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Lymphoma and extramedullary hematopoiesis of the spleen and liver diagnosed by FNA in a 5 year old FS Boxer

Case Study

Lymphoma and extramedullary hematopoiesis of the spleen and liver diagnosed by FNA in a 5 year old FS Boxer

A 5-year-old FS Boxer was presented for vomiting, diarrhea, anorexia, and weight loss. The blood chemistry revealed elevated ALT and elevated AST enzyme activities. The CBC showed a leukocytosis consisting of a neutrophilia and a monocytosis. Thoracic radiographs were performed; there was no evidence of mass lesions, and the cardiac silhouette was within normal limits.

A 5-year-old FS Boxer was presented for vomiting, diarrhea, anorexia, and weight loss. The blood chemistry revealed elevated ALT and elevated AST enzyme activities. The CBC showed a leukocytosis consisting of a neutrophilia and a monocytosis. Thoracic radiographs were performed; there was no evidence of mass lesions, and the cardiac silhouette was within normal limits.

Sonographic Differential Diagnosis

Highly suggestive for infiltrative splenic and hepatic disease with multicentric lymphoma, mast cell disease, or other neoplastic event.

Image Interpretation

The abdomen in this patient presented multiple enlarged lymph nodes. The spleen and liver were enlarged. The hepatic lymph node was also enlarged.

DX

Splenic and hepatic lymphoma and extramedullary hematopoiesis.

Outcome

The dog was presented to a referral hospital for an oncology consult at which time the owners reported that the dog had been experiencing signs of lethargy and polydipsia. Treatment options were discussed with the owners, however, they were still undecided which avenue to pursue. The patient eventually died at home.

Clinical Differential Diagnosis

Gastrointestinal symptoms – gastroenteritis (foreign body ingestion, garbage gut), IBD, gastrointestinal neoplasia (lymphoma, adenocarcinoma, mast cell tumor). Increased liver values – acute hepatitis (infectious, such as bacterial (Leptospira sp.) or viral), immune-mediated, or toxic), chronic active hepatitis, hepatic abscess, neoplasia, such as lymphoma.

Sampling

US-guided FNA taken from both the liver and spleen. Cytology revealed lymphoma and extramedullary hematopoiesis.

Patient Information

Patient Name : Serenity S
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 08_00015

Clinical Signs

  • Anorexia
  • Diarrhea
  • Vomiting
  • Weight loss

History

  • Anorexia
  • Diarrhea
  • Vomiting
  • Weight Loss

Images

Lymphnodestill

Blood Chemistry

  • ALT (SGPT), High
  • AST (SGOT), High

CBC

  • Monocytes, High
  • Neutrophils, High
  • WBC, High

Clinical Signs

  • Anorexia
  • Diarrhea
  • Vomiting
  • Weight loss