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A middle-aged NM DLH with a recent diagnosis of diabetes mellitus was presented for evaluation. Additional history was that with insulin therapy resulted in hypoglycemia and that he had been anorexic for 10 days. Ascites was present on physical examination. CBC was within reference range but serum biochemistry showed hypoalbuminemia and elevated ALT (269) and AST (273) activity.
Irregular pancreas with nodular omental changes and free fluid. The findings are strongly suggestive for pancreatic carcinomatosis or other form of carcinomatosis. Lymphomatosis and FIP are possible. Abdominocentesis, cytospin and slide preparation would be recommended. Guarded to poor prognosis.
The left limb of the pancreas was hypoechoic, irregular, coarse and enlarged at 1.0 cm with reactive surrounding fat.
A moderate amount of free fluid was noted. Nodular fat was noted throughout the cranial abdomen. Lymph node enlargement and omental nodules were noted. The cranial abdominal omentum coalesced around the pancreas and enveloped portions of the intestinal tract.
None
Pancreas – pancreatitis, neoplasia
Liver – cholangio-hepatitis complex, neoplasia, lipidosis, granulomatous disease
Cytology of the fluid revealed macrophagic-neutrophilic inflammation of fat.
