Case Study

Lymphoid hyperplasia and extramedullary hematopoiesis in a 12 year old FS Standard Poodle

A 12 year old FS Standard Poodle on hypoallergenic diet was presented for a growth on the lip, tachypnea, polyuria/polydipsia, recent trouble managing stairs, and restlessness. On physical examination, the dog had a swollen left lateral stifle, a 1/2 cm black pedunculated mass on the lip, and a stiff hindquarter was evident. Cytology from the lip mass was consistent with a basal cell tumor. On urinalysis, the urine had a cloudy and yellow appearance, the pH and specific gravity were normal, there was a 3+ proteinuria, and a few amorphous urate crystals. Urine culture yielded no growth.

A 12 year old FS Standard Poodle on hypoallergenic diet was presented for a growth on the lip, tachypnea, polyuria/polydipsia, recent trouble managing stairs, and restlessness. On physical examination, the dog had a swollen left lateral stifle, a 1/2 cm black pedunculated mass on the lip, and a stiff hindquarter was evident. Cytology from the lip mass was consistent with a basal cell tumor. On urinalysis, the urine had a cloudy and yellow appearance, the pH and specific gravity were normal, there was a 3+ proteinuria, and a few amorphous urate crystals. Urine culture yielded no growth. Abnormalities on CBC and serum biochemistry were lymphopenia, high ALT and ALP activity, hypercholesterolemia, mild hyperamylasemia, and hyperlipasemia. Total T4 was low, and leptosporosis test was negative.

Sonographic Differential Diagnosis

These images raise concern for splenic infiltrative disease such as mast cell neoplasia. Given changes on CBC, ruling out leptospirosis and Lyme disease is indicated.

Image Interpretation

The spleen was uniformly enlarged with multifocal hyperechoic punctiform mineralization as well as hyperechoic subcapsular hyperechoic nodules.

DX

Lymphoid hyperplasia and extramedullary hematopoiesis

Outcome

Further work-up including blood pressure measurement was recommended.

Clinical Differential Diagnosis

Metastatic neoplasia, glomerulonephritis, liver disease (cholangitis, chronic liver disease, neoplasia), pancreatic disease (acute pancreatitis, chronic pancreatitis, neoplasia, cysts), joint disease (CCL rupture, DJD, immune-mediated).