Case Study

03_00039 Chipper K Malignant histiocytosis, vascular and biliary ectasia

A 9-year-old MN Rottweiler dog presented for progressively worsening anorexia and mild weight loss. Preliminary diagnostic testing revealed moderate anemia with slight regeneration, anisocytosis, 24 percent band neutrophils, Dohle bodies, normal total WBC count, and mildly elevated SAP and mildly elevated AST.

A 9-year-old MN Rottweiler dog presented for progressively worsening anorexia and mild weight loss. Preliminary diagnostic testing revealed moderate anemia with slight regeneration, anisocytosis, 24 percent band neutrophils, Dohle bodies, normal total WBC count, and mildly elevated SAP and mildly elevated AST.

DX

Malignant histiocytosis with vascular and biliary ectasia

Sonographic Differential Diagnosis

Primary consideration is given to neoplasia, most likely of round cell origin. An acute inflammatory hepatopathy cannot be ruled out; however, it is considered less likely given the portal vascular changes.

Image Interpretation

Transverse view of the left liver and gallbladder reveals moderate hepatic enlargement with diffusely and moderately hypoechoic parenchyma and evidence of reduced vascular volume and sound attenuation (thin arrow). Diffuse intraparenchymal portal vascular displacement and, in the near field, a swollen serosal margin are present (wide arrow) adjacent to the falciform ligament.

Outcome

The patient was treated with immune suppressive cortisone because the owner declined chemotherapy. The patient was humanely euthanized after severe weight loss and clinical decline 1 month post-diagnosis.

Comments

Similar findings were derived from the splenic biopsy, which further supported the pathologistвЂ™s ultimate diagnosis of systemic malignant histiocytosis.