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54 Cards in this Set
- Front
- Back
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Frequency of MCT in dogs and cat
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The most common skin tumor in a dog and the second most common skin tumor in a cay
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Granules in MCT contain what substances (yes, histamine but three others)
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heparin, TNF, proteases
but depends on the environment which granules are experssed |
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Which breeds are at a higher risk for developing MCT?
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bulldog breeds BUT they typically have a more benign presentation
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Which breed is more likely to have an aggressive MCT?
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Shar-pei
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What is required for hematopoietic stem cells (CD34+) to differentiate into Mast cells?
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Stem cell factor
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What percent of MCT have kit mutations?
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25-30% of intermediate to high grade tumors
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What percent of MCT have multiple lesions?
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10-15%
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Location of MCT on the body?
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50% trunk and perineal region
40% limbs 10% on head and neck |
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Darier's sign is what?
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when there is swelling and redness after manipulation of MCT
can occur independently as well |
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What percent of MCT had GI ulceration at necropsy?
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35-85%
Histamine is acting on the parietal cells (H2R) |
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In general which GI chemicals are elevated and decreased in blood...
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Histamine - elevated
Gastrin - lower in response to circulating histamine |
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What is predictive of MCT behaviour? Are any of these factors independent prognostic indicators?
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HIsto grade
CS Location cell prolif rate (MI, AgNOR, PCNA, Ki67) Growth rate DNA ploidy MVD recurrence Systemic signs age sex tumor size ckit mutation |
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Which locations are worse prognosis?
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controversial but subungual, oral, mm, preputial, and scrotal have a worse px
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What classifies a MCT as high grade according to Kiupel's paper?
mitotic figures multi-nucleated bizarre nuclei one other description |
7 MF/10 hpf
3 multi-nucleated cells per 10/hpf 3 bizarre nuclei/10 hpf karyomegaly |
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Out of all the markers in MCT, which are the most reliable at predicting outcome?
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AgNOR (as or more predictive than grade)
Ki67 PCNA (not as helpful) MI (<5>) is strong predictor |
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ST of MCT in SQ?
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2 yr 90%
5 yr 85% and decreased survival was assoc with higher than 4 MI |
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Stages of MCT
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Stage
0 one tumor incompletely excised 1 one tumor dermis NO LN 2 one tumor dermis with LN 3 multiple tumors with LN 4 distant mets |
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Which stain is recommended for MCT id? if granules do not stain which special stains should you use?
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Romanowsky
special stains for granules include Toluidine blue stain Wright-Giemsa |
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What markers are used if stains do not id as MCT?
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vimentin (+)
tryptase (+) CD117 (kit) chymase MCP-1 IL-8 |
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If MCT is in surgical area and no neg prognostic indicator , what is the next step?
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just sx no further diagnostics are needed
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What percent of healthy LN have occasional MCT in them?
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about 50%
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When is the buffy coat useful in MCT dx
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if there is visceral involvement which is rare. BUT remember that peripheral mastocytosis also occurs in acute infections like parvovirus. So generally not useful.
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What are the recommended surgical margins?
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lateral 1-2 cm and if low or intermediate grade
One study showed that if 10mm lateral and 4 mm deep no mets or local recurrence |
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What are the options for lower limb MCT?
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amputation
RT @40-50 Gy has a 1 yr control rate |
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Is there any benefit to irradiating the sentinal node?
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Only if high grade or high risk of mets
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What percent of the mast cell tumor that are in completely removed recur?
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20 to 30%
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What is the benefit of adjuvant corticosteroid therapy in intermediate grade mast cell tumors that have been excised completely or treated with local RT post surgery?
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There is no benefit
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Which mass cell tumors respond to prednisone?
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Those that express glucocorticoid receptors. Therefore a subset of the mast cell tumor population respond to steroid therapy
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What is the response of high-grade Mast tumors to vinblastine and prednisone?
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Dogs with high-grade mast cell tumor had a median survival time of 1300 days
There is a 1-2 year 70% ST |
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What is the objective response rate in to toceranib in MCT?
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40% with Palladia vs 4% in placebo
The median duration of response was 12 to 18 weeks |
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What is the likelihood of responding to Palladia it's wild type C – kit?
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2X
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What are the most common side effects with Masitinb?
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G.I. Side effects are mild
Myelosuppression was mild Protein losing nephropathy leading to edema Increases in urea and creatinine |
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What is the response rate of adding Vinblastine with Toceranib?
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71%
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Toceranib, prednisone and hypofractionated RT for non-resectable or metastatic mast cell tumor.
What was the response rate overall what was the complete response rate? |
ORR was 75%
CR was 60% |
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what drug should be added if there is active evidence of gastric or duodenal ulceration
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Sucralfate, misoprostal, histamine blockers
Protamine sulfate, a histamine antagonist, is useful in severe hemorrhage |
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What are the three syndromes of mast disease seen in a cat?
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Cutaneous
Splenic/visceral Intestinal |
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Which exons have mutations in cats?
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Exon 8 and 9
Both encode the fifth immunoglobulin domain of kit |
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Which stains are used in feline mast cell tumors?
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Giemsa
Toluiine blue |
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How common is cutaneous feline mast cell tumors?
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They're the second most common skin tumor in accounting for 20% of all skin tumors
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What percent of cutaneous mast cell tumors in cats are multiple?
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20%
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What are the two distinct types of cutaneous MCT's?
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1) typical mastocytic
2) histiocytic mast cell tumors. These tumors regress spontaneously over a period of 4 to 24 months it also typically occurs in younger cat less than four years old. |
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Cutaneous mastocytic form has two subdivisions?
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Diffuse and compact
Compact MCT's typically are benign |
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The most common location for MCT's in a cat?
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Head and neck
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What is the benefit of using the dog MCT grading system in the cat?
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No predictive value
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What is the strongest predictive variable in cat?
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MI has the strongest predictive value
Other factors kit immunoreactivity score, ki 67 both correlate to unfavorable outcome. |
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. What is the definitive treatment for cutaneous feline mast cell tumor?
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Surgery
Local recurrence following excision, even if incomplete, are zero to 20%. |
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Is there a benefit to adding steroids into a cat protocol treating mast cell tumor?
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? MCT's in cats are not as responsive to prednisone as dogs.
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CCNU and cats with MCT?
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There is a 50% overall response rate
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What are the most common side effects with Masitinib?
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Neutropenia, proteinuria, increases in creatinine
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What is the most common hematologic finding with splenic mass cell tumors?
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Anemia
eosinophilia is less likely |
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What is the recommendation for splenomegaly and Mass cell tumor
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Even if there are other organs involved a splenectomy is recommended.
A good quality of life MST of 12 to 19 months |
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What are some negative prognostic indicators with splenic MCT's?
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Anorexia, weight loss, male
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Have frequent is MCT in the intestine?
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It is the third most common intestinal tumor typically involving the small intestine. Colonic involvement is usually less then 15% of cases.
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Treatment and prognosis for a intestinal mast cell tumor
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Surgery with wise surgical margins of 5 to 10 cm.
75% of animals are euthanized within two months. |
