Exam 7 L. 6 Flashcards Preview

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Flashcards in Exam 7 L. 6 Deck (17):
1

Cancer

1) cancer is a genetic disease
2) self-sufficiency in growth signals
3) in-sensitivity to anti-growth signals
4) ability to evade apoptosis
5) limitless replication potential
6) sustained angiogenesis
7) capacity to invade tissues and metastasize

2

What is it?

1) obtain confirmed histologic/cytologic diagnosis
2) confirm cytology with histopathology

3

Sarcoma

Originates from connective tissue/stroma (i.e. bone, cartilage, muscle)

4

Carcinoma

Originates from epithelial tissue (parenchyma, glandular structures, surfaces and linings)

5

Criteria of malignancy

1) pleomorphism
2) anisocytosis
3) macrocytosis
4) variation in N:C
5) increased N:C
6) variation in stages of maturation

6

Nuclear features of malignancy

1) Anisokaryosis
2) macronuclei
3) multiple nuclei
4) abnormal mitoses
5) fine chromatin
6) nuclear molding

7

Gold standard for diagnosis of cancer**

HISTOLOGY

8

Benign versus malignant tumors: biologic criteria

Criteria = ability to spread, invasiveness growth rate
Benign: non-metastatic, noninvasive, slow to moderate growth rate
malignant: metastatic, invasive/destructive, variable (often rapid)

9

Clinical staging

Estimate the extent of the cancer
-T = tumor size, measured precisely, recorded
- N = lymph node status
- M = distant metastasis, know probable sites (usually requires imaging)

10

N-regional lymph node

1) size, consistency are not sufficient
2) histologic exam: entire lymph node-gold standard
-alternatives: fine needle aspiration and cytology

11

M-metastasis

1) detection of pulmonary metastasis
-3 view thoracic radiographs: detection 5-8 mm
-CT detection lung metastasis: detection at 1-3 mm

12

Metastatic routes

1) vascular invasion with hematogenous spread
2) most sarcomas
-tumor cells travel vasculature lodge in small capillaries
-metastasis arise in tissues with high density capillary beds: lungs, liver, spleen
3) most carcinomas
-tumor cells gain access to lymphatics that drain the tumor bed
-metastatic lesions arise in LN, lymphatic vessels, and sites of high lymphatic activity (spleen, bone marrow)

13

As part of clinical staging...

Determine if there is any concurrent disease

14

Definitive cancer treatment

1) Cure: removing all tumor cells (usually through surgery or radiation, drug therapy usually isn't a cure)
2) complete remission: no gross evidence of disease

15

Palliation

1) improve quality of life with some tumor control possible is a prolonged remission
2) preserve quality-of-life with no tumor control

16

Cancer therapy

Multimodality therapy often gives the best results!

17

How often is response to therapy assessed?

1) the goal of follow-up is to detect tumor recurrence or metastasis at the earliest possible time to maximize further therapy
2) for postoperative or post radiation therapy patients, evaluate at regular intervals (i.e. 1, 2, 3, 5, 7, 9, and 12 months)
3) hematologic malignancies weekly to biweekly