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Effects of tumor on host
Terms in this set (32)
Effects of tumor on host may be due to: (4)
--•Hormone production, etc.
Location of tumor: can both benign and malignant play a role?
-how might it affect organ function? How might it effect relationships of different organs? what can it do to adjacent tissue? What can it do to hollow organs? What might cause external masses?
Benign and malignant tumors - negatively impact health
•May replace normal tissue and affect organ function
---•Visceral organs and skeleton
•May disrupt normal anatomic relationships of organs
---•Enclosed bony spaces i.e.- cranial vault
•Pressure atrophy or necrosis of adjacent tissue
•Rupture or stricture of hollow organs
•External masses - site of trauma, secondary infection, etc.
When might mesenteric lipomas in a horse cause problems? what will this present as?
Mesenteric lipomas in horses:
• Obstruct movement of intestinal contents
---If on a stalk (pedunculated) - strangulate it
Strangulated intestine is dark and dilated due to a pedunculated lipoma
Location: significance of pituitary adenomas
• Even nonfunctional tumors can cause CNS or endocrine disease due to expansion
Location: significance of oral tumors
-What is a locally aggressive tumor arising from gingival epithelium? describe these
Oral tumors can restrict eating or chewing & cause weight loss
• Acanthomatous epulis or acanthomatous ameloblastoma
--•never metastasize but are locally destructive and are notorious for recurring if excision is incomplete
Location: significance of nasal carcinomas
• Obstruct airways
• Infiltrate and deform the skull
Location: significance of Brain tumors
Brain tumors expand and infiltrate the adjacent tissue causing CNS signs, but seldom metastasize.
Location: significance of metastatic tumors
-What is metastatic hemangiosarcoma?
-what is a secondary problem associated with pulmonary or splenic masses?
Metastatic tumors may cause more problems than the primary tumor.
Metastatic hemangiosarcoma - Pulmonary metastases respiratory distress
Primary splenic tumor - clinically silent
Pulmonary or splenic masses may rupture and bleed, leading to respiratory distress (lung) or weakness and possible exsanguination (spleen)
What is a common route for ovarian and uterine carcinomas? what often develops in this case?
Implantation of the peritoneal cavity is a common route of metastasis for ovarian and uterine carcinomas (also called peritoneal carcinomatosis)
-Ascites often develops in patients with peritoneal metastasis
Tumors affecting functional activity:
-what are these basically defined as?
-what are the 4 main types we will see? (think cecretory areas
Hormone-producing tumors of endocrine glands
•Islet cell adenomas or carcinomas
---•Also known as "insulinomas"
•Adrenal cortical adenomas or carcinomas
What do functionally active endocrine tumors do?
Functionally active endocrine tumors typically produce hormone in an unregulated manner >>> results in abnormally high hormone levels.
Describe canine hyperadrenocorticism (cushings disease)\
-why might adrenal cortices be thickened?
Small, benign tumor that was functional and produced high, unregulated amounts of ACTH.
- Clinical signs include hair loss, pot belly, muscle wasting, polyuria and polydipsia
- Both adrenal cortices are thickened due to hyperplasia
--• response to a functional (ACTH secreting) pituitary adenoma.
What will thyroid adenomas do? what animal do we see this more in? WHat will hypertrophy be a result from?
• Cats can have clinical hyperthyroidism and cardiac hypertrophy due to excessive thyroid hormone produced by the tumor
---hypertrophy due to: caused by direct effect of thyroid hormone on the myocardium as well as ↑ cardiac workload from ↑ oxygen demand
Functional pancreatic islet cell (beta cell) adenoma and carcinoma: what animals do we see it in? what is it defined by and what does it cause? signs?
Most commonly in dogs and ferrets
• Excessive and uncontrolled insulin production >> severe hypoglycemia
• Clinical signs: exercise intolerance and collapse
-what does this occur with?
-what does this cause / signs?
-Know the picture showing its effects on serum electrophoresis
Monoclonal production of immunoglobulin by neoplastic (clonal) plasma cells
•Occurs with multiple myeloma (neoplastic plasma cells in bone marrow)
--• Monoclonal gammopathy
--• Amyloid deposits in organs (can cause dysfunction)
--• Hyper viscosity syndrome, which results in bleeding disorders, altered neuro function and/or heart failure
What are paraneoplastic syndromes?
