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Myelolipoma diagnosed by ultrasound-guided FNA in a 10 year old FS Labrador Retriever

Case Study

Case Study

Myelolipoma diagnosed by ultrasound-guided FNA in a 10 year old FS Labrador Retriever

10 year old FS Labrador Retriever dog was presented for a recheck urinalysis due to a persistent urinary tract infection. The CBC showed thrombocytosis. The blood chemistry found hyperbilirubinemia, hyperphosphatemia, hypernatremia, hyperamylasemia, and hypertriglyceridemia. The results of the ACTH stimulation test were within normal limits. The urinalysis showed a normal specific gravity, proteinuria, elevated WBC without the presence of bacteria. The urine microalbumin and urine protein/creatinine ratio were elevated.

10 year old FS Labrador Retriever dog was presented for a recheck urinalysis due to a persistent urinary tract infection. The CBC showed thrombocytosis. The blood chemistry found hyperbilirubinemia, hyperphosphatemia, hypernatremia, hyperamylasemia, and hypertriglyceridemia. The results of the ACTH stimulation test were within normal limits. The urinalysis showed a normal specific gravity, proteinuria, elevated WBC without the presence of bacteria. The urine microalbumin and urine protein/creatinine ratio were elevated. The dog was found to be hypertensive upon evaluation of her systemic blood pressure.

Sonographic Differential Diagnosis

Right adrenal mass, non invasive: Pheochromocytoma, adenoma, adenocarcinoma, myelolipoma, hyperplasia.

Image Interpretation

A mixed hyperechoic right adrenal mass is noted. No evidence of vascular invasion is present in any of the views. Left adrenal is sonographically normal.

DX

Myelolipoma with possible mixed lymphoid tissue.

Outcome

Cytology results were most compatible with a myelolipoma with possible mixed lymphoid tissue. The patient was discharged with a course of antibiotics and medication to treat her hypertension.

Clinical Differential Diagnosis

Hyperadrenocorticism (Pituitary or adrenal gland dependent with a secondary protein losing nephropathy, or atypical, i.e. overproduction of sex hormones), pheochromocytoma, primary protein-losing nephropathy with secondary hypertension, glomerulonephritis (immune-mediated, infectious (Dirofilaria immitis, Borrelia burgdorferi, Bartonella spp., Leptospira spp.) amyloidosis.

Sampling

U/S-guided FNA of right adrenal yielded results which were most compatible with a myelolipoma with possible mixed lymphoid tissue.

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Patient Information

Patient Name : Grace G
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 07_00032

History

  • UTI

Exam Finding

  • Hypertension

Images

07_00032_image_03_0701201107221807_00032_image_01_07012011072150gracegreenfnartadrenal_0604201101031207_00032_image_02_07012011072203

Blood Chemistry

  • Amylase, High
  • Hypertriglyceridemia
  • Phosphorus, High
  • Sodium, High
  • Total Bilirubin, High

CBC

  • Platelet Count, High

Urinalysi

  • Albumin Present
  • Protein Present
  • Urine Protein:Creatinine High
  • WBCs Present