Beta is a 10 year old Shepard/lab cross and a very good dog. My associate asked me to evaluate Beta because she has had an elevated Alk Ptase and ALT. Clinically Beta feels great. Her ultrasound findings were unremarkable except for the liver. It looks like a possible well circumscribed mass in what I consider the Quadrate lobe of the liver. Am I over reading this. I am enclosing a a photo and a short AVI clip.
Let me know what you think. Thanks in advance.
Beta is a 10 year old Shepard/lab cross and a very good dog. My associate asked me to evaluate Beta because she has had an elevated Alk Ptase and ALT. Clinically Beta feels great. Her ultrasound findings were unremarkable except for the liver. It looks like a possible well circumscribed mass in what I consider the Quadrate lobe of the liver. Am I over reading this. I am enclosing a a photo and a short AVI clip.
Let me know what you think. Thanks in advance.
Comments
Not overreading at all mainly
Not overreading at all mainly because there is a minor mass effect on the ventral aspect of the GB on the clip. This is likely pronounced nodular hyperplasia, hepatoma or low grade hepatocellular carcinoma and may have little to do with the LE elevation as there are some aspectrs of chronic inflammatory hepatopathy. Thing to do is core bx 14-16g of the general parenchyma and that of the mass transitioning between normal and abnormal tissue through the nodular changes to maximize the variety of heterogenous tissue captured in the stick and see what comes up. Nice images!
Not overreading at all mainly
Not overreading at all mainly because there is a minor mass effect on the ventral aspect of the GB on the clip. This is likely pronounced nodular hyperplasia, hepatoma or low grade hepatocellular carcinoma and may have little to do with the LE elevation as there are some aspectrs of chronic inflammatory hepatopathy. Thing to do is core bx 14-16g of the general parenchyma and that of the mass transitioning between normal and abnormal tissue through the nodular changes to maximize the variety of heterogenous tissue captured in the stick and see what comes up. Nice images!
I wish I was referring to the
I wish I was referring to the small mass ventral to the gallbladder. I missed that one. I was referring to what is measured in this new picture. I guess it must not be anything if you didn’t comment. Feel rather stupid now.
I wish I was referring to the
I wish I was referring to the small mass ventral to the gallbladder. I missed that one. I was referring to what is measured in this new picture. I guess it must not be anything if you didn’t comment. Feel rather stupid now.
No worries Randy as
No worries Randy as forest gump said “stupid is what stupid does” and asking a question is never a stupid thing…:)
This is a good example of why still image interpretation plagued and continues to plague telemedicine. The mass you measure is what I was discussing but if you look at your video toward the middle of the clip the hepatic parenchyma subtly pushed on the GB. nothing should focally push on anything. Hence its an expansive pathology wiht the diffs I mentioned above. Good question allowed me to clarify further. This expansive presentation is not represented in the still image and can go overlooked but is important and makes me reach for a needle even more.
No worries Randy as
No worries Randy as forest gump said “stupid is what stupid does” and asking a question is never a stupid thing…:)
This is a good example of why still image interpretation plagued and continues to plague telemedicine. The mass you measure is what I was discussing but if you look at your video toward the middle of the clip the hepatic parenchyma subtly pushed on the GB. nothing should focally push on anything. Hence its an expansive pathology wiht the diffs I mentioned above. Good question allowed me to clarify further. This expansive presentation is not represented in the still image and can go overlooked but is important and makes me reach for a needle even more.