Case Study

03_00179 Windsor E Lymphoma

An 11-year-old MN DSH was presented for progressive weight loss over the course of three months without a decrease in appetite. Physical examination found the patient with a body score of 2.5/5 with all else unremarkable. CBC was within normal limits and blood chemistry showed elevated ALT and elevated alkaline phosphatase. Thoracic and abdominal radiographs showed no abnormalities.

An 11-year-old MN DSH was presented for progressive weight loss over the course of three months without a decrease in appetite. Physical examination found the patient with a body score of 2.5/5 with all else unremarkable. CBC was within normal limits and blood chemistry showed elevated ALT and elevated alkaline phosphatase. Thoracic and abdominal radiographs showed no abnormalities.

Sonographic Differential Diagnosis

Two separate 18-gauge biopsies were performed on this patient without evidence of complications. The liver was mildly swollen in contour and inflammatory hepatopathy is likely. Underlying emerging lymphoma is a possibility.

Image Interpretation

The liver in this patient presented increased portal markings that were consistent with inflammatory hepatopathy. Minor gallbladder thickening was noted. The common bile duct was unremarkable. No periportal lymphadenopathy was evident. No overt structural evidence of inflammatory, infiltrative or regenerative pathology was noted.

DX

Biopsy of the liver revealed low-grade hepatic lymphoma.

Outcome

The patient was treated with Leukeran, prednisolone, and broad spectrum antibiotics for two weeks at which time a clinical reassessment will be performed.