A 10-year-old Golden Retriever dog presented for a routine checkup. Mild weight loss and palpable hepatomegaly were evident during physical examination. Moderately elevated SAP and mild to moderately elevated ALT were evident on blood chemistry analysis.
A 10-year-old Golden Retriever dog presented for a routine checkup. Mild weight loss and palpable hepatomegaly were evident during physical examination. Moderately elevated SAP and mild to moderately elevated ALT were evident on blood chemistry analysis.
Case Study
03_00077 Hunter S Large glycogen liver mass
Sonographic Differential Diagnosis
A benign or low-grade malignant neoplasm, hepatoma, nodular hyperplasia.
Image Interpretation
Long-axis left lateral lobar view reveals an ill-defined, lobulated, serosa-displacing, echogenic parenchymal swelling or mass. Note the smooth swollen serosal contour of the left lateral liver lobe.
DX
Moderate hepatocellular swelling and glycogen accumulation.
Outcome
The patient remained asymptomatic over the following 14 months but showed progressively elevated SAP with persistently elevated ALT. The patient presented for vomiting and icterus at that time. The sonogram demonstrated gallbladder congestion and cholangiohepatitis with mass impingement on the portal hilus. The owner denied further workup, and the patient was lost to follow-up. It was felt that the glycogen mass may have eventually influenced biliary outflow that may have predisposed it to posthepatic disease.
Comments
The conservation of architecture, even though a mass effect is seen, is consistent with a relatively benign or slow-growing process. Biopsy, as opposed to FNA, was essential to confirm this because of the need for a structural diagnosis.
Clinical Differential Diagnosis
Neoplasia, benign hepatopathy, hepatitis, pancreatitis, low-grade IBD, maldigestion.
Sampling
14-gauge US-guided biopsy revealed moderate hepatocellular swelling and glycogen accumulation.
Patient Information
Type of Imaging : Ultrasound
Images
