肿瘤学-呼吸系统肿瘤

TumorsoftheRespiratoryCanceroftheNasalPlanumRareinthedogfairlycommoninthecat犬少见，猫常见ThedevelopmentofSCC-correlatedtoUVexposure,itisseeninolder,lightlypigmentedcats.SCC-most Carcinomainsitu,superficialSCC,ordeeplyinfiltrativeSCC Othertumorsatthissite: melanoma,mastcelltumor,fibroma CanceroftheNasalPlanumHistorySCC-usuallyalonghistory(monthstoyears)StagesCrustingand结壳和红Superficialerosionsand表面腐蚀和溃Deeplyinvasiveanderosivelesions深部侵入和腐蚀损伤Associatedeyelid,periauricularskinandearpinnalesionsmayalsobeseenCanceroftheNasalPlanumBiopsyTherapyPreventionlimitsunexposure!预2categories2 Superficialminimallyinvasive表面轻微侵Canbemanagedeffectively-surgeryintralesionalchemo,radiation…能被有效控制手术，真皮内化疗，放Deeplyinfiltratingdisease润ResistanttotreatmentRT),Nosectomy治疗抵抗，鼻切NasalTumors鼻肿Speculateddolichcephalicbreedsordogslivinginurbanenvironments-higherrisk长头 Olderdogs,mediumtolargeLesscommoninthecatHistology2/3carcinomas2/3Adenocarcinoma,SCC, as- NasalTumors鼻肿Rarelymphoma(cat>dog)淋巴癌（猫>狗 Polyps,fibromasCharacterizedbylocalinvasion局 为特Metrate-转移lowatthetimeof atnecropsy50验尸时-SiteslungsandlymphnodesNasalTumors鼻肿Signs-Olderanimalswithanintermittentandprogressivehistoryofinitiallyunilateralepistaxisand/ormucopurulentdischargeAveragedurationofclinicalsigns-3平均临床症状持续3个DDx–bleedingdisorders,hypertension,fungalorbacterialinfections,developmentalanomalies.鉴 异常，高血压，真菌或细 ，发育异常NasalTumors鼻肿Requiresatissuebiopsy需要组织活RadiographsCTX光Lymphnodeaspiratespositiveinasmanyas10ofcases淋Thoracicradiographsusuallynormal胸部X光－通常正TherapySurgery6months手术<6个Radiation7.4-20months放疗－7.4-20Surgeryandradiation2347months手术和放疗－23，47个NasalTumors鼻肿Prognosis预PoorFactors-CrossingmidlineCribriformplateFacialdeformity面部NasalTumors鼻肿Rassnick.JAVMA.Factorsassoc.withsurvivalindogswithuntreatednasalcarcinomas-139cases多风险而 Mediansurvivaltime-95days(3.1Onlyriskfactorepistaxis107dogswithepistaxis-mediansurvival-88days(3months) 32dogswithoutepistaxis-mediansurvival-224days(7.3 Mostdiedorwereeuthanizedbecauseofdisease由于病程发展，大多 或CanceroftheLarynxandTrachea喉和气管癌RareYoungpatientswithactiveosteochondralsites-higherriskforforbenigntrachealosteocartilaginoustumors骨软骨骨化的年轻动物－开始 Canine-Laryngeal a,extramedullaryplasmacytoma,a,undifferentiatedcarcinoma, a,mastcell,adenocarcinoma,SCC CanceroftheLarynxandTrachea喉和气管癌Feline-LaryngealLymphoma(mostcommon),SCCandadenocarcinomahavebeenreported. Tracheal adenocarcinomaandSCC Leiomyomasandpolypshaveseveralreportsofbenigntrachealosteochondraltumors有几 CanceroftheLarynxandTrachea喉和气管癌Signs-Laryngeal:Progressivechangesinbark,exerciseintolerance,or喉：吠声有渐近性变化，运动不耐或吞 