Case Study

Splenic lymphoma in a 6 year old MN Beagle mix dog

A 6 year old MN beagle mix was presented for evaluation of generalized lymphadenomegaly, which had been diagnosed as lymphoma on fine-needle aspirate and cytology. Abnormalities on serum biochemistry included dehydration, elevated ALP activity, and hypercalcemia.

DX

Lymphoma

Sonographic Differential Diagnosis

Mesenteric root (jejunal) lymphadenopathy and nodular spleen. This is structurally consistent with lymphoma or other infiltrative disease involving the spleen and lymph nodes. Minor potential for infectious/fungal disease.

Image Interpretation

The spleen presented an aggressive, hypoechoic, focal nodular target lesion at 1.25 x 0.91 cm with other micronodular changes and minor capsular expansion. This is suggestive for infiltrative disease. The mesenteric root lymph nodes were enlarged in this patient with dramatic, hypoechoic parenchyma and echogenic capsules, surrounded by a hyperechoic, inflammatory pattern. This measured 3.34 x 2.23 cm. Other region lymph nodes were enlarged in the mesenteric root area. This would be consistent with lymphoma or similar neoplasia.

Outcome

Oncologist consultation was obtained, and the patient was treated with Prednisone as a palliative measure based on owner preference.

Comments

In this case, there was no obvious organ involvement elsewhere. Given the hypercalcemia in this patient, thoracic ultrasound is recommended, concentrating on the cranial mediastinum and sternal lymph nodes (even though radiographs only reveal slight density in the region). Hypercalcemia often is associated with cranial mediastinal lymphoma. Guarded prognosis. Immediate chemotherapeutic protocol would be warranted based on oncology consultation.