Tumors of the respiratory system are most commonly located in the thoracic or sinusal/parasinusal structures
Incidence is very lowthoracic cavity neoplasia was reported in 35 of 5629 necropsies. Primary lung tumors7.9% of thoracic neoplasia
The most frequent primary lung tumor is the granular cell tumor (or myoblastoma). They may be accompanied by osteoproliferative abnormalities of carpal, tarsal, and fetlock joints
Lung is a relative frequent site for secondary metastases from other organs
5068% of nasal passage tumors are malignant with SCC being the most frequent. SCC originates from mucosal or alveolar teeth epithelium and starts invading locally before metastasizing regionally
Signalment
Nasal/paranasal tumorsSCC (most frequent); mature adults, more frequent in aged horses. Mean age 812.4 years
Primary pulmonary tumors>7 years. Pulmonary granular cell tumor (most frequent); mean age 13 years, range 822 years
Lung metastases from distant primary tumorsmean age 8 years, range 3 months to 14 years
Sex predilectionmajority of females for pulmonary granular cell tumors and males for intrathoracic metastatic adenocarcinoma.
Signs
Historical Findings
Weight loss
Dullness
Exercise intolerance
Intermittent fever
Physical Examination Findings
Thoracic respiratory tumors;
Underweight
Signs of pleural effusion and ventral edema
Tachypnea
Coughing
Dyspnea
Hemoptysis
Abnormal lung auscultation sounds
Pallor, icterus, and intermittent epistaxis in cases of hemangiosarcoma
Proliferative osteopathy of carpal, tarsal, fetlock joints rarely seen
CBCresults depend on the invasiveness of the primary tumor: often an inflammatory hemogram is present
Chemistryno abnormalities unless a specific organ is showing functional insufficiency
Other Laboratory Tests
Thoracocentesisneoplastic cells can be observed in the pleural fluid
Lung biopsypreferentially US-guided to sample a mass, or through an endoscope if a mass is visible in the airways
Transtracheal aspiration cytology may reveal neoplastic cells
For nasal/paranasal tumorsbiopsy samples obtained deep within the mass. Superficial samples obtained by endoscopy are often nondiagnostic
Imaging
Head radiographynasal/paranasal SCC; dorsoventral view is useful to assess sinuses
Thorax radiographypulmonary tumors; single or several soft tissue density
Thorax USpleural effusion, masses in the lung parenchyma
Upper/lower airway endoscopy (including sinusoscopy)nasal/paranasal SCC; often ulcerated. Pulmonary tumor; masses in the main bronchi occasionally seen
Other Diagnostic Procedures
Thoracoscopyto visualize and biopsy masses affecting the lung surface.
Pathologic Findings
Nasal/paranasal SCCclassified as well, moderately, or poorly differentiated. Degrees of differentiation not correlated with the presence of metastasis
Pulmonary granular cell tumormost frequent primary pulmonary tumor. Usually unilateral. Local metastases frequently reported
Metastatic hemangiosarcomaprimary tumor more frequently in skeletal muscle or skin
Metastatic SCCprimary tumor more frequently in the stomach, but also penis, vulva, and eye
Treatment⬆⬇
TREATMENT
Lung neoplasmmass and lung resection have been attempted
Granular cell tumor removal by transendoscopic electrosurgery and ablation with a diode laser have been described. Nasal/paranasal mass removaloften malignant with risks of recurrence and metastasis