03_00448 Emily C Multicentric LSA

Case Study

03_00448 Emily C Multicentric LSA

 A 9-year-old SF DSH, SF with a history of being FeLV positive for 8 years was presented for evaluation of lethargy. Treatment had been prednisone T-cyte injections. Additional history was chronic anemia that had required transfusions in the past and pancreatitis. Prior ultrasound had revealed splenomegaly and hepatomegaly. Abnormalities on CBC and serum biochemistry were poorly regenerative anemia, lymphocytosis, elevated ALT and AST activity, hyperproteinemia, hypoalbuminemia, and prolonged APTT. Corona virus titer was positive.

DX

Multicentric LSA

Sonographic Differential Diagnosis

Infiltrative splenic and hepatic patterns with hepatic lymphadenopathy. Fine needle aspirates were performed without complication. Given the non-regenerative anemia, neoplastic invasion of the spleen likely lymphoma is suspected or similar round cell neoplasia. Blood transfusion, bone marrow aspirates are also recommended.

Image Interpretation

Liver was enlarged and coarse in architecture. Isoechoic nodular changes noted in the liver. Fine needle aspirates were performed of the liver without complication. The gallbladder was unremarkable. There is hepatic lymphadenopathy. Spleen was also enlarged and nodular. Fine needle aspirates were performed without complication.

Outcome

None

Clinical Differential Diagnosis

FeLV related disease – lymphoma, neoplasia, chronic infection, red cell aplasia
Liver – cholangio-hepatitis complex, neoplasia, granulomatous disease

Sampling

Liver and spleen FNA, as well as bone marrow aspirates, were positive for lymphoma.

Patient Information

Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete

Clinical Signs

  • Lethargy

Images

emily_conner_lymphoma_spleen_liver_bone_marrow_felv_positive_fnaemily_conner_lymphoma_spleen_liver_bone_marrow_felv_positive_fna_2

Blood Chemistry

  • Albumin, Low
  • ALT (SGPT), High
  • AST (SGOT), High
  • Total Protein, High

CBC

  • Lymphocytes, High
  • RBC, Low

Clinical Signs

  • Lethargy
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