6 yr FS DSH acute onset hematuria. Ua just showed blood (obtained yesterday via cysto). Blood work pending. Also having soft stool. Ultrasound shows some mild effusion near the urinary bladder and the hyperechoic areas on the ventral floor that do not change with gravity. Plump caudal mesenteric lymph nodes/hyperechoic mesentery. What are my rule outs for the dazzle response I’m seeing on power doppler? Vessels? I’m wondering if the effusion is from trauma, either before the cysto with cause unknown or potentially secondary to a traumatic cysto. Cystitis is my other top differential.
Comments
Looking at inflammation of the bladder wall with associated response in the surrounding tissue and lymph node reactive hyperplasia – sterile cystitis, interstitial/idiopathic cystitis, bacterial, eosinophilic. Neoplasia less likely but would still consider emerging lymphoma (extra-nodal lymphoma). Recommend urine cytology, urine culture, and possibly a catheter-assisted aspirate/biopsy of the wall. Also consider FNA cytology of the lymph node.
Thank you, Dr. Lobetti!