Difference between revisions of "Adenocarcinoma"

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==Gastric Adenocarcinoma==
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[[Image:adenocarcinoma stomach histopath2.jpg|thumb|right|100px|Adenocarcinoma- histological (Courtesy of BioMed Image Archive)]]
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[[Image:adenocarcinoma stomach histopath2.jpg|thumb|right|200px|Adenocarcinoma- histological (Courtesy of BioMed Image Archive)]]
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* Adenocarcinoma is the most common gastric neoplasm in small animals.
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[[Image:adenocarcinoma stomach.jpg|thumb|right|200px|Adenocarcinoma- gross (Courtesy of BioMed Image Archive)]]
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** This is a tumour of the mucosal epithelium.
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Adenocarcinoma is the most common gastric neoplasm in small animals. It is a tumour of the mucosal epithelium. These are generally found in the fundus (particularly along the lesser curvature), and in the pylorus. There are two main internal appearances of gastric adenocarcinoma, both of which show thickened, oedematous, pale and firm tissue:
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* These are genreally found in the fundus (particularly along the lesser curvature), and in the pylorus.
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# A diffuse infiltration of gastric mucosa by neoplastic glandular epithelial cells.
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* There are two main internal appearances of gastric adenocarcinoma, both of which show thickened, oedematous, pale and firm tissue:[[Image:adenocarcinoma stomach.jpg|thumb|right|100px|Adenocarcinoma- gross (Courtesy of BioMed Image Archive)]]
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#* Causes a diffuse rugal thickening.  
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*# A diffuse infiltration of gastric mucosa by neoplastic glandular epithelial cells.
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# A more solitary lesion that is seen as a thick plaque-like lesion
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*#* Causes a diffuse rugal thickening.  
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#* Generally has a central erosion/ulceration of the tumour tissue.  
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*# A more solitary lesion that is seen as a thick plaque-like lesion
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#* Distinguishable from  a peptic ulcer as the edges of the eroded area are raised and thickened (tumour tissue).  
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*#* Generally has a central erosion/ulceration of the tumour tissue.  
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*#** Distinguishable from  a peptic ulcer as the edges of the eroded area are raised and thickened (tumour tissue).
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* The external appearance of an affected [[Forestomach - Anatomy & Physiology|stomach]] can include thickening of the draining lymphoid vessels due to tumour infiltration ('cording of the lymphatics') and evidence of a scirrhous reaction to the carcinoma.
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* Adenocarcinomas are locally aggressive and spread via the lymphatics to the [[Lymph Nodes - Anatomy & Physiology|lymph nodes]], lung, [[Liver - Anatomy & Physiology|liver]] and [[Adrenal Glands - Anatomy & Physiology|adrenal glands]].
  
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The external appearance of an affected [[Monogastric Stomach - Anatomy & Physiology|stomach]] can include thickening of the draining lymphoid vessels due to tumour infiltration ('cording of the lymphatics') and evidence of a scirrhous reaction to the carcinoma. Adenocarcinomas are locally aggressive and spread via the lymphatics to the [[Lymph Nodes - Anatomy & Physiology|lymph nodes]], lung, [[Liver - Anatomy & Physiology|liver]] and [[Adrenal Glands - Anatomy & Physiology|adrenal glands]].
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==Intestinal==
  
