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78 Cards in this Set
- Front
- Back
what are the layers within the skin |
epidermis dermis hypodermis (SQ) |
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which cells in the epidermis can cause skins tumors? what type of tumors |
- epithelial cells: -- keratinocytes: papilloma / SCC -- melanocytes: melanoma |
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what cells in the dermis can cause tumors |
-- adnexal tissues: epithelial tissue that goes down into the dermis -- connective tissue - fibroblasts -- blood vessels -- hematopoietic cells -- nerve cells |
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what type of tumors happen in the adnexal tissues |
- sweat and sebaceous glands: adenoma/ adenocarcinoma - modified sebacious glands: meibomian gland and perianal tumors |
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what type of tumors would arise from the connective tissue |
fibromas fibrosarcoma |
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what type of tumors would arise from the blood vessels |
hemangioma hemangiosarcoma |
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what type of tumors would arise from the hematopoietic cells |
mastocytoma/MCT histocytoma /cutaneous histocytoma plasmacytoma / myeloma |
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what type of tumors would arise from the nerve sheat |
schwanoma malignant peripheral nerve sheath tumors |
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why type of tumors arise from the hypodermis (SQ) |
adipose tumors - lipoma - infiltrative lipoma - liposarcoma |
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what are the two broad parts of the diagnostic work up for skin tumors |
clinical diagnosis definitive diagnosis |
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can you treat a skin tumor based on how it looks |
no |
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what is the clinical diagnosis |
age warning signs risk factors: breed, genes, carcinogen exposure PE: clinical appearance, invasiveness, new lesions blood work problem list: r/o other differentials |
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what are the warning signs |
- suspicion: lesions is unresponsive to treatment > 2 months, chronic lesion of unknown origin - danger signs: --- appearance: inflamed, non-healing ulcer/erosion) -- growth pattern: rapid, irregular, fixed -- anything that interferes w/ local function |
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what is used to make the definitive diagnosis |
cytology or biopsy |
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can you rule out cancer when a cytology is negative |
no |
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can you provide a grade with cytology |
no, you need a biopsy |
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what type of biopsy would you use on a cats nose |
shave or wedge (never a punch) |
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why would you not punch biopsy a cats nose |
this will spread the tumor below normal skin |
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what is the staging protocol for skin tumors |
TNM tumor regional LN mets systemic mets |
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what makes up the T in staging |
size of the tumor and invasion -- palpation, measurement of the superficial lesion -- imaging: rads, CT, US, MRI |
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what makes up the N in staging |
palpation of the RLNs FNA or biopsy of enlarged LNs |
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what makes up the M in staging |
radiographs, abdominal US, CT blood work, BM evaluation |
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what is stage grouping |
some tumors are grouped together based on their response to treatment and their TNM stage I, II, III, IV |
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what is the malignant tumor of keratinocytes |
squamous cell carcinoma |
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what is the etiology of SCC |
-- spontaneous -- induced: canine/feline papilloma virus, FIV, chronic inflammation, chemical carcinogens, excessive sun exposure |
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do SCC met |
yes, they can met to the regional LN |
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do SCC cause solitary or multiple lesion |
either |
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where do canine sunlight assocaited carcinomas happen |
non-pigmented skin on the flank and abdomen of thin coated breeds. |
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what about animals that don't go outside |
they can get it from light through the window |
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what is the process of SCC with sun exposure |
develops in stages over time and continues year to year where it left off thickening of the skin, scaling and crusting --> hyperkeratosis and scabbing (in situ carcinoma) --> BM is penetrated leading to bleeding --> tumor starts to chew up the ear. |
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what is carcinoma in situ |
not yet broken through the BM |
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when should these lesions be removed |
early when they are small |
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what other type of tumor can sunlight cause in dogs |
hemangiosarcoma |
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why should you biopsy this lesion |
biopsy is required to differentiate HAS from hemangioma |
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are you concerned about an HAS meting |
yes -- these are tumors of the blood vessels which makes mets easy. |
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is papilloma transforamtion related to sun exposure |
no |
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what would make you think a lesion was papilloma realted as opposed to SCC from sun exposure |
on haired or pigmented areas |
