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Onco boards 2024 > tumor specific LC part II > Flashcards

tumor specific LC part II Flashcards

1
Q

most common primary bone tumor in dogs,

A

osa - 85%

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2
Q

age demographic of osa

A

mostly older
few early 18 - 24 mths

Primary rib OSA tends to occur in younger adult dogs, with a mean age of 4.5 to 5.4 years

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3
Q

frequency of axial osa

A

75% of OSAs occur in the appendicular skel- eton with the remainder occurring in the axial skeleton

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4
Q

breeds at risk for osa

A

Saint Bernard, Great Dane, Irish Setter, Doberman Pin- scher, Rottweiler, German Shepherd, and Golden Retriever; however, size seems to be a more important predisposing factor than breed

> 40kg

males slightly more than females

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5
Q

ezrin - what is it, why care

A

Ezrin is a cellular protein belonging to the ezrin-radixin-moesin family and serves as a physical and functional anchor site for cytoskeletal F-actin fibers - cell adhesion and motility

during metastatic progression PKC directed ezrin phosphorylation leads to migration of canine OSA cells

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6
Q

Based on RT-PCR, six of the OSA cell lines what percent of primary OSA tumor samples overexpressed HER2;

A

40%
suggest neg prog for survival

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7
Q

mTOR pathway and cancer

A

contributes to growth, survival, and chemotherapy resistance

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8
Q

select the pathways that are active in osa cell lines

HH/notch
mTOR
wnt/b catenin

A

all 3

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9
Q

sub classifications of osa

A

osteoblastic, chondroblastic, fibroblastic, poorly differentiated, and telangiectatic

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10
Q

differentials for osa

A

fungal osteomyelitis

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11
Q

ihc for osa

A

not great ihc more so look at osteoid matrix

C-kit
vimentin?

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12
Q

cyto stain for osa

A

ALP

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13
Q

diagnostic rate of trephine bx of osa
dx rate of jamshidi

A

94% - increases risk o pathologic fracture
92% for tumor vs not and 82% for sp tumor type

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14
Q

frequency of second bone lesion at dx of osa

what dx method

A

7.8%

Nuclear scintigraphy was found to be the most useful modality for the detection of occult bone metastases - can get false +

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15
Q

stages of osa

A

stage 1 - low grade no mets
stage 2 - high grade not mets
stage 3 - lesions with regional or distant mets regardless of the grade

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16
Q

ezrin and osa

A

it has been demonstrated in murine preclinical models that ezrin is necessary for OSA metastases

ezrin staining in primary tumors was associated with a significantly shorter median DFI (116 days -4 mth ) compared with dogs with low primary tumor ezrin staining (188 days - 6 mths)

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17
Q

RON MET and OSA prognosis

A

expression of RON, but not MET, was prognostic for survival

Hepatocyte growth factor receptor (MET) and RON are members of the MET protooncogene family of receptor tyrosine kinases, and signaling through MET or RON promotes tumorigenesis and the formation of metastases

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18
Q

Survivin and osa

A

small protein belonging to the inhibitor of apoptosis family and participates in the processes of cell division as well as apoptosis inhibition
inhibits both caspase-dependent and -independent mediated apoptosis, and its expression can promote tumorigenesis

surviving sign decreases DFI

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19
Q

in what species do spontaneous brain tumors occur

A

humans, dogs and cats

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20
Q

most common primary brain tumors in dogs

A

meningioma 45%
glioma 40%
choroid plexus tumors 5%

ependymomas, primary central nervous system (CNS) lymphoma, primitive neuroecto- dermal tumors (PNETs), gliomatosis cerebri, and primary CNS histiocytic sarcoma (HS)

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21
Q

what percent of brain tumors are secondary brain tumors and what are the most common types

A

50%
HSA 29-35%
pituitary 11-25%
lymphoma 12-20%
met carcinoma 11 - 20%

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22
Q

There is a pro- pensity for PBTs in juvenile animals to be what type

A

neuroepithelial tumors of glial, neuronal, or embryonal origin

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23
Q

breeds over represented to form meningiomas

A

goldens, boxers, mini schnauzers, rat terriers

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24
Q

breed that gliomas are over represented

A

brachycephalic breeds - boxer Bostons bullmastiffs and English and French bulldogs

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25
Q

locus on what chromosome is strongly associate with glioma across many breeds

A

canine chromosome 26

single nucleotide variants in three neighboring genes DENR, CAMKK2, and P2RX7 that are highly associated with glioma susceptibility.

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26
Q

breakdown of feline primary intracranial tumors

A

70% of all tumors are primary
50% of primary bt are meningiomas
ependymomas, gliomas, and choroid plexus tumors, are infrequently reported

no breed or sex predilections

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27
Q

most common secondary brain tumors in cats

A

lymphoma 50%
pituitary tumors 30%

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28
Q

causes of clinical signs from brain tumors

A

hydrocephalus, intracranial hemorrhage, neuroinflammation, peritumoral edema

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29
Q

compensatory mechanisms when BT develop

A

decrease CSF production
shifting CSF into the spinal subarachnoid space

eventually autoregulatory mechanisms become overwhelmed and intracranial hypertension (ICH) develops - decrease in cerebral perfusion pressure

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30
Q

symptoms of brain tumors

A

new seizures that develop over the age of 5 in dogs

only 25% of cats will develop seizures - more commonly behavior changes - lethargy inappetence vestibular dysfunction

often will show signs of multifocal damage - even if its a solitary tumor due to the 2ndary effects

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31
Q

what percent of cats have multifocal brain tumor lesions

A

20%

occasional in dogs

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32
Q

distribution of canine oligodendroglioma

A

manifest with multifocal or diffuse leptomeningeal involvement

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33
Q

how do choroid plexus tumors metastasize

A

met within the CNS by “drop metastasis”

  • cancer cells are exfoliated into the subarachnoid space or ventricular system and implanted distantly
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34
Q

differential diagnoses in dogs and cats with focal intra- cranial disease

multifocal or diffuse localization

A

anomalies/malformations, infectious or immune-mediated meningoencephalitis, traumatic brain injury, and stroke

metabolic disorders, neurodegenerative diseases, and meningoencephalitides

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35
Q

what percent of dogs also had other co-morbidities with brain tumors

A

3 - 23% rec cxr and aus

however these tests only changed dx in 1% and treatment in 8% of cases

clinically stable patients with a suspected brain tumor and unremarkable general physical examination, the authors do not routinely perform screening radiographs or AUS before MRI, but do recommend these procedures before brain tumor treatment

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36
Q

preferred modality for brain tumors and accuracy

A

MRI
70% accuracy of predicting the brain tumor type

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37
Q

what do meningiomas look like on imaging

A

broad-based skull attachment, have dis-
tinct tumor margins, hypointense T1, hyperintense T2, contrast on both

some have intratumoral fluid , mineralization, calvarial hyperostosis, or dural tail sign

Calvarial hyperostosis can result from tumor-
induced reactive osseous changes or tumor invasion into bone

Peritumoral edema is observed in more than 90% of canine meningiomas

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38
Q

what is the sn of mri at correctly identifying the intracranial meningiomas
dog?
cats?

