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dence of differentiation also correlates with prognosis. A grading These lesions are also with mixed lepidic and papillary scheme combining scores for overall differentiation of tumor, growth but show extension beyond the capsule into adjacent mitotic count, nuclear pleomorphism, nucleolar size, fibrosis, and parenchyma. Invasion is limited to <5mm and does not contain cells degree of invasion showed strong association with post-diagnosis in patterns associated with more aggressive growth (micropapillary, disease-free solid, or squamous differentiation) (Figure 12.14C). Since the most common lung tumors in the dog begin as circum- scribed growths that have the capacity to progress to more invasive Invasive adenocarcinoma and potentially metastatic growths, the concept of diagnosing These lesions are greater than 3 cm with greater than 5 mm invasion benign versus malignant tumors should be based on the likelihood of adjacent parenchyma (Figure 12.14D). Use of size distinctions in of recurrence after surgical removal. In the TMN classification the dog to subclassify tumors is less valuable than in humans given 484 Tumors in Domestic Animals A B C D Figure 12.14 Prognostic features for solitary pulmonary tumors based on size and morphology. (A) Atypical alveolar hyperplasia: A well-delimited but unencapsulated region of epithelial proliferation that largely lines pre-existing alveolar structures. Such regions should be less than 3 cm diameter to be included in this category. (B) Bronchioloalveolar adenoma: A discrete growth forming a capsule partially from compressed adjacent parenchyma. Neoplastic cells form mixed papillary and lepidic growth and are supported by tumor stroma. This lesion should also be or less. (C) Minimally invasive adenocar- cinoma: A mixed papillary and growth extends beyond a distinct capsule formed from fibrovascular proliferation. This lesion is also or less and extension beyond the capsule is less than (D) Invasive adenocarcinoma: A papillary growth, with some regions of solid tumor in this example, shows significant extension beyond a fibrous capsule. This tumor is 4cm and extends 10 mm beyond the capsule. the wide variation in breed sizes. Many lesions smaller than 3cm acinar predominant have evident cytologic and invasive features, suggestive of more solid predominant with mucin production aggressive behavior. squamous. Invasive adenocarcinomas are subclassified based on the proportion of tumor for each pattern type (see Histologic features): Criteria of serious concern for metastasis or recurrence lepidic predominant Subjective perspectives suggest a progression in the dog from mixed papillary predominant lepidic and simple papillary growths to more acinar structures, micropapillary predominant often containing mucus. Further progression may result in solid Tumors of the Respiratory Tract 485