Castor is an 11 year old Maine Coon with a recent history of weight loss.
I took abodominal x-rays and submitted a CBC and Profile. I am posting the x-rays and images of the ultrasound.
The only abnormalities on the lab work was an Alk Ptase of 96 and a Total Bili of 0.4. There are some changes on the x-ray consistent with hepatic enlargement.
I was not expecting to see the changes observed on the ultrasound.
I would appreciate feedback. I can submit cine loops if helpful.
I have a FNA pending. Uniform population of neoplastic cells noted. I will update when I get the results back.
I see free abdominal fluid.
?- is that that the common bile duct dilated on the picture with color doppler or is that just free fluid?
Comments
These are likely
These are likely hepatpocellular carcinomas… cine loop subxyphoid probe tail up and down pointing at the diaphragm helps localize right from left and also taking loops from left intercostal and right intercostal or image positions 9-13 on the SDEP 17 point abdomen poster (http://sonopath.com/products)
It looks like the cbd is dilated/congested by mass impingement in the stills but so hard to call things on stills. The anechoic fluid is either congested hepatic vein from mass impingement or free fluid… cine loop should define.
These are likely
These are likely hepatpocellular carcinomas… cine loop subxyphoid probe tail up and down pointing at the diaphragm helps localize right from left and also taking loops from left intercostal and right intercostal or image positions 9-13 on the SDEP 17 point abdomen poster (http://sonopath.com/products)
It looks like the cbd is dilated/congested by mass impingement in the stills but so hard to call things on stills. The anechoic fluid is either congested hepatic vein from mass impingement or free fluid… cine loop should define.
I agree with Eric, looks like
I agree with Eric, looks like hepatocellular carcinoma and it’s quite diffuse. Agree also it could be a vein, CBD or free fluid…can’t say from a still. Regardless, you’ll get your answer shortly on cytology.
It can also be beneficial when you have a liver mass(s) to do the same subxyphoid view Eric was referring to but also in transverse plane and start tail down and fan by bringing the tail up and take a clip. This defines well the extent of left and right involvement. I find this helpful when advising a surgeon about resectability and potential involvement of the portahepitus hilus.
I agree with Eric, looks like
I agree with Eric, looks like hepatocellular carcinoma and it’s quite diffuse. Agree also it could be a vein, CBD or free fluid…can’t say from a still. Regardless, you’ll get your answer shortly on cytology.
It can also be beneficial when you have a liver mass(s) to do the same subxyphoid view Eric was referring to but also in transverse plane and start tail down and fan by bringing the tail up and take a clip. This defines well the extent of left and right involvement. I find this helpful when advising a surgeon about resectability and potential involvement of the portahepitus hilus.