A

60-100%
cannot distinguish grade or subtype

estimated to be 96% in cats

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39
Q

what does a glioma look like on imaging

A

originate within and may infiltrate and displace the neuropil

appear poorly marginated and may or may not demonstrate contrast enhancement

A “ring enhancing” pattern, in which a circular ring of contrast enhancement surrounds nonenhanc- ing abnormal tissue, is often associated with gliomas

not possible to reliably differentiate types of gliomas (astrocyto- mas from oligodendrogliomas) or accurately predict the grade of gliomas

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40
Q

what is the most common tumor type that is found in the intraventricular location

A

Choroid plexus tumors and ependymomas are the most common tumors found in an intraventricular location, and both of these tumors types often uniformly contrast enhance

rarely meningiomas arising from the tela choroidea of the third ventricle, oligodendroglioma, PNET, and central neurocytoma

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41
Q

can you discriminate between gr iii and gr I choroid plexus tumors

A

Identification of intraventricular or sub- arachnoid metastatic tumor implants on MRI studies is a reliable means to clinically discriminate grade III choroid plexus carcino- mas (CPC) from grade I papillomas (CPP)

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42
Q

what lesions can be occult on imaging studies of the brain

A

Lymphomatosis and gliomatosis cerebri

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43
Q

minimally invasive brain biopsy techniques

A

endoscopic-assisted, free-hand, and image-guided procedures

diagnostic in about 95% of tumors with AEs in 5%

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44
Q

most common grade of meningiomas in cats and dogs

A

The majority of feline meningiomas are grade I tumors

(grade II) meningiomas account for a sig- nificantly higher proportion (40%) of meningiomas in dog

Anaplastic (grade III) meningiomas are rare in humans, dogs and cats, and account for about 1% of all canine and feline meningiomas

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45
Q

palliative care for brain tumors

A

anti-epileptics, pain meds, steroids

Animals that have peritumoral vasogenic edema on MRI are more likely to respond favorably to corticosteroid treatment

animals without significant vasogenic edema may benefit also from the antiinflammatory and euphoric effects of corticosteroids; corticosteroid therapy alone may also tran- siently reduce the tumor burden in some cases

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46
Q

MST after palliative care of PBT

A

9 weeks, with a range of 1 to 13 weeks

supratentorial tumors treated pal- liatively have a better prognosis (MST 25 weeks) than those with infratentorial tumors (MST 4 weeks)

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47
Q

most common chemo to treat brain tumors

A

lomustine (CCNU), carmustine (BCNU), and temozolomide (TMZ), or the antimetabolite hydroxyurea, all of which penetrate the blood–brain barrier (BBB)

chemo has limited efficacy

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48
Q

should you use chemo for brain tumors

A

therapeutic responses to chemotherapeutic agents (such as bleomycin, carboplatin, CCNU, irinotecan, and TMZ), as well as mechanisms of chemo- resistance observed in canine glioma cell lines

but no survival benefit is seen in any study

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49
Q

treatment of feline supratentorial meningiomas

A

Cytoreductive surgery - located over the cerebral convexities, visibly well demarcated, and are not usually infiltrative into the underlying brain parenchyma

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50
Q

mst of feline meningiomas treated with sx
recurrence rate

A

MSTs ranging from 23 to 37 months
25% recurrence

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51
Q

When standard cytoreductive surgical techniques are used, the MST for canine meningiomas is

A

approximately 7 months

advanced surgical techniques (cortical resection, extirpation with an ultrasonic aspirator, or endoscopic assisted resection) have reports of 16 - 70 mths

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52
Q

mst RT + sx in dogs with meningiomas

A

16 to 30 months

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53
Q

average rate of surgical adverse events for PBT treatment is approximately

A

11%

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54
Q

Common causes of morbidity and early perioperative mortality for PBT sx

A

aspiration pneumonia, intracranial hemorrhage or infarction, pneumocephalus, medically refractory provoked sei- zures, transient or permanent neurologic disability, electrolyte and osmotic disturbances, and thermoregulatory dysfunction

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55
Q

biomarkers shown to have prognostic value in dogs with meningiomas treated with surgery and RT

A

survival was negatively correlated with VEGF expression
ST 25 mths with <75% VEGF
ST 15 mths with >75% VEGF

Progesterone receptor expression was positively correlated with survival (negative correlation with proliferative index)

91% survival at 2 years with PF > 24%

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56
Q

MSTs associated with RT treatment of extra- axial masses, the majority of which were presumptively diagnosed meningiomas

A

9 to 19 months

intraaxial masses ranges from 9 to 13 months

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57
Q

is rt useful for brain tumors

A

RT is effective at reducing tumor size, improving neurologic signs, and providing a sur- vival benefit in dogs and cats with pituitary tumors

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58
Q

risk of AE with rt treated brain tumors

A

10% of brain tumor cases treated with RT will experience treatment-related mortality or adverse effects

hypofractionated RT, delivery of a high dose per fraction resulted in the death of nearly of 15% of treated dogs because of suspected delayed radiation side effects

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59
Q

bacterially derived minicells were packaged with doxorubicin, targeted to EGFR using bispecific antibodies to EFGR, and administered intrave- nously to dogs with brain tumors

RR and AE?

A

Durable and objective tumor responses were seen in 24% of dogs and no significant toxicities were observed

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60
Q

What are prognostic factors for brain tumors?

A

Type of tx, neuro signs, location, histology, multi lesions

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61
Q

What are the different spinal tumors occurring and different locations?

A

Most extradural-OSA, HSA, STS; Intradural/extramedullary-meningioma; Intramedullary-glioma

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62
Q

What is the tx and outcome for spinal tumors?

A

Meningioma sx+RT-13-78months;
Nerve sheath 6months;
cats 180-1400days (6-47 mo)

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63
Q

Two most common tumors intramedullary spinal mets

A

TCC, HSA,

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64
Q

Expression of microRNAs in plasma and in extracellular vesicles derived from plasma for dogs with glioma vs dogs with other brain diseases

A

Results suggested that miR-15b and miR-342-3p have potential as noninvasive biomarkers for differentiating glioma from other intracranial diseases in dogs

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65
Q

what is the best way to determine volumetric criteria for evaluation of therapeutic response in dogs with intracranial gliomas

A

1D, 2D, contrast enhancing volumetric techniques and t2W tumor volumetric measurements all were comparable methods of determining tumor response

Reccomend t2w tumor volume calc due to simplicity, universal application, and superior performance

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66
Q

immune infiltration in gliomas

A

Low grade and high grade differed in # of FoxP3+ cells, Mac387+ cells, and CD163+ cells. More numerous in high grade

