vacuolated appearing liver

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vacuolated appearing liver

Two week history of decreased appetite progressing to anorexia the last 2 days.  Having diarrhea and increased borborygmus.   Has free reign of a farm.  Owner saw him drinking from an irrigation ditch 3 weeks ago.  
Blood work showed an ALT of 230, ALP 884 and elevated cholesterol.  With supportive care, liver values are improving. 

Two week history of decreased appetite progressing to anorexia the last 2 days.  Having diarrhea and increased borborygmus.   Has free reign of a farm.  Owner saw him drinking from an irrigation ditch 3 weeks ago.  
Blood work showed an ALT of 230, ALP 884 and elevated cholesterol.  With supportive care, liver values are improving. 

I performed FNA’s of the liver and enlarged lymph nodes (two primary ultrasound findings), so results still pending.  Just wondering what your biggest rule outs are when you see parenchyma like this (non-vascular via doppler)?

Comments

kromero

Additional comment – both

Additional comment – both adrenals were “plump” measuring 7 mm at the poles. 

randyhermandvm

When I see lesions that look

When I see lesions that look like this I think of Biliary Cyst Adenomas. 

We can weigh in and see what others say.

kromero

Thank you for your input,

Thank you for your input, Randy! I will post aspirate results when they become available. 

Electrocute

What is the patient’s

What is the patient’s signalment?  Breed, sex, age?

kromero

Sorry – 9 year old MN Aussie

Sorry – 9 year old MN Aussie

EL

Cystadenoma but they can

Cystadenoma but they can trasnform to carcinoma. FNA usually unrewarding here because they are fibrous and not cellular.

kromero

Thank you! Cytology came back

Thank you! Cytology came back as necrotic, low cellularity.  Wishing I had gotten a sample more on the edge of the lesion.  It was 2 cm down, so I had some challenges getting a good sample.   Do you tru cut these lesions if you suspect carcinoma? I talked w/ the owner about a seriel ultrasound in the next month to monitor any progression. 

(Signalment 9 year old MN Aussie)

EL

You can core bx but need to

You can core bx but need to get the edge of the normal to abnormal parenchyma tangentially to have any value.

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