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==Intestinal Adenocarcinoma==
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* An '''intestinal adenocarcinoma''' is a malignancy of epithelial cells from the intestinal mucosa.
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[[Intestinal Adenocarcinoma|Intestinal adenocarcinomas]] are a reasonably common malignant neoplasm of dogs and cats arising from the epithelial lining of the gastrointestinal tract. As yet, no causative organism or chemical agent has been identified for intestinal adenocarcinomas, but experiments have suggested that nitrosamines may have a role. Intestinal adenocarcinomas can be nodular or annular in appearance. By the time of diagnosis, they have often metastasised via the lymphatic and vascular routes, most commonly to the mesenteric lymph nodes. Other sites of metastasis include the liver, kidneys, peritoneal cavity, omentum and lungs. Intestinal adenocarcinomas display aggressive local growth and invasion, and tumours frequently recur after resection.
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* Found in both the [[Small Intestine - Anatomy & Physiology|small]] and [[Large Intestine - Anatomy & Physiology|large intestines]]
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** Common in the canine [[Rectum - Anatomy & Physiology|rectum]].
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* Species affected:
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** Fairly common in dog and cat.
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** Seen related to bracken ingestion in the older sheep.
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** Occasionally occur in horses.
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* These tumours usually grow away from the mucosa, down through the muscularis mucosae and into the submucosa, muscular layers and the serosa.
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** They may, however, project into the lumen.
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* Intestinal adeocarcinomas may take an annular form.
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** This may result in stenosis of lumen
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*** Muscle proximal to the lesion becomes hypertrophied and dilated.
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* Spread may be
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*# Via the lympahtics.
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*#* To the lymph nodes, lung and [[Liver - Anatomy & Physiology|liver]].
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*# Transcoelomic spread
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*#* Small, white plaques on serosa and adjacent tissues e.g. diaphragm.
  
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==Perianal Gland Adenocarcinoma==
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==Tumours of the Perianal Area==
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These tumours are far '''less commonly''' diagnosed than [[Adenoma#Hepatoid Gland Tumours (Perianal Adenomas)|perianal adenomas]]. '''Large breed male dogs''' are overrepresented, but they do also occur in spayed female dogs.
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===Adenocarcinomas of the Glands of the Anal Sac (Apocrine Glands)===
  
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A '''hormonal dependence has not been shown'''.
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* Apocrine glands are the true anal glands- not to be confused with the anal sacs or the perianal glands.
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* Much less common than intestinal adenocarcinoma.
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* Commoner in bitches than dogs.
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* Can be bilateral.
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* Consequences:
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** May cause local problems.
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** May metastasise.
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** Often secrete a parahormone-like substance to cause paraneoplastic syndrome.
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*** This can arise even when the primary tumour is very small.
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*** Results in bone resorption and hypercalcaemia,
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**** In turn can cause renal failure. which in turn can cause renal failure.
  
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===Clinical features===
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See [[Anal Sac Adenocarcinoma - WikiClinical]]
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Tumours are usually single, ulcerated and invasive. They tend to grow rapidly, and to a larger size than the benign version.
 
  
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30% of adenocarcinomas '''metastasize''' to the sublumbar lymph nodes, liver and lungs.
 
  
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===Diagnosis===
 
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'''Cytology''' will reveal large hepatoid cells with a large nucleus, prominent nucleoli and a large cytoplasm. It will not distinguish between adenomas and adenocarcinomas.
 
  
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Further investigation should be carried out if malignancy is suspected, including: '''thoracic and abdominal radiography''', '''abdominal ultrasound''', and '''cytology or biopsy of enlarged lymph nodes'''.
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[[Category:Stomach and Abomasum - Proliferative Pathology]][[Category:Dog]][[Category:Cat]]
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[[Category:Intestines_-_Proliferative_Pathology]]
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===Treatment===
 
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Adenocarcinomas do not regress following castration. Small tumours can be treated by '''wide surgical excision, with or without cryosurgery'''.
 
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For large masses, '''surgical debulking followed by radiotherapy''' may be useful.
 
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Dogs with metastasis have a poor prognosis, but may be treated by surgical excision and '''intravenous doxorubicin''' for a slightly prolonged survival time.
 
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==Adenocarcinomas of the Glands of the Anal Sac (Apocrine Glands)==
 
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Apocrine glands are the true anal glands - not to be confused with the anal sacs or the perianal glands. These tumours are much less common than intestinal adenocarcinoma. They are more common in bitches than dogs and can be bilateral.
 
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The masses may cause local problems and metastasise. They often secrete a parahormone-like substance to cause paraneoplastic syndrome. This can arise even when the primary tumour is very small resulting in bone resorption and [[hypercalcaemia]], which in turn can cause [[:Category:Renal Failure|renal failure]].
 
