Sonopath Forum

Cat Spleen FNA, Liver also?

10 yr old, FS DSH
Hyperthyroid, on Methimazole
Acute onset green-black diarrhea and not eating x 2 days
Lethargic
BW normal except low BUN, T-4 = 4.6 high N, WBC = 7,620; 6% Monos, 14% Eos, 6% Baso (abs # 450 H)

I’ve never seen high Basophils…. MCT is listed as a possible cause.

Abd US overall normal except thick spleen with variably sized hyperechoic nodules/patches.

10 yr old, FS DSH
Hyperthyroid, on Methimazole
Acute onset green-black diarrhea and not eating x 2 days
Lethargic
BW normal except low BUN, T-4 = 4.6 high N, WBC = 7,620; 6% Monos, 14% Eos, 6% Baso (abs # 450 H)

I’ve never seen high Basophils…. MCT is listed as a possible cause.

Abd US overall normal except thick spleen with variably sized hyperechoic nodules/patches.

I’m planning on FNA of the spleen next week; should I do the liver as well ? The liver looks “coarse” to me…. not sure what to make of the hyperechoic areas (perivascular?). To my eyes, the liver would need a biopsy vs FNA, and I’m not sure there’s much to justify that.

My biggest concern is MCT in the spleen. Thoughts?

Thank you!!

Comments

November 10, 2018 at 5:23 pm -

The spleen is scallopping and

The spleen is scallopping and course surely fit mct or reactive spleen or even multiple myeloma can look like this. Very non specific but 25g fna with benadryl 1mg/# im 10 min before is what I would do. When thinking round cell neoplasia i am always a fan of fna of both spleen and liver because if just spleen and mct then remove the spleen but if liver has it in an early phase then its chemo an dno sx and prognosis drops. Plus when the cytologist has infiltrates in both spleen and liver he/she will tend to be more definitive with the dx.

This liver doesnt look bad to me and the hyperechoic areas look like mineralization in the biliary tree i think… not an mct player. If a money case then just fna spleen but if a solid checkbook behind it then i would fna both organs searching the spleen for pathology and screening the liver to see if it has joined the pathology party yet or not.