Respiratory Neoplasia Flashcards
(21 cards)
What are the different PE tests for determining nasal air flow patency?
What are the clinical signs of an intranasal mass?
Epistaxis, mucopurulent discharge
Facial deformity
Dyspnea, sneezing
Chronic duration (2-3 months)
What is the superior diagnostic for nasal tumors?
CT scan
What are the different types of biopsies for nasal tumors?
Rhinoscopy - small samples
Curette
Laryngeal cup forceps
Core
Hydropulsion - larger pieces
Rhinotomy - last resort
What is the biologic behavior of nasal tumors?
Locally aggressive
Slow to metastasize
What is the treatment for nasal tumors?
Palliative (MST 95d)
Sx alone (MST 3-6m)
Chemo (not curative alone)
Radiation!!
What is the treatment of choice for nasal tumors?
Radiation therapy
What are the most common differentials for a mediastinal mass?
Thymoma
Lymphoma
What is the diagnostic workup for a mediastinal mass?
US guided FNA
Cytology
Flow to differentiate (CD4+CD8+ = thymoma)
Pre-operative thoracic CT
What is the treatment for a mediastinal LSA?
Chemotherapy
What is the treatment for a thymoma/ectopic thyroid?
Surgery
What is the treatment for a chemodectoma?
Radiation therapy
What is precaval syndrome/cranial vena cava syndrome indicative of?
Thymic mass causing compression or obstruction of the cranial vena cava
Reversible if thymic mass is eliminated
What are the diagnostics of choice for a patient with hypercalcemia and a thymoma?
Ionized calcium
PTH and PTHrp
R/o myasthenia gravis
What paraneoplastic syndromes are associated with a thymoma?
Hypercalcemia
Myasthenia gravis +/- megesophagus
Polymositis
Erythema multiforme
Arrhythmias
Exfoliative dermatitis (cats)
What are the clinical signs associated with a solitary lung nodule?
Cough
Dyspnea
Lethargy
Weight loss
Lameness
Digit mass (cats)
What are differential diagnoses for lung nodules?
Primary lung tumor (carcinoma)
Metastasis
Malignant histiocytosis
Granuloma
Fungal
What diagnostics should be done with a solitary lung nodule?
CT (more sensitive) = lymphadenopathy, other pulmonary lesions
FNA with cytology (US guidance) = AVOID penetrating normal lung tissue
What are the limitations for CT with solitary lung nodules?
Does not distinguish resectability
Does not inform invasiveness/adhesions
What is the treatment of choice for solitary lung nodules?
Lung lobectomy
Can do thoracoscopic lobectomy with smaller lesions)
What is the most common primary lung tumor?
Adenocarcinoma