Tracheal:coughingandexercise气管：咳嗽和运动不Laryngeal-biopsiedunderdirect喉－－在直接观察下活Tracheal-biopsiedviabronchoscopy/surgical(radiographsmayrevealamassnarrowingtheCanceroftheLarynxandTrachea喉和气管癌Therapy-Larynxsurgeryand/orradiation手术和/Lymphomaradiationand/orchemotherapy淋巴瘤－放疗/SurgicalresectionPrognosis-Ifbenignandtreatedsurgicallygood如果是良性，手术后－好Ifmalignantlittleinformationavailable如果是恶性－有用信息不LungCancer肺Veryrare很少Metastaticcancertothelungismu orecommonthanprimarylungcancer癌转移至肺比 Almostallprimarylungtumorsarecarcinomas-犬多 性肺肿瘤是癌Bronchial,bronchoalveolar,alveolar支气管，支气管肺泡，肺Gradingdifferentiated,undifferentiated(correlatedtotheincidenceofmetastasis)分阶段－分化，未分化的（与转移率有关）SCClesscommon鳞状细胞癌－少Benigntumors LungCancer肺Signs症 non-productivecoughingexerciseintolerance,otherrespiratorysigns非生产性咳嗽，运动不耐，其他呼吸症状Signsusuallypresentseveralweekstomonths症状表现－几周至几Thoracicradiographs胸X solitarylungmass,caudallunglobes-mostBronchoscopycentrallylocatedlesions支气管镜检－中心局部transtrachealorbronchoalveolarlavage(rarelydiagnostic,lymphoma)经气管或支气管肺 （很 ，除了淋巴瘤TransthoracicFNA-80%accurate,经胸廓的细针穿刺抽吸－准确率80LungCancer肺XComparisonofCTandradiographswithhistopathologicalfindingsintracheobronchiallymphnodesindogswithprimarylungtumors(14cases)犬性肺肿瘤时，支气管淋的CT和X光在组织病ImportanceofCT的重要LungCancer肺PleuralEffusions-assesscarefully-becausetheycarryapoorprognosisandmaylimitthevalueofsurgical胸膜渗出－仔细评估－因为预后不良，TreatmentBronchoscopy,tracheallavage,andFNAarenotbeforesurgeryforsolitarylesionsbecausethetreatment(lobectomy)isthesameforalletiologies. 必需的，因为各种病因的治疗（肺叶切除）都是一样Surgicalremoval-comple obectomy手术摘除－完全肺叶切除LungCancer肺PrognosisBestprognosis最好的预NoclinicalsignsSolitarylesions单一Smalldiameter5cm直径<5NegativelymphnodesNomalignantpleuraleffusionWelldifferentiatedadenocarcinomaPeripherallesionsbetterprognosisthanSCC(oftendiffuseat 时常见有弥散MedianSurvival1year平均存活1LungCancerGoldy肺LungCancerGoldy肺CtandlungMetastasisNemanicetal.JVIM.ComparisonofthoracicradiographsandsinglebreathholdhelicalCTfordetectionofpulmonarynodulesindogswithmetastaticneoplasia犬转移瘤时，肺部根瘤 CTissignificantlymoresensitivefordetectingsofttissuenodulesindogs在犬软组织性瘤根的 Shouldbeconsideredinanypatientwithneoplasiathathasthepotentialforpulmonarymetastasistomorereliablystagethedisease有肺部转移潜在性得肿瘤患者应该被更可靠的诊Sig.10yearold,FS,History-acutedyspneaforthelastweek.Nocoughingornasaldischarge.Sheisdepressed.病史：上周起严重呼吸 PhysicalexamT-38.4,P-80,R-Increasedresp.effort,esp.onMass–caudaldorsaltothepalateontheleftsideoftheProblemlistDDxDiagnostic CasesLola病例CBC-WNL血常规－－正ChempanelWNL生化－－正ThoracicradiographsWNL胸腔X光－－CasesLola病例CasesLola病例AbdominalandcervicalUS腹部和颈部超Abdomen-WNL腹部－WNLLarynx-cranialarea-smallpointwherethemasswasimaged喉－颅侧－团块处有小点CasesLola病例Biopsyincisional