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Metastatic splenic carcinoma diagnosed by FNA in an 8 year old MN cat

Case Study

Case Study

Metastatic splenic carcinoma diagnosed by FNA in an 8 year old MN cat

An 8-year-old MN cat, with history of FIV-positive status, was presented for inappetence for 2 weeks. On physical examination, mucoid diarrhea, weight loss, and tenesmus was present. Abnormalities on CBC and serum biochemistry included mild anemia, mild hypoalbuminemia, and elevated ALP, and hyperglobulinemia.

An 8-year-old MN cat, with history of FIV-positive status, was presented for inappetence for 2 weeks. On physical examination, mucoid diarrhea, weight loss, and tenesmus was present. Abnormalities on CBC and serum biochemistry included mild anemia, mild hypoalbuminemia, and elevated ALP, and hyperglobulinemia.

DX

Metastatic carcinoma

Sonographic Differential Diagnosis

Colonic and mesenteric root lymphadenopathy could be inflammatory, primary neoplasia, or metastatic neoplasia. The enlarged spleen also raises concern for emerging neoplasia such as multiple myeloma, lymphoma, or metastatic disease. Fine-needle aspirates of the spleen, colonic lymph node, the colonic wall, and liver are recommended given the patient’s history. It is important to assess if chemotherapy is necessary in this patient.

Image Interpretation

A enlarged, hypoechoic and irregular lymph node associated with the colon and colonic thickening with minor areas of loss of mural detail were noted. The spleen in this patient presented mild enlargement with slight scalloping of the capsule. Subtle hyperechoic nodular changes within the spleen were noted and potentially linked to metastatic disease. The spleen width measured 1.4 cm

Outcome

The patient was humanely euthanized.

Clinical Differential Diagnosis

GI symptoms – inflammatory bowel disease (IBD), neoplasia, infectious (bacterial/viral/fungal.) Elevated ALP – cholangitis-cholangiohepatitis complex, lipidosis, neoplasia, abscessation. Systemic infections. Neoplasia.

Sampling

U/S guided FNAs of the lymph node and spleen were conducted. Cytology of the lymph node revealed necrosis and probable metastatic carcinoma. Cytology of the spleen revealed probable metastatic carcinoma.

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Patient Information

Patient Name : Nemo Y
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 08_00025

Clinical Signs

  • Anorexia

History

  • FIV positive

Exam Finding

  • Diarrhea
  • Tenesmus
  • Weight loss

Images

08_00025_nemoyang_firststillimageln_06282011040458Splenomegaly_02082011072646

Blood Chemistry

  • Albumin, Low
  • Alkaline Phosphatase (SAP), High
  • Globulin, High

CBC

  • RBC, Low

Clinical Signs

  • Anorexia