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67
Q

rt for presumptive gliomas

A

3 fx of 8-10 Gy one or more courses
636d - 21 mths (similar to fx rt)
- perfoming a 2nd course sig improved outcome - 258d (8.6 mo) vs 865d (28 mo)
- using chemo improved outcome

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68
Q

protooncogene highly expressed in canine gliomas

A

BMI1 - not associated with higher grade

inhibition activates the Rb pathway

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69
Q

Inter-pathologist agreement on diagnosis, classification and grading of canine glioma

A

Agreement on subtype and grade 66%, subtype only 80%, and grade only 82%

Agreement was similar for oligodendrogliomas and astrocytomas but lower for undefined gliomas

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70
Q

gliomas

Rt + temo

RR
MST

A

RT alone - RR 63.2%
RT + TMZ - RR 90.9%

MST palliation - 94 days
MST RT alone - 383 days
MST RT + TMZ 420 days (not statistically different)

TMZ did not improve outcomes

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71
Q

Positive prognostic factors for gliomas

A

tumor <5% of brain volume and normal mentation at presentation

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72
Q

location of worse outcome for canine gliomas

A

Subventricular zone more likely to develop mets and had shorter tumor specific survival 306 vs 719 days and a shorter TTP

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73
Q

Mri biomarker for oligodengrogliomas

A

T2-FLAIR mismatch sign as an imaging biomarker for oligodendrogliomas in dogs

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74
Q

Stereotactic Volume Modulated Arc Radiotherapy in Canine Meningiomas
rr

A

33 Gy given in 5 fx
ORR 65.5%
2 yr OS 74.3% and disease specific survival 97.4%

minimal se

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75
Q

CyberKnife stereotactic radiotherapy for treatment of primary intracranial tumors in dogs

mst
location based
tumor type influence

A

PFI 347d
MST 738d -25 mth (same as fx)
Cerebrum location pfi 357d
Cerebellum pfi 97 d
Brain stem pfi 266d
Tumor type was sig assoicated with mst - menigioma better than histiocytic

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76
Q

what imaging showed the best margins for different brain tumor types
glioma, HS, Meningioma

A

Meningioma and histiocytic - contrast had best margins
Glioma - T2 had best surgical margins

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77
Q

negative prognostic factor with brain tumor surgery

A

post op seizures

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78
Q

Solitary intraventricular tumors in dogs and cats treated with radiotherapy alone or combined with ventriculoperitoneal shunts

MST

A

Median survival time was 162 days rt alone vs 1103 days vps rt

Ventriculoperitoneal shunting led to rapid normalization of neurological signs and RT had a measurable effect on tumor volume. Combination of VPS/RT seems to be beneficial.

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79
Q

what percent of spinal tumors are extra dural

A

50% most coming from vertebrae - osa, chondrites, plasma, fibrosarcoma, hsa

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80
Q

Intradural-extramedullary tumors account for XX% of all tumors

A

35%
meningioma are most common

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81
Q

what percent of tumors are intra medullary

A

15%

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82
Q

most common spinal cord tumor in cats

A

lymphoma - cant be primary but more common secondary and part of multi centric disease

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83
Q

spinal cord lymphoma in cats - felv status

A

hx 90% were +
now 56%

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84
Q

ependymomas and nephroblastomas are more commonly seen in dogs of what age

A

younger than 6

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85
Q

breeds predisposed to nephroblastoma

A

GSD and goldens (<3yrs)

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86
Q

what percent of dogs with intramedullary tumros showed pain

A

68%

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87
Q

progression of signs in dogs with spinal cord tumors

A

acute decompensation is rare for primary intramedullary tumors compared to metastatic tumors

only get acute if pathologic vertebral fx hemorrhage or necrosis

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88
Q

cats with lymphoma treated with a combination of vincristine, cyclophosphamide, and prednisone had a complete remission rate of?

A

50% in 6 cats - 14 wk duration

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89
Q

MSTs for dogs with intraspinal meningioma treated with surgery alone

if RT is added?

A

6 to 47 months

postoperative RT in dogs with meningiomas increased the MST to approximately 45 months

dogs receiving RT took significantly longer to neurologically decline than dogs that did not

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90
Q

spinal meningioma in cats mst

A

6-17 mths

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91
Q

mst vertebral tumors for dogs

for cats

A

MST of 4.5 months in dogs with a variety of vertebral tumors

Cats with malignant vertebral tumors also have a guarded to poor long-term prognosis with surgical treatment, with a reported MST of 3.7 months

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92
Q

PNST arise from what cells

A

Schwann cells, perineurial cells, or intraneural fibroblasts

dont use the differentiation tho - just use malignant vs benign

cats mostly benign tumors

tend to not met

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93
Q

most commonly affected nerve with pnst

A

trigeminal nerve
caudal cervical spinal nerve roots c6-t2

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94
Q

Secondary pnst

A

lymphoma, malignant sarcomas, HS, and hamartomas, can occa- sionally involve peripheral nerves

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95
Q

neurolymphomatosis in cats

A

diffuse infiltra- tive peripheral nerve lymphoma
usually B cell

usually T cell in dogs

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96
Q

what % of PNST affect the brachial plexus

A

33%
mass can be palpable on pe

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97
Q

preferred tx method of PNST

A

surgery

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98
Q

PNST prognostic factors

A

Proximity to and invasion into the vertebral canal, which occurs in 45% of dogs

incomplete margins

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99
Q

mst of PNST dogs

A

hx poor - 6 mth
better if complete resection - 1303d ~43mo
use of VMAT RT inc to 8 mth

cats better but no number given

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100
Q

MSTs for dogs with trigeminal PNST treated with SRS or SRT

A

745 days and 441 days

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101
Q

What 2 tumor types is hemangiopericytoma classified as?

A

Peripheral nerve sheath and cutaneous perivascular wall (b/c people, but still has staining for nerves-S100+ & vimentin+

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102
Q

what component of the immunoglobulin causes clinical signs in myeloma related disorder

A

m component

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103
Q

diagnosis of MM

A

bone marrow or visceral organ plasmacytosis
osteolytic lesions
serum or urine myeloma proteins

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104
Q

what percent of dogs with MM respond to chemotherapy SOC and what’s general mst

dogs
cats

A

dogs:
>80% respond
MST 1.5 - 2.5 y

cats:
50-80% respond
MST 4-13 mths

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105
Q

Dog with multiple plasma cutaneous lesions
what is prognostic for multiple cutaneous plasma tumors

A

> 10 tumors
rec melphalan and pred

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106
Q

Dog with elevated iCa and elevated TP with normal albumin BM shows 10% plasma cells next step

A

malignancy profile
protein electrophoresis
start melphalan

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107
Q

Feline myeloma disease treatment of choice

A

CTX good but melphalan rr higher, - cyclophosphamide (250 mg/m2 PO or IV every 2–3 weeks) and prednisolone (1 mg/kg PO daily for 2 weeks and then every other day) protocol or a COP protocol or ctx 25 mg/cat twice weekly

melphalan and pred RR 70ish% but causes more significant myelosuppression

0.1 mg/kg once daily for 10 to 14 days, then every other day- Long- term continuous maintenance (0.1 mg/kg, once every 7 days) has been advocated or melphalan at 2 mg/m2, once every 4 days continuously

Withrow like ctx

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108
Q

What are risk factors for developing plasma cell tumors/MM?

