– 3 year old intact male Golden Retreiver who lives in a rural area presented for a chronic rear leg lameness that suddenly became acutely painful
-PE showed a painful caudal abdomen and palpable caudal abdominal mass
-Radiographs showed a soft tissue density in the caudal abdomen causing ventral displacement of the colon. Radiographic images of the pelvis, femurs, and stifle joints were normal.
– 3 year old intact male Golden Retreiver who lives in a rural area presented for a chronic rear leg lameness that suddenly became acutely painful
-PE showed a painful caudal abdomen and palpable caudal abdominal mass
-Radiographs showed a soft tissue density in the caudal abdomen causing ventral displacement of the colon. Radiographic images of the pelvis, femurs, and stifle joints were normal.
-Abdominal ultrasound shows multiple, markedly enlarged sublumbar lymph nodes up to 5.2cm in diameter. They are rounded in countour with nodular parenchyma. Lymph node echogenicity is mixed, but overall hypoechoic to the surrounding fat. The prostate shows normal size (3.0cm) with normal uniform parenchyma. Echogenicity may be increased. The only mass I could readily palpate was actually the colon being displaced ventrally. The bladder was small with a normal wall and normal anechoic content.
-Ultrasound guided fine needle aspiration was performed and cytology is pending. I had to use a 20 gauge needle as the lymph nodes were quite firm. In-house cytology shows mostly lymphocytes with no evidence of neoplastic change (not basophilic, no blast cells seen, normal nuclear to cytoplasmic ratio, normal cytoplasm and nucleus). A few dividing cell were seen. Upon examination of a separate slide, my colleage also saw both intracellular and extracellular bacteria .
-My primary rule out was neoplasia based upon the large and abnormal appearance of the sublumbar lymph nodes (LSA, MCT). Now I am wondering what infectious disease could be causing this? Mycobacterial? Fungal? Brucellosis? Can acute prostatitis cause such large lymph nodes?
Thanks all for your input!
Comments
Looks like big distorted
Looks like big distorted undifferentiated iliac LN. 25 g needle should give the answer…lsa likely
Hi Eric,
I could not get this
Hi Eric,
I could not get this original post to publish so I resubmitted it and there is a different chain of responses and follow up. I had to use a 20g to get the FNA (very firm LN’s). The primary vet saw intracellular and extracellular bacteria on her slide, I saw mostly reactive, non-neoplastic lymphocytes on my slide, the cytologist reported possible mesenchymal/spindle cell neoplasia but too much necrosis for a definitive diagnosis. Core biopsies are recommended next.
-M