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==[[Anal Sac Adenocarcinoma]]==
 
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[[Anal Sac Adenocarcinoma|Anal sac adenocarcinoma]] is a highly malignant neoplasia that readily metastasizes to the medial iliac lymph nodes. Around 50% may lead to paraneoplastic hypercalcaemia due to parathyroid hormone-related peptide (PTH-rP). The tumours can be between 1 and 10cm in size and 50% of them will metastasize
 
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==Nasal Cavity==
 
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Adenocarcinoma of the nasal cavity is most common in dogs but also sheep. Glandular acini in layer of cuboidal or columnar epithelium are present with often mucin filled acini.
 
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==[[Uterine Adenocarcinoma - Rabbit|Uterine Adenocarcinoma in Rabbits]]==
 
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==References==
 
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Withrow, S. (2001) '''Small animal clinical oncology''' ''Elsevier Health Sciences''
 
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Morrison, W. (2002) '''Cancer in dogs and cats: medical and surgical management''' ''Teton NewMedia''
 
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{{Learning
 
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|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis01994.asp, Canine adenoma and adenocarcinoma]
 
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}}
 
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[[Category:Stomach and Abomasum - Proliferative Pathology]][[Category:Intestinal Diseases - Dog]][[Category:Intestinal Diseases - Cat]]
 
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[[Category:Nasal Cavity - Hyperplastic/Neoplastic Pathology]]
 
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[[Category:Respiratory System - Hyperplastic/Neoplastic Pathology]]
 
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[[Category:Neoplasia]]
 

Revision as of 19:44, 6 June 2010

Adenocarcinoma- histological (Courtesy of BioMed Image Archive)
  • Adenocarcinoma is the most common gastric neoplasm in small animals.
    • This is a tumour of the mucosal epithelium.
  • These are genreally found in the fundus (particularly along the lesser curvature), and in the pylorus.
  • There are two main internal appearances of gastric adenocarcinoma, both of which show thickened, oedematous, pale and firm tissue:
    Adenocarcinoma- gross (Courtesy of BioMed Image Archive)
    1. A diffuse infiltration of gastric mucosa by neoplastic glandular epithelial cells.
      • Causes a diffuse rugal thickening.
    2. A more solitary lesion that is seen as a thick plaque-like lesion
      • Generally has a central erosion/ulceration of the tumour tissue.
        • Distinguishable from a peptic ulcer as the edges of the eroded area are raised and thickened (tumour tissue).
  • The external appearance of an affected stomach can include thickening of the draining lymphoid vessels due to tumour infiltration ('cording of the lymphatics') and evidence of a scirrhous reaction to the carcinoma.
  • Adenocarcinomas are locally aggressive and spread via the lymphatics to the lymph nodes, lung, liver and adrenal glands.

Intestinal

  • An intestinal adenocarcinoma is a malignancy of epithelial cells from the intestinal mucosa.
  • Found in both the small and large intestines
  • Species affected:
    • Fairly common in dog and cat.
    • Seen related to bracken ingestion in the older sheep.
    • Occasionally occur in horses.
  • These tumours usually grow away from the mucosa, down through the muscularis mucosae and into the submucosa, muscular layers and the serosa.
    • They may, however, project into the lumen.
  • Intestinal adeocarcinomas may take an annular form.
    • This may result in stenosis of lumen
      • Muscle proximal to the lesion becomes hypertrophied and dilated.
  • Spread may be
    1. Via the lympahtics.
      • To the lymph nodes, lung and liver.
    2. Transcoelomic spread
      • Small, white plaques on serosa and adjacent tissues e.g. diaphragm.

Tumours of the Perianal Area

Adenocarcinomas of the Glands of the Anal Sac (Apocrine Glands)

  • Apocrine glands are the true anal glands- not to be confused with the anal sacs or the perianal glands.
  • Much less common than intestinal adenocarcinoma.
  • Commoner in bitches than dogs.
  • Can be bilateral.
  • Consequences:
    • May cause local problems.
    • May metastasise.
    • Often secrete a parahormone-like substance to cause paraneoplastic syndrome.
      • This can arise even when the primary tumour is very small.
      • Results in bone resorption and hypercalcaemia,
        • In turn can cause renal failure. which in turn can cause renal failure.

See Anal Sac Adenocarcinoma - WikiClinical

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