A

Petroleum product, RT, viral (viral Aleutian dz of mink), chronic immune stimulation and implants (silicone gel), carcinogens (ag industry)

over expression of cyclin D1 and RTK dysregulation

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109
Q

What are some IHC for MM?

A

MUM1/IRF4, thioflavin T, CD79a

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110
Q

What are prognostic factors for MM?

A

Bence jones proteins, extensive boney lysis, hypercalcemia, renal disease, high peripheral neutrophil:lymphocyte ratio

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111
Q

What is the tx and outcome for solitary osseous plasma cell tumors and EMP?

A

Cutaneous/oral surgery can be curative; Visceral even with mets can still do well

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112
Q

What is the tx and outcome for MM?
CR%

A

Melphalan,
43%CR (happy if Ig decreases 50%)
MST 1.5yr

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113
Q

Which locations can progress to multiple myeloma in the dog/cat?

A

Dog- solitary osseous plasma cell tumor
Cat-cutaneous

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114
Q

what are the most common Ig in MM in dog?
cat?

A

dogs: IgA and IgG.
IgA maybe more than IgG

cats: IgG > IgA
5:1 ratio maybe be equal in another study

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115
Q

which Ig causes macroglobulinemia

A

IgM
Waldenström’s

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116
Q

single case of a B-cell lymphoma pro- gressing to MM exists in the dog

A

just know that

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117
Q

cytology of plasma cell

A

normal plasma cells to plasma blasts
bi/multinucleate cells often

increased size, multiple nuclei, clefted nuclei, anisocytosis, anisokaryosis, variable nuclear: cyto- plasmic ratios, decreased chromatin density, and variable nucleoli; nearly one quarter had “flame cell”

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118
Q

flame cell

A

eosinophilic cytoplasm of a plasma cell

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119
Q

light chain is called

A

bence Jone protein

120
Q

what type of gammopathy with mm

A

typically monoclonal
but can have poly or biclonal

121
Q

para neoplastic syndromes with MM

A

hyper viscosity syndrome
bone disease
hypercalcemia
bleeding diathesis
renal disease
immunodeficiency
cytopenia
heart failure

122
Q

what percent of dogs have boney lesions with mm
dogs
cats

what bones

A

dogs:
25 - 66%
can be diffuse, or osteolytic lesions
cats:
8 - 65%

vertebrae, ribs, pelvis, skull, and the metaphyses of long bones

can use bisphosphonates

123
Q

IgM (Waldenström’s) macroglobulinemia localized to what organs

A

rare in the bone
spleen, liver, lymphoid tissue

124
Q

how does m component cause bleeding diathesis

A

epistaxis and gingival bleeding
M components may interfere with coagulation by
(1) inhibiting platelet aggregation and the release of platelet factor-3
(2) causing adsorption of minor clotting proteins
(3) generating abnormal fibrin polymerization
(4) producing a functional decrease in calcium

~50% of dogs have prolonged Pt and PTT

10% to 30% of dogs and up to one-quarter of cats have clinical evidence of hemorrhage

125
Q

most common Ig to cause hyperviscocity

A

IgA

126
Q

SE of Hyperviscosity

A

bleeding diathesis
neurologic signs (dementia, depression, seizure activity, coma),
ophthalmic abnormalities (dilated and tortuous retinal vessels, retinal hemorrhage retinal detachment),
increased cardiac workload with the potential for subsequent development of cardiomyopathy

127
Q

cause of renal disease in MM

A

Bence Jones (light-chain) proteinuria, tumor infiltration into renal tissue, hypercalcemia, amyloidosis, diminished perfusion secondary to HVS, dehydration, or ascending urinary tract infections

128
Q

frequency of bench Jone proteinuria

A

Bence Jones proteinuria occurs in approximately 25% to 40% of dogs and 40% of cats

129
Q

immune suppression from mm in humans - how does it affect them

A

15 x more susceptible to infections
dec response to vaccines

130
Q

% bone marrow affected to be MM

A

Normal marrow contains less than 5% plasma cells
Current recommendations require more than 20% marrow plasmacytosis to be present, although a 10% cutoff in cats has been recently recommended with special attention to cellular atypia

131
Q

is pet scan helpful for mm

A

NO
predominant osteolytic activity with osteoblastic inactivity pres- ent, scans seldom give positive results and are therefore not useful for routine diagnosis

132
Q

infectious causes of monoclonal gammopathy

A

ehrilichiosis
leishmaniasis
FIP
MGUS

133
Q

dosing of melphalan

A

daily dosing with an initial starting dose of 0.1 mg/kg PO, once daily for 10 days, which is then reduced to 0.05 mg/kg PO, once daily continuously

pulse-dosing regimen uses melphalan at 7 mg/m2 PO, daily for 5 consecutive days every 3 week

with pred daily then EOD at 0.5mg/kg - taper off at 60 days

134
Q

bone marrow toxicity of melphalan

A

can cause irreversible thrombocytopenia

135
Q

how quick does mm respond

A

lab work 3- 6 wks
cs 3-4 wks

in cats 2-4 wks and 8 weeks for boney lesion

136
Q

monitoring of mm

A

serum ig levels lag behind bence Jones

rec performing bence Jone test monthly until a good response is seen and then every 2-3 months after

137
Q

Bortezomib for mm

A

proteasome inhibitor
shown to have activity against canine melanoma in cell culture and mouse xenograft models

not use din dogs for mm yet
one case report for feline mm - tolerated 0.7mg/m2

proteosomes normally break down misfolded proteins. by inhibiting them you all them to accumulate in the cell and then lead to apoptosis

138
Q

1-, 2-, and 3-year survival rates of mm

A

81%, 55%, and 30%,

139
Q

IgM macroglobulinemia tx and st

A

77% rr to chlorambucil mst 11 mths

140
Q

location frequency of emps

A

86% skin
9 % oral cavity lips
4% gi

141
Q

behavior of emps

A

Cutaneous and oral EMP in dogs are typically benign tumors that are highly amenable to local therapy

Colorectal EMPs tend to be of low biologic aggressiveness, and most do not recur after surgical excision

noncutaneous/nonoral EMP appears to be somewhat more aggressive in the dog

142
Q

cutaneous plasmacytosis

A

biologically aggressive disease with treatment and outcomes more like MM

more than 10 and up to hundreds of lesions
chemotherapy recd
progression-free 153 d (5 mo)
MST 542 days (18 mo)