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where does SCC usually occur on the cat |
on the head: nares, pinna, eyelids, lips |
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would a SCC be more aggressive if it was growing above or below the skin |
below |
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where do SCC generally occur on the cat |
trunk, limbs, scrotum, lips, digits, anus, nose |
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SCC lesions can be erosive or proliforative in the dog/cat |
either |
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what would the skin look like with an SCC |
crusting lesions that develops into a deep ulcer |
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how would you treat a SCC |
surgery: early and complete resection w/ narrow margins
radiation: alone for small lesions, bad sx location or w/ surgery
Topical 5FU in dogs COX inhibitors immunotherapy |
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what about systemic chemo |
not with SCC |
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what do you have to warn owners when they use 5FU |
no sun exposure people can't touch it photosensitive
NO CATs |
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how does immunotherapy work |
chemical peel -- the entire area sloughs off -- very painful
not for cats -- will make them sick when they lick it off |
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what types of tumors do dogs get in their nail bed |
SCC melanoma |
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what clinical signs are associated with SCC of the nail bed |
pain swelling ulceration of the skin purulent exudate loss of nail |
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how bad are these nail bed SCC |
locally invasive almost always result in bone lysis 20-30 % met to the RLNs |
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could you treat this with chemo |
no it does not work amputation gives 14 months |
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what causes feline digital carcinoma |
often metastatic from other locations: lungs, cutaneous
primary digital SCC are uncommon |
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how would you treat this cat |
stage it to determine if a digit amputation can be done. |
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which tumor type if the most comon skin tumor in older cats |
basal cell carcinoma |
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what would a BCC look like |
solitary, well circumscribed, hairless, dome shaped, may contain pigment
|
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how bad are basal cell tumors |
almost always benign -- slow growing and generally caught early |
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how would you diagnose it |
clinical appearance cytology |
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could the lesion be a SCC when the skin is intact |
No -- SCC starts as an ulcer |
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what is an infiltrative BCC |
tumor that grows down into the skin and eventually causes an ulceration |
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how would you treat this if it happened on a cats eyelid |
surgery to remove the eye and lid -- radiation will destroy the eyelid and require the eye to be removed anyway |
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is basal cell carcinoma more common in the dog or cat |
cat |
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how would the BCC be treated |
surgery + radiation for an incomplete resection |
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second most common skin tumor in dogs and rare in cats |
sebaceous gland tumors |
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how concerned are you about sebacious gland tumors |
now too concerned -- most are benign hyperplasia > adenoma >> carcinoma is rare |
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how would you treat one of these tumors |
surgical resection if it is growing quickly and tends to bleed |
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how concerned are you about meibomian gland tumors |
usually benign |
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perianal tumors are common in dogs/cats |
common in dogs rare in cats |
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what causes these tumors |
adenomas: hormonal dependent -- testosterone
adenocarcinoma: no sex or hormonal predisposition |
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how would you treat an adenoma |
castration and tumor removal |
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what about the adenocarcinoma |
resection and radiation
careful not to take resect or radiate too much of the sphincter |
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anal sac tumors happen more commonly in which populations of dogs |
older female dogs |
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what are the prognostic factors associated with an anal sac adenocarinoma |
size hyperCa regional LN mets |
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how would you treat this |
surgery + radiation + mitoxantrone (careful about rectal mucosa and risk of incontinence) |
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what are the typical round cell tumors of the skin |
histiocytoma lymphoid - plasmacytoma, lymphoma transmissible venereal tumor mast cell tumor |
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which type is common in young dogs (< 3 yrs) |
histiocytoma |
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how concerned are you about the histiocytoma |
they are benign and almost always regress. |
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how would you diagnose this |
FNA or excisional biopsy |
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would you be concerned about a cutaneous plasmacytoma |
almost always benign |
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which animals would expect to see this in |
older dogs large breed |