The patient is a canine Beagle, NM, 10 years old. Depressed, bloody diarrhea, PU/PD, severely elevated SAP, moderately elevated ALT, severely elevated GGT, Spec cPL mildly elevated, severe anemia, severely increased platelets.
The patient is a canine Beagle, NM, 10 years old. Depressed, bloody diarrhea, PU/PD, severely elevated SAP, moderately elevated ALT, severely elevated GGT, Spec cPL mildly elevated, severe anemia, severely increased platelets.
Case Study
03-00289 Snoopy D Liver mass *BK*—NEEDS SB–
Sonographic Differential Diagnosis
Left sided liver mass extending to the right side and dorsally into the diaphragm enveloping the vena cava. This is not overtly resectable. FNAs were performed on the mass itself without evidence of complication. This is likely hepatocellular carcinoma or similar neoplasia. Poor long term prognosis.
Image Interpretation
The liver in this patient presented an 8.8 x 7.6 cm, mixed, hyperechoic nodular mass with areas of capsular expansion and reactive surrounding omentum. Microaccumulation of fluid was noted within the mass as well. It appeared to derive from the left liver and extend into the deep left liver enveloping the cranial aspect of the gallbladder and separate nodular changes were noted in the right liver in the region from the vena cava inlet through the diaphragm. Loss of architecture was noted throughout this region. The gallbladder revealed a minor amount of dependent debris. The mass appeared to impinge upon the portal vein from the left side with nodular changes on the right side are suspected as well.
DX
Liver mass
Outcome
2 days post liver tumor removal, the patient developed anorexia. The SAP levels diminished to half presurgical levels and there were persistently moderately elevated AST, ALT, and GGT levels. Six months later a repeat ultrasound was performed. The liver in this patient was riddled with multiple, mixed hyperechoic and hypoechoic masses. The masses had target type appearance and occupied both the left and right liver lobes with deviation of the gallbladder and significant loss of architecture. This is consistent with diffuse, metastatic neoplasia. The portal vein velocity was normal at 35 cm/sec. Free fluid was noted in the caudal abdomen and is likely secondary to lymphatic obstruction. Multiple liver masses. Free fluid. Poor prognosis.
Clinical Differential Diagnosis
Hepatitis, mucocele/bile peritonitis, pancreatitis, gastroenteritis, neoplasia
Sampling
FNA of liver mass
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Patient Information
Gender :
Male, Neutered
Species :
Canine
Type of Imaging : Ultrasound
Clinical Signs
- Depression
- Diarrhea
- PU-PD
Images
Blood Chemistry
- GGT High
CBC
- Platelet Count, High
Clinical Signs
- Depression
- Diarrhea
- PU-PD
Special Testing
- cPLI Positive