143
Q

IHC panel for poorly differentiated round cell tumors

A

tryptase (mct), chymase (mct) , serotonin (mct), CD1a (HS), CD3(t cell), CD79a (b cell/plasma cell), CD18 (HS), and MHC class II (HS)

with naphthol AS-D chloroacetate stain

144
Q

solitary osseous plasma cell tumor tx

A

surgery and RT

RT can be used alone (i.e., without surgery) in those cases where fractures are stable, as a palliative measure for bone pain, or in the case of vertebral SOP if the patient is ambulatory and stable

145
Q

Emp recurrence rate and met rate

A

5% RR
2% met rate

146
Q

clonality assay in canine B cell tumors targeting the immunoglobulin light chain lambda locus

A

20 of 23 cases of DLBCL showed clonality (87.0 %), whereas 8 of 30 cutaneous plasmacytomas were clonal (26.7 %)

147
Q

most common location of SOP (solitary osseous plasmacytoma)
mst in one study

A

vertebrae
MST 912 d ~30 mo
MST with rt 1166d ~38 mo

148
Q

Parotid Salivary Gland Extramedullary Plasmacytoma with Local Lymph Node Metastasis in a Dog

A
149
Q

Response and outcome following radiation therapy of macroscopic canine plasma cell tumours

A

pRT ~30 Gy vs dRT ~48 Gy
95% had CR
improved pain

PFST 611 days, 20 mo
MST 771d 26 mo
Worse if PR only and pRT

150
Q

canine oral extramedullary plasmacytoma
mst

A

MST 973 days - 2.7 yr
Histologic characteristics not associated with malignancy

variable tx - sx, rt, chemo

151
Q

Hypoglobulinemia in a dog with disseminated plasma cell neoplasia

A
152
Q

Diagnostic performance of routine electrophoresis versus species specific immunofixation for the detection of immunoglobulin paraproteins (M-Proteins) in dogs with multiple myeloma

A

Using species specific immunofixation with SPE improved m protein detection SN and SP

with morphologic features has sensitivity of 95.1% and specificity of 81.4%

153
Q

what % improvement of M protein was beneficial to survival

A

Median survival was longer for dogs that attained ≥90% densitometric M-protein reduction (630 days-21 mths) than for those that did not attain at least 50% reduction in densitometric M-protein (284 days- 9 mth)

154
Q

Cyclical 10-day dosing of melphalan for canine multiple myeloma

A

2 mg/m2 melaphalan q24 for 10 days followed by 10 days chemo break, 40 mg/m2 pred q24q10d then q48h,

well tolerated but shorter OST compared to pulse dose or daily dose

155
Q

What specific bone marrow disorder is seen in FeLV+cats but rare in dogs?

A

Myelodysplasia-BM hyperplasia with maturation arrest/cytopenias, doesn’t always progress to leukemia

156
Q

What is aleukemic leukemia?

A

Neoplastic blast in BM but not circulation

157
Q

What missense mutations have been found in dog AML?

A

FLT3, CKIT, RAS

158
Q

In AML classification AML-M1-7 which one do animals not develop?

A

AML-M3 promyelocytic

159
Q

What syndrome is sometimes called preleukemia because it can progress?

A

Myelodysplasia

160
Q

Which AML can look like MCT in circulation?

A

Basophil

161
Q

What form of CLL is there circulating increased lymphocytes but no BM involved?

A

Tcell LGL, blast arise from spleen

162
Q

What is Richters syndrome

A

CLL that progresses with blast in circulation

163
Q

What mutations associated with disease are expressed on exon 8,9,11,17?

A

Exon 8-9-GIST, MCT, AML
exon11-GIST, MCT;
exon17-mastocytosis, leukemia/peop

164
Q

what are the causes of the morphology seen here

A

acanthocytes

HSA*, osa, lsa
liver disease in people

165
Q

English Bulldog CLL cell expression molecules

A

polyclonal b cell lymphocytosis

expressed lower class II MHC and CD25
splenomegaly, and hyperglobulinemia

get this younger than most breeds - 6 yrs vs 11 yrs

166
Q

essential thrombocythemia

A

myeloproliferative neoplasia of platelets
chronic

platelet counts that are persistently greater than 600,000

167
Q

chronic myelogenous leukemia

A

myeloproliferative neoplasia of granulocytes and/or monocytes

168
Q

AML age/sex

A

typically 7-8 yo
can be as young as 7 mo
2:1 M:F

169
Q

EPO

A

regulates erythroid proliferation and differentiation and is produced in the kidney, where changes in oxygen tension are detected

170
Q

stem cell to rbc pathway

A

pluripotent sc -> hematopoetic sc -> blast forming unit E -> colony forming unit - E -> rbc

171
Q

AML cell

A

blastic

172
Q

what are the myeloproliferative neoplasms

A

polycythemia vera, CML, essential thrombocythemi, primary myelofibrosis

173
Q

relative frequency of AML subtypes

A

42% monocytic leukemia (M5a, M5b), 33% myelomonocytic leukemia (M4), 13% myelo- blastic leukemia without differentiation (M1), 5% megakaryo- blastic leukemia (M7), and one each of myeloblastic leukemia with some differentiation (M2) and erythroleukemia (M6)

174
Q

BCR–ABL translocation is reported in dogs with what type of leukemia

A

acute myeloblastic leukemia

raleigh chromosome 9->26

175
Q

what mutation has been founding dogs with polycythemia vera

A

JAK2

176
Q

polycythemia vera PCV

A

65 - 85%

177
Q

Chronic Myelogenous Leukemia

A

similar to chronic neutrophilic leukemia in humans
total wbc typically > 100,000
Eosinophils and basophils may also be increased
hypersegmentation, ringed nuclei, and giant forms
MST 1 to 3 months, with some cases surviving up to 6 months or longer with aggressive treatment protocols

178
Q

human Philadelphia chromosome is what in the dog

A

chromosomes 9 and 26, and BCR–ABL translocation,
termed the “Raleigh chromosome,”

179
Q

what genetic chromosomal aberration has been seen in dogs with CML

A

chromosomes 9 and 26, and BCR–ABL translocation, termed the “Raleigh chromosome,”

180
Q

variants of CML

A

chronic myelomonocytic leukemia and chronic monocytic leukemia (CMoL)

181
Q

CML may terminate
in “blast crisis”
MST?

