03_00031 Kelsey L Hepatic lymphosarcoma Do Not Complete For Research Only

Case Study

03_00031 Kelsey L Hepatic lymphosarcoma Do Not Complete For Research Only

An 8-year-old FS Rhodesian Ridgeback presented for anorexia and mild weight loss. Physical examination revealed mild muscle wasting but was otherwise normal. The preliminary blood chemistry analysis demonstrated mildly elevated ALT, mildly elevated AST, mildly elevated SAP, and mildly elevated bilirubin with isosthenuria and 3+ bilirubinuria. The PT value was slightly elevated. The patient was non-responsive to 3 days of IV medical therapy.

An 8-year-old FS Rhodesian Ridgeback presented for anorexia and mild weight loss. Physical examination revealed mild muscle wasting but was otherwise normal. The preliminary blood chemistry analysis demonstrated mildly elevated ALT, mildly elevated AST, mildly elevated SAP, and mildly elevated bilirubin with isosthenuria and 3+ bilirubinuria. The PT value was slightly elevated. The patient was non-responsive to 3 days of IV medical therapy.

Sonographic Differential Diagnosis

Aggressive inflammatory hepatopathy and infiltrative neoplasia.

Image Interpretation

The sonogram demonstrated a diffusely and mildly hypoechoic parenchyma. In the far field, the caudal serosal margin is distended (arrows) and mildly irregular, consistent with enlargement likely secondary to infiltrative disease. The portal walls are mildly increased in echogenicity. An acute inflammatory hepatopathy also could be considered; however, irregular distension of serosal surfaces is not a common feature unless a preexisting underlying nodular component is present.

DX

High grade, diffuse, hepatic lymphosarcoma

Outcome

The patient was euthanized owing to poor prognosis and financial concerns.

Comments

Periportal lymphadenopathy also was evident in this case (not shown here), which further suggests an aggressive parenchymal process.

Clinical Differential Diagnosis

Hepatitis, biliary disease, neoplasia, pancreatitis, ulcerative gastric disease.

Sampling

16-gauge US-guided biopsy revealed high-grade, diffuse hepatic lymphosarcoma.

Patient Information

Species : Canine
Type of Imaging : Ultrasound

Clinical Signs

  • Anorexia
  • Weight loss

Exam Finding

  • Muscle Wasting

Images

KELSEYLITTHEPATICLYMPHOSARC_1an_03192009012421KELSEYLITTHEPATICLYMPHOSARC_2an_03192009012536

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • AST (SGOT), High
  • Total Bilirubin, High

Clinical Signs

  • Anorexia
  • Weight loss

Urinalysi

  • Bilirubin Present
  • Isosthenuria Present