Case Study

Malignant epithelial cell tumor of the spleen, diagnosed on FNA, in a 16 year old MN DSH cat

An 16 year-old NM DSH was presented for evaluation of small kidneys and an abdominal mass. Urinalysis showed an inappropriate urine specific gravity (1.014). CBC was within normal limits but elevated creatinine was present on serum biochemistry.

An 16 year-old NM DSH was presented for evaluation of small kidneys and an abdominal mass. Urinalysis showed an inappropriate urine specific gravity (1.014). CBC was within normal limits but elevated creatinine was present on serum biochemistry.

Sonographic Differential Diagnosis

Etiologies for the splenic changes would be neoplasia (lymphoma, mast cell tumor, hemangiosarcoma, sarcoma), granuloma, and hematoma.

Image Interpretation

Splenomegaly with a smooth homogeneous parenchyma, smooth capsule, and normal vasculature. Diffuse increased echogenic appearance. Large mottled vascularized echogenic mass (2.96 x 3.72 cm) in the head of the spleen.

DX

Splenic mass: malignant epithelial cell tumor

Outcome

None

Clinical Differential Diagnosis

Renal disease – chronic kidney disease, pyelonephritis. Abdominal mass – splenic torsion, intussusception, intestinal or gastric foreign body, neoplasia, granuloma, cyst, or abscess (in any of the following organs: liver, pancreas, stomach, or lymph nodes).

Sampling

U/S guided FNA. The cytologic findings are consistent with a malignant epithelial cell tumor. There are no significant lymphoid cells noted and thus the mass is likely effacing the spleen. The first differential is a carcinoma. It is likely metastatic to the spleen. Origins of the mass include pancreatic or even liver.