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Pancreatitis and abnormal right kidney in a 13 yr MN Persian

Sonopath Forum

Sonopath Forum

Pancreatitis and abnormal right kidney in a 13 yr MN Persian

  • 13 year old MN Persian with history of vomiting, anorexia, and depression
  • Bloodwork showed a positive fPLI
  • Abdominal ultrasound shows an enlarged hyperechoic left pancreas, enlarged hypoechoic pancreatic body and right pancreas with adjacent clumping echogenic fat
  • The right kidney is misshapen with moderate renal pelvic dilation and a hypoechoic rim.  Clumping reactive fat is present adjacent to the right kidney (and right pancreas).  There is also what looks like a small stone in the right renal pelvis

    • 13 year old MN Persian with history of vomiting, anorexia, and depression
    • Bloodwork showed a positive fPLI
    • Abdominal ultrasound shows an enlarged hyperechoic left pancreas, enlarged hypoechoic pancreatic body and right pancreas with adjacent clumping echogenic fat
    • The right kidney is misshapen with moderate renal pelvic dilation and a hypoechoic rim.  Clumping reactive fat is present adjacent to the right kidney (and right pancreas).  There is also what looks like a small stone in the right renal pelvis
    • Differential diagnoses for the pancreas include severe pancreatitis and neoplasia (carcinoma)
    • Differential diagnoses for the right kidney hypoechoic rim include neoplasia (carcinoma, lymphoma) and FIP.  Differentials for the renal pelvic dilation include neoplasia, pyelonephritis, and obstruction.
    • US guided FNA performed on the abnormal pancreatic/fat tissue and cytology is pending.
    • Any other thoughts?  The plan is to provide aggressive medical management over the weekend while awaiting cytology results.

     

Comments

EL
October 26, 2019 at 4:03 pm -

Ugly pancreas needs a needle

Ugly pancreas needs a needle necrosis vs carcinoma or even panc lsa. RK is a mass likely round cell neoplasia with a distorted subcapsular halo and capsular escape. 25g fna of both organs should tell the complete story.

Electrocute
October 26, 2019 at 10:12 pm -

Thanks Eric. This is probably

Thanks Eric. This is probably the ugliest cat pancreas I have ever seen. I just did an FNA of the pancreas since it was 6pm on a Friday and didn’t want to run the risk of a kidney bleed.  Will pursue FNA of kidney next if pancreatic FNA is nondiagnostic.

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