A

transformation from a
predominance of well-differentiated granulocytes to excessive
numbers of poorly differentiated blast cells

mst weeks to months

182
Q

Basophilic leukemia

A

increased WBC count with a high proportion of basophils in peripheral blood and bone marrow

should be distinguished from mast cell leukemia (mastocytosis)

183
Q

signs of essential thrombocythemia

A

Thrombosis and bleeding
>600,000 Plt
splenomegaly

r/o including inflammation, hemolytic anemia, iron deficiency ane- mia, malignancies, recovery from severe hemorrhage, rebound from immune-mediated thrombocytopenia, and splenectomy

184
Q

myelofibrosis mechanism

A

breakdown of intramedullary megakaryocytes and subsequent release of factors that promote fibroblast proliferation or inhibit collagen breakdown may be the underlying pathogenesis of the fibrosis

185
Q

myelofibrosis causes

A
  • myeoproliferative disorders
  • RT
  • congenital hemolytic anemia
  • idiopathic
  • necrosis secondary to ehrlichiosis speticemia or drug toxicity ( estrogen, cephalosporin)
186
Q

preleukemia

A

Myelodysplasia - cytopenias in two or three lines in the peripheral blood

187
Q

myelodysplasia prognostic factors

A

poor prognostic factors include increased percentage of blast cells, cytopenias involving more than one lineage, and cellular atypia

188
Q

myelodysplasia subtypes

A

MDS with excessive blasts (MDS-EB) - blast percentages are greater than 5% and less than 20% and progression to AML may occur

MDS with refractory cytopenia (MDS-RC) with blast percentages less than 5% and cytopenias in one or more lineages

MDS with erythroid predominance (MDS-ER) in which the M : E ratio is less than one and prognosis is poor

189
Q

treatment of myelodysplasia

A

none usually if cytopenias are not bad - may need blood transfusion
human EPO has been given experimentally

190
Q

treatment of thrombocythemia

A

one report - vincristine, Ara-C, cyclophosphamide, and prednisone - human med doesn’t know benefit

could use apoquel oclacitinib as a jak inhibitor

radiophosphorus in people has been reported

191
Q

treat meant of CML

A

Imatinib mesylate (Gleevec), a tyrosine kinase inhibitor, is known to be an effective therapy for CML in humans

One dog with chronic monocytic leukemia treated with toceranib (Palladia) and prednisone therapy achieved a clinical remission

Hydroxyurea is the most effective agent for treating CML during the chronic phase.
initial dosage is 20 to 25 mg/kg twice daily. Treatment with hydroxyurea should continue until the leukocyte count falls to 15,000 to 20,000. Then the dosage of hydroxyurea can be reduced by 50% on a daily basis or to 50 mg/kg given biweekly or triweekly

humans use bisulfan alternatively

Vincristine and prednisone therapy resulted in a short remission in one dog

192
Q

polycythemia vera treatment

A

The PCV should be reduced to 50% to 60% or by 1/6th of its starting value

Phlebotomies should be performed as needed, administering appropriate colloid and crystalloid solutions to replace lost electrolytes; 20 mL of whole blood/kg of body weight can be removed at regular intervals

chemotherapeutic drug of choice is hydroxyurea, an inhibitor of DNA synthesis. This drug should be administered at an initial dose of 30 mg/kg for 10 days and then reduced to 15 mg/ kg PO daily

Radiophosphorus (32P) has been shown to provide long-term control in people with PV

could consider JAK inhibition and use apoquel

193
Q

treatment of AML

A

grave

doxorubicin, cyclophosphamide, vincristine, 6-thioguanine, and prednisone

cytosine arabinoside (Ara-C), 100 to 200 mg/m2, given by slow infusion (12–24 hours) daily for 3 days and repeated weekly, has been used, as well as several other variations using subcutaneous injections of Ara-C

194
Q

rr of AML and MST

A

response rates to multiagent protocols are relatively high (50%–70%),

responses are not durable

MSTs 0.5 to 2 months

195
Q

flow for myeloproliferative neoplasias

A

CD34+
negative for CD3, CD4, CD8, CD21, CD79, and IgG,
myeloperoxidase (MPO) and CD11b for myeloid cells
CD41 for megakaryoblasts

AML in dogs, most were CD45/CD18/CD34 positive

196
Q

polycythemia vera vs absolute polycythemia

A

EPO concentrations in dogs with PV tend to be low or low-normal, whereas in animals with secondary absolute polycythemia, the levels are high

197
Q

AML and bone marrow

A

If erythroid cells are less than 50% of ANC and the blast cells are greater than 20%, a diagnosis of AML or AUL is made.

If erythroid cells are greater than 50% of ANC and the blast cells are greater than 20%, a diagnosis of erythro- leukemia (M6) is made.

If rubriblasts are a significant proportion of the blast cells, a diagnosis of M6Er, or erythroleukemia with erythroid predominance, can be made.

198
Q

ALP and AML

A

A recent study indicated that ALP was a useful marker for the diagnosis of AML if neoplastic cells express only CD34

199
Q

A case of acute monocytic leukemia (AMoL or AML-M5) in an adult FeLV/FIV-positive cat

A

Blasts on cbc
Cd3 neg pax 5 neg dimly cd18 pos moderate pos for iba1
Monocytic differentiation

200
Q

Treatment of myeloid neoplasia with doxorubicin and cytarabine in 11 dogs
mst

A

Median duration of remission in 7/11 responder 344 days (11 mo)

OST all dogs 369 day (12 mo)

201
Q

A retrospective review of acute myeloid leukaemia in 35 dogs diagnosed by a combination of morphologic findings, flow cytometric immunophenotyping and cytochemical staining results

dx
ost

A

diagnosis : 20% blasts in bone marrow identified as myeloid based on morphology and flow and cytochemical stains

bi cytopenia 44%
pancytopenia 44%

ost 19 days - improved with chemo

202
Q

dog with TCC on deramaxx which is true

a. Gi toxicity higher than piroxicam alone

b. when PD on deramaxx can add in chemotherapy and it is likely to improve disease

c. add gemcitabine

A

a. 17% of dogs had gastrointestinal signs with piroxicam alone - 6 dogs had to take holidays and only 2 resumed
19% of dogs had Gi signs with deramaxx alone bu the GI signs ere more mild and no dogs had to stop administration

b. MST 300 - 338 days; 10-11 mo (longest reported) were for the dogs who initially received cisplatin alone, and then when that treatment failed (due to toxicity or tumor progression) they received a COX inhibitor alone - opposite to the answer choice

c. gemcitabine and piroxicam 26% RR (CR/PR) 50% SD mst 230d

unsure what’s correct

203
Q

TCC and risk of UTI

A

80%
staph positive culture - other is e.coli
female with urethral involvement increased risk

204
Q

TCC firocoxib rr

A

20%

205
Q

TCC stent facts

A

> 90% success, longer stent the higher the risk of incontinence

206
Q

TCC BRAF sens and spec

A

Sn 80
Sp 100

207
Q

complications with urethral stents

A

migration
incontinence
uti

208
Q

where does tcc met in the spinal cord

A

intramedullary

209
Q
  1. What is true of radiosensitivity and repair of sublethal RT-induced damage In TCC?
A

Surviving cell fractions at 2 Gy: 0.6
o ɑ/β low = higher dose/less fractionation indicated

210
Q

K9 BRAF mutation in TCC
- mutation
- frequency

A

o Somatic mutation in V595E on Chr16
o Homologous to human V600E
o Present in 87% of invasive TCC

211
Q

Which of the following are initiators for K9 TCC?

