Case Study

Pancreatic epithelial neoplasia in an 19 year old MN DSH cat

An 18-year-old MN DSH was presented for weight loss, and a palpable abdominal mass. CBC taken four months prior had shown leukopenia, neutropenia, lymphopenia, and monocytosis.

An 18-year-old MN DSH was presented for weight loss, and a palpable abdominal mass. CBC taken four months prior had shown leukopenia, neutropenia, lymphopenia, and monocytosis.

Sonographic Differential Diagnosis

Emerging small intestinal mass. Differentials include lymphoma, mast cell tumor, adenocarcinoma, etc. Severe extensive pancreatic inflammation and multiloculated cyst like structures. These may be secondary to chronic active pancreatitis, particularly if the patient has suffered from chronic pancreatitis and developed cysts in the past. However both regions are extensive and neoplasia cannot be excluded.

Image Interpretation

Both limbs of the pancreas showed extensive multiloculated cyst like structures surrounded by hyperechoic and inflamed fat. The abnormal tissue in the right pancreas measured 5 x 1.5cm. The multiloculated cyst like structures had thin walls and anechoic contents but some regions lacked distal enhancement. The small intestines contained a 3cm section that showed severe thickening and severely decreased wall layering. The wall layer measured 0.52cm in that region.

DX

Pancreas and intestinal mass were suspicious for epithelial neoplasia.

Outcome

The cat’s health continued to decline to a point where he was found in lateral recumbency and was subsequently euthanized.

Clinical Differential Diagnosis

G.I. clinical signs- mass, neoplasia, abscess, granuloma, enlargement of liver/spleen/kidney/pancreas/lymph node/mesentery.

Sampling

Ultrasound guided fine needle aspirate pancreas and intestinal mass. Fine needle aspirate cytology of both the pancreas and intestinal mass were suspicious for epithelial neoplasia. CBC and serum chemistry two months later showed leukopenia, neutropenia, lymphopenia, monocytosis and elevated lipase (288), elevated free T4 (7.1).