A 10-year-old MN DSH was presented for evaluation of decreased appetite and lethargy. Abdominal effusion was present on physical examination. Serum biochemistry showed azotemia.
A 10-year-old MN DSH was presented for evaluation of decreased appetite and lethargy. Abdominal effusion was present on physical examination. Serum biochemistry showed azotemia.
Pancreatic mass, suspect carcinoma, carcinomatosis. I recommend cytology assessment +/ cytospin of the free fluid and culture if a definitive diagnosis is not obtained. There was no overt evidence of organ metastasis noted; however, omental seeding and metastasis is suspected.
The right pancreatic base revealed a 2.25 x 3.0 cm mass with irregular, nodular, ill defined surrounding changes throughout the omentum. Ultrasound-guided FNA was performed without complication. The mass appeared to be adhered to the duodenum.
A large amount of mildly echogenic free fluid was noted.
Ascites – modified transudate (neoplasia, cardiac disease, portal hypertension), exudate (bacterial peritonitis, FIP, blood, urine, bile), blood
FNA revealed cellularity is high consisting predominantly of large immature lymphoid cells admixed with a few small lymphocytes and blood. The cells have a small to moderate amount of basophilic cytoplasm often with small discrete vacuoles. The nuclei are round with nucleoli. Microscopic Findings: Lymphoma. The predominance of lymphoblasts is consistent with lymphoma.