A

Somatic mutation of V595E
2,4-dichlorophenoxyacetic acid (2,4 D) (OR 4.4

212
Q

tcc express what cancer promoting pathway

A

PDL1

literally so many studies showing this idk

213
Q

What is the effect of combining piroxicam and CIS for tcc

A

Moderate to severe renal AE with TCC

214
Q

what cox inhibitor was shown to not increase renal toxicity with cisplatin

A

firocoxib

215
Q

TCC prioxicam alone
RR (pr/cr)
SD
PFI
MST

A

21% rr
59% sd
PFI 120 d - 4 mth
MST 244d - 8 mth

216
Q

TCC deracoxib
RR (pr/cr)
SD
PFI
MST

A

RR 17%
SD 71%
PFI 133d - 4 mo
MST 323d - 11 mth

217
Q

TCC Ferocoxib
RR (pr/cr)
SD
PFI
MST

A

RR 20%
SD 33%
PFI 105 d - 3.5 mo
MST 152 d - 5 mths
some received cisplatin after failure

218
Q

TCC mitoxantrone + piroxicam
RR (pr/cr)
SD
MST

A

RR 35%
SD 46%
PFI 106 - 194d - 6 mo
MST 247 - 291 days - 10 mths

219
Q

TCC vinblastine alone
RR (pr/cr)
SD
PFI
MST

A

RR 36%
SD 50%
PFI 122 - 143 ~4-5 mo
MST 147d - 531 d ~5-18mo
higher survival rates seen in dogs that received vinb alone and then once pd received piroxicam alone

220
Q

TCC vinblastine piroxicam
RR (pr/cr)
SD
PFI
MST

A

PR 58%
SD 33%
PFI 199 d ~6.5 mo
MST 299 d ~10 mo

221
Q

TCC vinb - folate conjugate
RR (pr/cr)
SD
MST

A

RR 56%
SD 44%
PFI 115d
MST 115 d - 4 mth

222
Q

TCC cisplatin alone
RR (pr/cr)
SD
PFI
MST

A

RR 0 - 25%
SD 25-50%
PFI 84 - 124
MST 105-130 d - 3.5 - 4 mths

combo of several studies

dogs that did the best started on cisplatin and switched to Piroxicam or firocoxib
300-338 d

223
Q

TCC cisplatin and piroxicam
RR (pr/cr)
SD
MST

A

RR 50% - 71%
SD 17% -28%

MST 246- 320 days ~8-10 mo

combo of two studies

224
Q

TCC carbo alone - 12 dogs total
RR (pr/cr)
SD
MST

A

RR 0%
SD 8 dogs
PFI 41 d
MST 132 days

225
Q

TCC prioxicam + carbo
RR (pr/cr)
SD
MST

A

RR 38%
SD 45%
PFI 73d
MST 161 d - 263d ~5-8.5 mo

226
Q

TCC prioxicam + doxo
RR (pr/cr)
SD
PFI
MST

A

RR 9%
SD 60%
PFI 103d
MST 168 d

227
Q

TCC 5 azacitadine
RR (pr/cr)
SD
MST

A

RR 22%
SD 50%
MST 203 d ~7mo

228
Q

TCC leukeran metronomic 4 mg/m2
RR (pr/cr)
SD
PFI
MST

A

RR 3%
SD 67%
PFI 119 d ~4mo
MST 221d ~7 mo

229
Q

Vinblastine/toceranib/COX inhibitor
RR

A

RR 33-55%

230
Q

Cisplatin (60 mg/m2/ piroxicam/tavocept
RR
SD
MST

A

RR 27%
SD 73%
MST 253 d ~8.5mo

231
Q

TCC firocoxib and cisplatin
RR (pr/cr)
SD
MST

A

RR 57%
SD 21%
MST 179 days - 6 mths

232
Q

Psma = prostate specific membrane antigen
can this be used to distinguish between prostatic carcinoma and tcc?

A

NO PSMA was not differentially expressed

may be a target for treatment or dx of both disease

233
Q

Irreversible Electroporation Balloon Therapy for Palliative Treatment of Obstructive Urethral Transitional Cell Carcinoma in Dogs

A

no complications noted
1/3 dogs had benefit

234
Q

Usefulness of squash preparation cytology in the diagnosis of canine urinary bladder carcinomas

sn, sp, accuracy, npv, ppv

A

Se 98%
Sp 65%
Accuracy 89%
Npv 92%
Ppv 88%

235
Q

cytologic findings on urinary bladder cancer cytology

A

absence of neutrophilic inflammation
presence of multinucleate cells
nuclear molding

236
Q

Assessment of HER2 Expression in Canine Urothelial Carcinoma of the Urinary Bladder

A

HER2 expression in a subset of UC but also polypoid cystitis and normal bladder so not a good target

237
Q

what’s better urine sediment or diagnostic catheterization?

A

SN and SP increased with diagnostic catheterization

238
Q

BRAF mutation status and its prognostic significance tcc

A

BRAF status NOT associated with OST
most common variant was a V-to-E missense mutation in BRAF

239
Q

Expression of receptor tyrosine kinase targets PDGFR-β,VEGFR2 and KIT in canine transitional cell carcinoma

A

PDGFR-b significantly expressed in TCC vs normal and cystitis
VEGFR2 stained but was similar across all tissue samples
minimal staining of kit

240
Q

what are environmental exposure risks for tcc

A

Proximity to a farm and insecticide use were contributing factors to TCC risk

Low activity glutathione variants are unlikely to contribute as it does in humans

241
Q

ct scans of patients with tcc revealed more what than traditional staging

A

boney mets and sternal lymphadenopathy

242
Q

prognostic factors for tcc

A

boney mets, tcc location, sternal lymphadenopathy

243
Q

mst of urethral vs bladder tcc
met rate of urethral vs bladdeer tcc

A

urethral 122 d - 4 mth , met rate 42%
bladder 420 d - 14 mth , met rate 6.3

244
Q

palliative rt for cats with ucc

A

6 Gy weekly x 4 = 24Gy
Resolved symptoms in all cats minim AE grade 1 GI in one G2 urinary
Good tx option

245
Q

most common location o bladder masses in cats

A

one study says trigone

Withrow says away from the trigone

246
Q

met rate of tcc in cats

A

21%

247
Q

pfs and mst in cats with tcc who had
surgery (partial cystectomy) and nsaids

A

pfs 113 d ~3.5 mo
mst 155 d ~5 mo

Withrow says 261 days ~ 8 mo from a smaller study

248
Q

most common bladder tumors in cats

A

UCC

also mesenchymal, lymphoma, and others

249
Q

mst cats with tcc treated with meloxicam

A

311 days ~10mo

250
Q

what percent of urethral lesions are granulomatous/chronic active urethritis

A

24%

251
Q

renal cancers in dogs

A

renal cell carcinoma (RCC), adeno- carcinomas, iUC, papillary cystadenocarcinomas, and less commonly, sarcomas

