– 13 year old DSH MN with history of severely decreased appetite; no v/d

– CBC, biochem, fPLI unremarkable

– 3 view chest rads show one questionable area of increased radio-opacity (alveolar pattern)

– a focal region of eccentric, hypoechoic wall thickening with loss of wall layering found (approx 1cm diameter) in the intestine

– cystic jejnunal LN seen

– trace pericardial effusion with normal LA

– u/s guided FNA’s of intestinal lesion performed but not holding my breathe as I often get inconclusive results with these

– 13 year old DSH MN with history of severely decreased appetite; no v/d

– CBC, biochem, fPLI unremarkable

– 3 view chest rads show one questionable area of increased radio-opacity (alveolar pattern)

– a focal region of eccentric, hypoechoic wall thickening with loss of wall layering found (approx 1cm diameter) in the intestine

– cystic jejnunal LN seen

– trace pericardial effusion with normal LA

– u/s guided FNA’s of intestinal lesion performed but not holding my breathe as I often get inconclusive results with these

DDx:  lymphoma, FIP thoughts?

This would be a good case for intra-operative ultrasound