- Presented initially 1 and 1/2 years ago for elevated liver enzymes of 2 years duration, patient was asymptomatic
- Abdominal US showed diffuse hepatomegaly
- Presented initially 1 and 1/2 years ago for elevated liver enzymes of 2 years duration, patient was asymptomatic
- Abdominal US showed diffuse hepatomegaly
- Ultrasound guided core biopsy histopath results were vague: mild to moderate periportal hepatocyte swelling and clearing, mild to moderate hepatocellular brown pigment. Special staining showed a small amount of copper and iron in the centrilobular hepatocytes. The pathologist noted that this could be due to early copper storage disease but there was no evidence of hepatocyte injury or necrosis. The pathologist recommended testing for Cushings as well.
- LDDT done at that time did not support hyperadrenocorticism
- I believe that supportive tx was done (metronidazole, Denamarrin) but can’t quite remember.
- Liver enzymes improved but then became elevated again recently. The dog is also now losing weight.
- Abdominal US shows marked hepatomegaly and bilateral, nonobstructive, renal mineralization.
- The left liver wraps around towards the right liver, but I cannot convince myself that it is a mass-the internal archictecture appears normal.
- I am posting some stills that make the left liver look like a mass, but in the clips it is pretty much continuous with the normal liver parenchyma and capsule. It also shows normal hepatic veins. The hepatic carcinomas I have seen are usually a bit more obvious (rounded and encapulated with loss of normal vasculature markings).
- What do you all think? FNA’s were done and are pending. Owner declined core biopsies.
Comments
Possiblity would be a
Possiblity would be a hepatoma, which often have the same appearance of ormal liver tissue. FNA may help but often require core biopsy.
Lobar swelling and vacuolar
Lobar swelling and vacuolar hepatopathy lipogranuloma nodular hyperplasia mixed bag here with histopath depending on where the needle goes. The coalescence suggests hepatoma. This subjectivly looks benign and the bx fits. Usually dont do much with these til the swelling is pedunculated that can torse or causes mass effects on the stomach or gb. I don’t chase cushings unless the usg is repeatedly < 1.020 but atypical cushings (U tennessee panel), hypothyroid, breed predispositions toxins, drugs, wind changing direction… 🙂 all can cause this type of vac hepatopathy pattern. I’m sure your histopath had at least 8 diffs for underlying cause:) Bottom line these are benign and usually not a functional issue unless a mucocele starts up or inflammatory disease jumps in.
Thanks Remo and Eric. Â I will
Thanks Remo and Eric. I will post cytology when I get it back.