Neoplasms of the Liver Flashcards
(29 cards)
In which species is primary hepatic tumour more common, cat or dog?
Cats!
Metastatic tumour is 3x more frequent than primary hepatic tumour in the dog
Which species is more likely to have a benign hepatic tumour?
Cats! – if malignant, tend to be found at a younger age than benign ones
Dogs tend to get malignant hepatic tumours
What are the 4 general tissues types for primary hepatic tumours?
- hepatocellular
- bile duct
- neuroendocrine
- mesenchymal
What’s the most common primary hepatic tumour in the dog?
hepatocellular adenoma/ carcinoma
What’s the most common primary hepatic tumour in the cat?
bile duct adenoa
Describe the clinical distribution of hepatocellular carcinoma.
- massive (up to 85%) > nodular (up to 25%) > diffuse (up to 19%)
- metastatic rate is up to 37% for massive, and 93%+ with nodular or diffuse
- the L lateral & medial, and the caudate lobes are most commonly affected
- Mini schnauzers?
Describe the clinical distribution of hepatocellular adenoma.
Adenoma is more common than carcinoma in cats
- singletons can get quite big, pedunculated
Hepatocellular tumours can be divided into 3 groups in the dog based on what?
keratin 19 (k19) staining
<5% = well differentiated
Bile duct carcinoma (cholangiocarcinoma) is most common in which species?
Cats! 2nd most common in the dog after HCC
Where are the 3 locations for cholangiocarcinoma? Which is the most common location of dogs? cats?
- intrahepatic
- extrahepatic
- within the gallbladder
- intrahepatic = most common in the dog
- intra and extra-hepatic = same frequency in the cat
- within the gallbladder is rare in both species
What’s a typical signalment for cholangiocarcinoma in dogs?
female, lab
What’s the a typical signalment for cholangiocarcinoma in cats?
there is no breed or sex predisposition in cats
What’s the metastatic rate of gallbladder carcinoma in dogs and cats?
dogs: 88%
cats: 78%
What’s the most common metastatic location for gallbladder carcinoma?
regional LNs and lungs
What’s the common distribution pattern of cholangiocarcinoma in cats?
nodular: up to 54%
massive: 37-46%
diffuse: 17-54%
Describe the biological behaviour of hepatic neuroendocrine tumours.
Rare - 3% dogs, 13% cats
aka = hepatic carcinoid
- biologically aggressive
- usually intrahepatic, none surgical, due to diffuse nature
- frequently metastasize –> regional LNs, peritoneum, lungs, etc
- tend to occur at a younger age (7yo)
What’s the most common mesenchymal tumour in the liver in cats? dogs?
Cats = hemangiosarcoma
Dogs = leiomyosarcoma
What’s the biological behaviour of hepatic mesenchymal tumours in dogs?
Aggressive
- >80% have metastasis to spleen and lungs
- nodular (2/3) > massive (1/3)
What are some clinical signs associated with liver tumour?
vague –> lethargy, anorexia, vomiting, weight loss, PU/PD, ascites, pyrexia
- jaundice is more common with bile duct carcinoma and diffuse neuroendocrine tumours in dogs
What CBC/ Biochem changes are noted with liver tumours?
CBC:
- anemia: due to chronic disease, RBC sequestration, iron deficiency, loss
- neutrophilia: tumour induced inflammation
- thrombocytosis: 50% dogs of massive HCC
- regenerative anemia, thrombocytopenia: HSA
Biochem:
- elevation in liver values –> not correlated with severity of cancer
- primary liver cancer more likely to cause hypoproteinemia, hypoglycemia, and increase in ALT
- primary liver cancer less likely to cause hyperbilirubinemia
- AST: ALT ration < 1 = HCC or bile duct carcinoma; if >1 = neuroendocrine or mesenchymal
How frequent is icterus in cats with biliary neoplasia?
only 1/3!
How can alpha fetoprotein be used in hepatic neoplasia?
about 75% of dogs with HCC and 50% of biliary neoplasia will have elevated alpha fetoprotein; but alpha fetoprotein has multiple potential sources in the dog, so it’s not very specific
Is CT or MRI better for hepatic neoplasia diagnosis?
MRI has better detection, quantification, and localization vs CT
What’s the diagnostic agreement between cytology and histology for hepatic neoplasia in dogs? in cats?
30% agreement in dogs, 50% in cats
