Case Study

CT – organomegaly of the pancreas, spleen and lymph nodes suggesting round cell neoplasia in a 7 year old MN Standard Poodle

This 7 year old MN Standard Poodle presented for abdominal CT

DX

pancreatomegaly, splenomegaly and adenolmegaly of the splenic and portal lymph nodes

Image Interpretation

CT of the abdomen –

Especially the left lobe of the pancreas is enlarged with multilobular appearance, undulating margination and enhancment. Fat stranding of the surrounding mesentery is not noted. The portal and splenic lymph nodes present moderate enlargement at a maximum diameter of 2 cm and are rounded. The spleen presents moderate generalized enlargement with regular attenuatio and enhancement pattern.

Outcome

Organomegaly of the pancreas without evidence of regional peritonitis: Differentials include primary or secondary neoplastic infiltrate, chronic pancreatitis, as well as incidental nodular hyperplasia.

Splenomegaly: Hypotensive congestion owing to general anesthesia versus neoplastic infiltration or hypersplenism of other origin.

Adenomegaly of the splenic and portal lymph nodes: The enlargement pattern is suggestive but not demonstrative for a neoplastic infiltrate.

However, altogether with the known thoracic and peripheral lymph node changes a multicentric round cell neoplasia such as lymphoma or histocytic sarcoma should be ruled out by sampling of the peripheral lymph nodes as well as ultrasound guided sampling of the enlarged lymph nodes, liver, spleen (and pancreas).
Consider cPLI testing as well.