Case Study

Metastatic splenic carcinoma diagnosed by FNA in an 8 year old MN cat

An 8-year-old MN cat, with history of FIV-positive status, was presented for inappetence for 2 weeks. On physical examination, mucoid diarrhea, weight loss, and tenesmus was present. Abnormalities on CBC and serum biochemistry included mild anemia, mild hypoalbuminemia, and elevated ALP, and hyperglobulinemia.

DX

Metastatic carcinoma

Sonographic Differential Diagnosis

Colonic and mesenteric root lymphadenopathy could be inflammatory, primary neoplasia, or metastatic neoplasia. The enlarged spleen also raises concern for emerging neoplasia such as multiple myeloma, lymphoma, or metastatic disease. Fine-needle aspirates of the spleen, colonic lymph node, the colonic wall, and liver are recommended given the patient’s history. It is important to assess if chemotherapy is necessary in this patient.

Image Interpretation

A enlarged, hypoechoic and irregular lymph node associated with the colon and colonic thickening with minor areas of loss of mural detail were noted. The spleen in this patient presented mild enlargement with slight scalloping of the capsule. Subtle hyperechoic nodular changes within the spleen were noted and potentially linked to metastatic disease. The spleen width measured 1.4 cm

Outcome

The patient was humanely euthanized.

Clinical Differential Diagnosis

GI symptoms – inflammatory bowel disease (IBD), neoplasia, infectious (bacterial/viral/fungal.) Elevated ALP – cholangitis-cholangiohepatitis complex, lipidosis, neoplasia, abscessation. Systemic infections. Neoplasia.

Sampling

U/S guided FNAs of the lymph node and spleen were conducted. Cytology of the lymph node revealed necrosis and probable metastatic carcinoma. Cytology of the spleen revealed probable metastatic carcinoma.