-what is the clinical significance?
Syndrome cannot be explained by
•Local or distant spread of tumor
•Hormones indigenous to the tissue of origin
Paraneoplastic syndromes clinically important
•Earliest sign of neoplastic disease
•More problems than the primary tumor
What are the 4 paraneoplastic syndromes we are concerned with?
1._______________ of malignancy
1.Hypercalcemia of malignancy
Define hypercalcemia of malignancy
-What is it caused by tumor wise? what does it lead to?
too much calcium
•Production of parathyroid hormone-related protein (PTHrP) by neoplastic cells
•Pseudo hyperparathyroidism or hypercalcemia of malignancy
•Hypercalcemia leads to metastatic calcification
Signs of hypercalcemia of maligancy
-what neoplasms is it most associated with?
Hypercalcemia also results in muscle weakness, anorexia and vomiting, renal failure and cardiac arrhythmia
•Most associated with:
--•Apocrine gland adenocarcinoma of the anal sac in 90% of cases
--•Lymphoma in 20% of cases
What is AGASACA?
Apocrine gland anal sac adenocarcinoma
How might hypercalcemia of malignancy appear in a kidney?
Dilated and mineralized renal tubules from a dog with anal sac adenocarcinoma and PTHrP production
Define hypertrophic osteopathy
-What is it associated with neoplasm wise? How might it present?
Bony proliferation (subperiosteal) along the diaphysis of long bones.
•Associated with intrathoracic neoplasms
--•Space occupying intrathoracic masses (granulomas or abscesses).
--•Tumors in other locations -urinary bladder
Huge swollen limb
Hypertrophic osteopathy: mechanism? describe the differential diagnosis
Precise mechanism is unknown -Abnormalities in prostaglandin production are suspected
•Bony proliferation similar to HO is also seen in dogs with Hepatozoon americanum infection
•Protozoal parasite in skeletal muscle and heart
Myasthenia Gravis: what is it defined as? what is this due to? What does it result in?
Blockade of acetylcholine, which blocks transmission at neuromuscular junction
•Due to antibody production against acetylcholine receptor
Results in exercise intolerance, with progressive weakness to point of collapse.
•Megaesophagus also occurs
Myasthenia gravis: what neoplasm is it associated with? Define this neoplasm
Myasthenia gravis is seen in association with thymomas.
•Up to 40% of thymoma cases also have MG
Thymomas arise from thymic epithelial cells;
not from thymic lymphocytes.
-This is a thymic neoplasm (thymoma).
-Not the same as thymic (mediastinal) lymphoma.
Define cancer cachexia:
Progressive loss of body fat and lean body mass
•Accompanied by profound weakness, anorexia and anemia.
•Weight loss of cachexia is only partially due to decreased food intake
Cancer cachexia: what atrophy of fat might we see? how will this look?
Serous atrophy of fat may be seen
•Body fat becomes transparent and gelatinous
•Serous atrophy of fat can also be seen with starvation
Cancer cachexia: in starvation, is fat or muscle loss preferred? What happens to basal metabolic rate and why?
•In starvation, fat loss is preferential
•In starvation, basal metabolic rate decreases to compensate for decreased nutritional intake
What is cancer cachexia due to? WHat cytokines pay a role and how??
Due in part to an increased basal metabolic rate
Increase in circulating TNFα and IL-1 likely plays a role
•Cytokines produced by tumor and by host in response to tumor
•Other cytokines and hormones are also associated with cachexia
Cancer cachexia: what does this do to digestion? nutrients? can extra calories help?
Impaired digestion may be seen in patients with cancer
•Nutrient loss may also result from cancer-related effusions
•Extra calories do not fully reverse catabolic state of cancer cachexia
How might severe cancer cachexia appear in abdominal cavity and mesentary
Little to no adipose
What will cancer cachexia appear like in coronary groove, bone marrow, and renal pelvis? what is a common finding in cachectic cattle?
Cachexia with serous atrophy of fat. The fat in the coronary groove, bone marrow and renal pelvis is reduced to gelatinous material.
A common finding in cachectic cattle is fat atrophy in the tongue resulting in a "floppy" tongue.
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