Thursday, March 6, 2008

Grading Tumors

Best article I have found appears (online) in Veterinary Pathology: "Feline Vaccine-Associated Fibrosarcoma: Morphologic Distinctions" [SS Couto, SM Griffey, PC Duarte, and BR Madewell]

"Tumors were graded based on cellular differentiation, presence and extension of necrosis within the neoplasm, and mitotic rate. All sarcomas were scored 1-3 for overall differentiation (1=tumor cells closely resembled the mature differentiated type; 2=tumors that had a defined histological phenotype; and 3=poorly differentiated tumors), mitotic rates (1=1-0 mitotic figures per 10 400x fields; 2=10-19 figures per ten 400x fields; 3= 20 or more figure per ten 400x fields), and necrosis (1=no necrosis; 2=necrosis of <50% 3=" necrosis">50% of the total area). Final scores of 3-4 were designated Grade I; scores of 5-6 were designated grade II; and scores 7-9 were designated Grade III."

Additionally, presence of "spindle cells" and "multinucleated giant cells" confirm chemically induced neoplasm or cancer.
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The article is quite detailed, has extensive references and illustrations. For those who are dealing with Grade III, it offers a means to visualize neovascularization, cavitation, necrosis.

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Reviewing the literature of 10 professional journals over the last 20 yrs, I have discovered increasing agreement re: the 12-18 signatures of VAS.

A final note: Last November's University of Pennsylvania vet newsletter begins a section on vaccination with "Though not uncommon, VAS..." Hmmm, that which is not uncommon is common ... I guess this represents progress from the earlier "statistically improbable," "rare," "unlikely" of earlier articles.

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