252
Q

what para neoplastic syndrome is associated with renal cystuadenocarcinoma

A

nodular dermatofibrosis

253
Q

what inherited msisense mutation is found in renal cystadenocarcinoma

A

FLCN (folliculin gene)
similar to Bird HOGG Dube in people

254
Q

what renal tumor has been reported in young dogs and dogs of all ages

A

nephroblastoma

255
Q

clinical signs of renal tumors

A

hematuria, pain in the area of the kidneys, a palpable abdominal mass, bone pain secondary to hypertrophic osteopathy, or other nonspecific signs such as GI upset or behavior changes

in a cat most common sign is weight loss

256
Q

what paraneoplastic lab work abnormalities can you see with renal tumors

A

polycythemia vera from excessive epo production
anemia
hypercalcemia
elevated ALP
hypoalbuminemia

257
Q

what is the treatment of choice for renal tumors

A

nephrectomy even for palliation
- must have ct, no mets, and normal renal functions

258
Q

mst renal tumors

A

16 mth rcc
9 mth renal sarcoma
6 mths nephroblastomas

259
Q

negative prognostic factors for rcc

A

high mitotic count >30 , high cox 2 expression, specific subtypes, fuhrman nuclear grade ( gr 1- 4)

260
Q

mst for rcc based on mc

A

mc <10 1184d 40mo
mc >10<30 452d 15 mo
mc >30 187d 6mo

261
Q

what subtypes are better or worse for rcc

A

mst clear cell - 87 days WORST ~3 mth

chromophobe, papillary, multilocular cystic

262
Q

met rate at dx vs necropsy in renal tumors

A

16-34% at dx
88% of sarcomas at death
75% of nehphroblastomas at death
69% with carcinom

263
Q

Excluding lymphoma, reported feline primary renal tumors include

A

tubular RCC, tubulopapillary RCC, sarcomatoid RCC, adenocarcinoma, adenoma, iUC, squamous cell carcinoma, leiomyosarcoma, nephroblastoma, and hemangiosarcoma

tubular and tubulopapillary RCC were most common

264
Q

paraneoplastic syndrome in cats with renal tumors

A

polycythemia vera

265
Q

treatment of renal tumros in cats

A

nephrectomy
chemo unknown benefit

266
Q

most common grade of ucc in dogs

A

70% grade 3 (high grade) tumors, 29% grade 2 (intermediate grade) tumors, and 1% grade 1 (low grade)

267
Q

non ucc bladder tumors

A

squamous cell carcinoma, adenocarcinoma, undifferentiated carcinoma, rhabdomyosarcoma, lymphoma, hemangiosar- coma, fibroma, and other mesenchymal tumors

268
Q

% of ucc tumors in urethra? prostate?

A

urethra 56%
prostate 29%

269
Q

% of ucc tumor with mets at diagnosis

A

nodal - 16%
distant mets - 14%

270
Q

who staging ucc

A

T2 - 78%
T3 - 20%

271
Q

% mets at necropsy dogs

A

58% distant mets
42% nodal mets
33% had both

272
Q

sites of mets for ucc

A

lungs most common
liver, kidney, adrenal gland, spleen, bone, skin, heart, brain, GI, spinal

273
Q

how many dogs with ucc have 2nd tumors at necropsy

A

13% including las, hsa, thyroid carcinoma, etc

274
Q

% bone mets at necropsy

A

9% documented in records
14% when CT was used at euthanasia

275
Q

other locations of uc besides the bladder

A

can occur in the abdominal wall, either through seeding from instruments and needles used in surgical and nonsurgical procedures, or through natural spread of transmural lesions along bladder ligaments.
UC in the abdominal wall is typically aggressive and poorly responsive to medical therapy

276
Q

risk factor for ucc

A

exposure to older flea control , lawn chemicals, obesity, maybe cyclophosphamide, female gender, risk is higher in neutered dogs of any breed
** breed

risk was significantly lower in dogs that ate vegetables at least three times per week in addition to their dog food - carrots

277
Q

IHC of tcc

A

uroplakin III
GATA 3

278
Q

breeds associated with tcc

A

scottish terriers
shetland sheepdog
westie
beagle
dalmation

279
Q

surgery for ucc
psi
mst

A

UC lesions away from the trigone
following chemo and nsaids
with or with out chemo
psi 235 d mst 348 d

subset of dogs with sx and piroxicam/deracoxib lived 722d - 749

280
Q

what is the chance of tumor control for ucc by any means

A

75%

281
Q

factors associated with advanced stage of ucc

A

younger - increased risk of nodal mets
prostate involvement - increased risk of distant mets
higher T stage - increased nodal and distant mets

282
Q

when to treat a uti in a dog with ucc

A

A positive urine culture, with a low colony count in the absence of worsening clinical signs and supporting findings on urinalysis, is not an indication to treat with antibiotics

if a dog has new or progressive signs - perform a ua - if If the urinalysis reveals pyuria or the presence of intra- cellular bacteria -perform a culture

can treat with drug that will kill staph and E. coli - tms or clavamox

283
Q

what abx have been associated with uti resistance after treatment for 30 days

A

amoxicillin, doxycycline, enrofloxacin

284
Q

mst following urethral stent placement

A

20-78 days range 2 - 536 d - for prostate

285
Q

frequency of incontinence with stents in tcc

A

25 - 39%

286
Q

mst following ureteral stent placement

A

57 days range 7 - 337

287
Q

transurethral carbon dioxide and near infrared diode laser ablation of uc complications

A

perfo- ration with iUC spread, transient postprocedural worsening of stranguria and hematuria, urethral stenosis, and infection

in a small study outcome was not better than medical management alone

288
Q

rt SE for UC

A

chronic colitis, cystitis, and urethral strictures

improved with use of srt
newer study - mild and self-limiting and included colitis (38%), erythema or hyperpigmentation (19%), and stranguria (5%). Late complications included urethral stricture (9%), ureteral stric- ture (5%), or rectal stricture (5%).

289
Q

mst IMRT for UC

A

654 d ~22mo
event free interval 317 d 10.5 mo

290
Q

palliative rt for uc

A

10 daily f of 2.7 gy
mild colitis cystitis vaginitis and dermatitis
CR/PR 61%
SD 38%

291
Q

how frequently do you monitor uc lesions

A

4-8 weeks

292
Q

multiagent protocols for ucc

A

no benefit known
no known benefit of using a maintenance protocol

293
Q

benefit of tavocept with cisplatin

A

less renal toxicity
but response was worse

294
Q

can you avoid gi toxicity of piroxicam if you give gi protectants

A

no - one study showed they were worse

295
Q

RCC prognostic with sx
a. 1 year
b. slightly more than 1 year
c. 6 months

A

b
mst with nephrectomy 16 months

296
Q

Is c-kit ever mutated in feline tumors and if so what exon?

A

Yes, 68% higher than dogs, exon8

297
Q

What two tumors stain positive for cytokeratin & vimentin?

A

Mesothelioma and synovial cell sarcoma, ovarian CA, RCC tubulopapillary

Onco boards 2024 (17 decks)

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