liver nodule

Sonopath Forum

11 yr MN Cocker, ALT 180, ALP 274, rest WNL, no symptoms.  Owner wants to wait on aspirate, so just wondering your impression of the 3 x 1.5 cm lesion in the right middle liver (not distorting the capsule).  Tried to use PD and adjust PRF, but getting a lot of noise.  Because of the hyperechoic fibrous looking core, I’m imagining we might not get our answer from FNA alone, but the liver is enlarged so thought it would be a good place to start. 

11 yr MN Cocker, ALT 180, ALP 274, rest WNL, no symptoms.  Owner wants to wait on aspirate, so just wondering your impression of the 3 x 1.5 cm lesion in the right middle liver (not distorting the capsule).  Tried to use PD and adjust PRF, but getting a lot of noise.  Because of the hyperechoic fibrous looking core, I’m imagining we might not get our answer from FNA alone, but the liver is enlarged so thought it would be a good place to start. 

Comments

EL

This looks like a nodular

This looks like a nodular hyperplasia presentation as architecture disruption is minor. Core bx best but fna will likely come up vac hepatopathy +/- nod hyperplasia. HCC usually comes up with supicious epithelial cells on fna.

Your power doppler gain is a bit too high which is why you are getting splash so back it down just to the point of flow signals and artifact is gone.

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