung digit syndrome

Answer 14

Cats - weight bearing digits, 3rd phalanx

DO NOT AMPUTATE W/O rads

Question 15

Lung tumor treatment

Answer 15

Lateral thoracotomy w/ hilar lnn biopsy

compete lobectomy preferred

Question 16

Dog lung tumor prognostic variables

Answer 16

*tumor size
*Location (peripheral)
*CS at presentation
Clinical stage (CT)
Histo score (excision biopsy)

Question 17

Cat lung tumor prognostic variables

Answer 17

HISTOLOGIC GRADE
well differentiated is much better
lnn involvement
pleural effusion :(

Question 18

Histiocytic sarcoma

Answer 18

bernese MD, Flat coat retriever
malignant tumor of AG presenting dendritic cells
mets to lnn, kidney, liver, cns
surgery and CCNU good px

Question 19

Cranial mediastinal tumor

Answer 19

9y dog, 10y cat
mass effect in thorax
caval syndrome
Paraneoplastic syndromes

Question 20

Thymoma PNSs

Answer 20

67% have signs

Myasthenia gravis!!

Question 21

Cr mediastinal tumor differentials

Answer 21

LSA > thymoma

Question 22

Thymoma classification

Answer 22

invasive (cranial vena cava, thoracic wall, pericardium)
Non invasive (well encapsulated)

Question 23

Thymoma work up/staging

Answer 23

unremarkable labs
rads - mass effect, pleural effusion, MG
Transthoracic FNA/cytology

Question 24

Thymoma FNA/Cytology results

Answer 24

large number of small mature lymphocytes and intermittent mast cells

Question 25

Thymoma Treatment

Answer 25

Surgery (GS)
exploratory - invasive or not
avoid cranial vena cava and phrenic nerves
RT - very responsive
Chemo - ineffective
Medical manage MG

Question 26

Thymoma Prognosis dogs

Answer 26

good.
Sx > RT
negative factors: young, megaesophagus, histo subtype

Question 27

Thymoma Prognosis cats

Answer 27

Excellent

MG is rare in cats

Question 28

Myasthenia Gravis

Answer 28

Ab destruction of Ash-receptors at neuromuscular junction

striated m in canine esophagus = megaesophagus