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20- SA- Dermatology > Cutaneous masses: workshop > Flashcards

Cutaneous masses: workshop Flashcards

1
Q

when investigating skin mass- what are generally the first diagnostic tests done

A

cytology- usually FNA
tissue biopsy - histopath

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2
Q

what is angioedema

A

Localised/generalised large oedematous swelling, usually involving head
Potentially fatal if involves airways
Associated with anaphylactic shock on rare occasions

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3
Q

Treatment for urticaria

A

Many cases of urticaria resolve spontaneously in 12-48h
dex IV in acute cases
adrenaline if signs of analphylaxis
avoid cause if known

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4
Q

Descrieb Calcinosis cutis

A

inappropriate deposition of calcium/phosphate in skin/subcutis - gritty white deposits, often with surrounding inflammation

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5
Q

List 3 causes of calcinosis cutis

A

dystrophic calcification
metastatic calcification
idiopathic

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6
Q

what do we see on cytology with a haematoma

A

initially cytology is same as blood smear (though no platelets). Macrophages (engulfing rbcs) +/- fibroblasts may appear with time.

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7
Q

describe management of haematoma

A

Find cause and address if necessary
Usually self-limiting- keep quiet, ?apply pressure (light bandage), and wait to resorb
Occasionally acute, severe haemorrhage – identify source UGA and ligate if possible. Antibiotic cover – risk of secondary infection.

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8
Q

what is a seroma

A

accumulation of sterile fluid (filtrate of blood) under a wound
Soft, non-painful swelling 2-5 days post-surgery (d/d infection!). No heat on palpation.
FNA: Straw-coloured/blood-tinged fluid

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9
Q

management of seroma

A

conservative unless refractory or causing wound distruption
repeasted drainage if size causing discomfort
if severe surgical debridement

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10
Q

what do arthropod-but granuloma look like

A

1cm diameter, firm, ill-defined erythematous nodule with central black mark

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11
Q

management of arthropod-bite granuloma

A

check no evidence of retained arthropod
?short course of steroids
If not resolving, consider surgical removal and submission for histopathology and tissue culture to confirm diagnosis

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12
Q

diagnosis of panniculitis

A

FNA- pyogranulomatous inflammation with background fat
Biopsy- important to rule out infection as initial step

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13
Q

if you can’t identify/ correct cause of panniculitis (solitary and multifocal lesion) what should you do

A

Solitary lesion —> surgical excision if possible

Multifocal lesion —> immunosuppressive therapy

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14
Q

what neoplasia can occur in younger animals

A

histiocytoma

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15
Q

T/F most canine skin tumours are malignant

A

False- 2/3 benign

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16
Q

T/F most feline skin tumours are malignant

A

True - 2/3

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17
Q

what is the most common canine skin tumour

A

lipoma

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18
Q

what is the most common feline skin tumour

A

fibrosarcomas

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19
Q

decribe what is seen on cytology with epithelial neoplasia

A

High yield, cells associated with one another, rafts, sheets, acini, cuboidal, columnar

20
Q

what is seen on cytology with round cell tumours

A

High yield, discrete round cells, not adherent

21
Q

what is seen on cytology with spindle/ mesenchymal cell tumour

A

Low yield, spindle shaped cells, usually single but may be in association/sheets, may be “matrix”

22
Q

Describe Elliptical incisional biopsy

A

Include margin
Take from representative area
Ensure to remove whole biopsy tract when mass removed….

23
Q

Describe Elliptical excisional biopsy

A

May cure benign, non-infiltrative neoplasms
Remove deeper tissue en bloc so can assess all margins (send untrimmed), but can never confirm 100% excision
Not if suspect infiltrative mass – look at FNA cytology first!

24
Q

List the 4 rules to approaching a cancer cases

A
  1. Establish the diagnosis (type and grade of tumour)
  2. Establish the extent/stage of the disease
  3. Investigate any complications
  4. greatest chance of cure lies with the primary surgery
25
Q

treatment of sebaceous gland tumours

A

If slow-growing and well-circumscribed, may leave and monitor.
Excise if any change or traumatised

26
Q

what is the most common pigmented tumour in cats

A

basal cell tumour

27
Q

describe basal cell tumours

A

solid, ulcerative or cystic
Aggressive characteristics on cytology/histopathology but low-grade behaviour usually
Excise with as wide a margin as possible

28
Q

Management of canine papillomas (warts)

A

Usually allow to resolve spontaneously, though new ones may develop
Surgery if causing problems

29
Q

describe pigmented viral plaques

A

Especially French bulldogs, pugs - are viral papilloma’s
May not spontaneously resolve and occasionally –> SCC
Care re concurrent use of immunosuppressive drugs…

30
Q

what animals do perianal (hepatoid) gland tumour occur in

A

Usually older male, but <25% in females
In entire and neutered animals
often androgen-dependent

31
Q

treatment of perianal (hepatoid) gland tumour

A

Hormonal – surgical or chemical castration – most will regress
If necessary, wide surgical excision

32
Q

what should you always do with a possible lipoma

A

FNA to confirm

33
Q

what are spindle cell sarcomas

A

mesenchymal
solitary, slow-growing masses
May appear well-circumscribed but actually highly infiltrative
Low rate of metastasis
poor exfoliation on FNA

34
Q

Treatment of spindle cell sarcoma

A

wide-radial excision if possible but frequently recur
OR
cytoreductive surgey and radiotherapy

35
Q

what happenes when mast cells degranulate

A

histamine is released -> this can cause erythema, pruritus, oedema –> the mass may fluctuate in size

they can also release heparin and proteases

36
Q

what is Dariers sign

A

local pruritus, erythema, wheal after rubbing lesion

37
Q

what are the 2 types of primary cutaneous lymphoma

A

Epitheliotropic lymphoma (T cell origin)
Non-epitheliotropic lymphoma (T or B cell origin)

38
Q

treatment of primary cutaneous lymphoma

A

chemothepary
surgery if solitary/ localised
radiotherapy?

39
Q

prognosis of primary cutaneous lymphoma

A

Non-epitheliotropic lymphoma- Rapid metastasis, grave prognosis
Epitheliotropic lymphoma- Chronic, may wax/wane initially

40
Q

describe Canine cutaneous histiocytoma

A

common rapidily growing well demarcated masses
in young dogs- common on extremities

41
Q

describe melanomas

A

well-defined deeply-pigmented flat/plaque/dome-shaped lesions in pigmented skin
most benign –> wide excision
on non-haired skin and digits- more likely malignant

42
Q

tteatment of melanomas

A

Excise with wide margins where possible

43
Q

what is a cutaneous cyst

A

epithelium-lined cavity containing fluid or solid material

44
Q

treatment of cutaneous cyst

A

May observe without treatment but risk of rupture (especially at certain sites) so may elect to excise
If rupture inflammation +/- infection
Resolve inflammation/infection before excision

45
Q

what is a dermoid cyst

A

congenital defect- e.g. Rhodesian ridgeback
Cysts dorsal midline neck/trunk
Filled with hair/keratinous material
may extend to dura mater

46
Q

Decsribe injection site sarcomas

A

type of feline fibrosarcoma
usually intrascapular
consult oncologist after biopsy but before surgery

47
Q

Treatment of mast cell tumours

A

surgery if possible
chemotherpay- TKIs, protein kinase C activators

20- SA- Dermatology (21 decks)

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