Case Study

Nodular hyperplasia, lymphoplasmacytic hepatitis, portal fibrosis in a 11 year old MN Labrador Retriever dog

An 11-year-old MN Labrador Retriever mixed breed dog presented for a swollen abdomen. Physical examination revealed palpable irregular hepatomegaly. Blood chemistry analysis revealed mild ALT and moderate SAP elevations.

An 11-year-old MN Labrador Retriever mixed breed dog presented for a swollen abdomen. Physical examination revealed palpable irregular hepatomegaly. Blood chemistry analysis revealed mild ALT and moderate SAP elevations.

Sonographic Differential Diagnosis

Chronic hepatobiliary inflammation with nodular hyperplasia and neoplasia.

Image Interpretation

Long-axis view of the left lateral liver lobe demonstrates a well-circumscribed, ovoid, echogenic, heteroechoic nodule within the left lateral liver lobe (small arrow). The left lateral liver lobe volume is increased, resulting in a curvilinear, distended appearance to the serosal margins (large arrow).

DX

Regenerative nodular hyperplasia.

Outcome

The patient was managed well on a liver support protocol and remained clinically normal other than the swollen abdomen on a 2-month follow-up examination. The patient was lost to follow up.

Clinical Differential Diagnosis

Liver pathology: Hepatic neoplasia, inflammatory hepatopathy, benign hepatopathy.

Sampling

16-gauge US-guided biopsy of the nodule revealed regenerative nodular hyperplasia. Samples from random parenchyma demonstrated mild chronic fibrosing lymphoplasmacytic hepatitis with mild portal fibrosis.