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Reactive lymphoid hyperplasia and extramedullary hematopoeisis diagnosed on splenic FNA in a 10 year old MN Golden Retriever

Case Study

Reactive lymphoid hyperplasia and extramedullary hematopoeisis diagnosed on splenic FNA in a 10 year old MN Golden Retriever

A 10 year old NM Golden Retriever was presented with a history of systemic hypertension, emerging pulmonary hypertension, and mitral insufficiency, which was being managed with 2.5 mg amlodipine once a day. A soft tissue sarcoma had been removed previously from the dog’s back. Arrhythmia, multiple soft movable subcutaneous masses, weight loss, and muscle wasting were noted on physical examination. Urinalysis was within normal limits. On CBC, thrombocytosis, lymphocytosis, and monocytosis were present. The only abnormality on serum biochemistry was elevated GGT activity.

A 10 year old NM Golden Retriever was presented with a history of systemic hypertension, emerging pulmonary hypertension, and mitral insufficiency, which was being managed with 2.5 mg amlodipine once a day. A soft tissue sarcoma had been removed previously from the dog’s back. Arrhythmia, multiple soft movable subcutaneous masses, weight loss, and muscle wasting were noted on physical examination. Urinalysis was within normal limits. On CBC, thrombocytosis, lymphocytosis, and monocytosis were present. The only abnormality on serum biochemistry was elevated GGT activity.

Sonographic Differential Diagnosis

Small splenic mass with micronodular splenic changes (hepatoma, hemangiosarcoma, infiltrative neoplastic disease).

Image Interpretation

The spleen presented diffuse nodular hypoechoic changes with an overt 3.2cm mass at the caudal pole with mixed echogenic hypoechoic changes.

DX

Reactive lymphoid hyperplasia and EMH

Outcome

Splenectomy was recommended, which is being considered by the owner.

Clinical Differential Diagnosis

Subcutaneous masses – neoplasia, cysts, abscessation, hematomas. Arrhythmia – cardiomyopathy, left ventricular hypertrophy secondary to the hypertension. Splenic disease – neoplasia (primary or metastatic), hypersplenism, torsion, infarction. Hypertension – primary/essential, renal disease, cardiac disease, Cushing’s disease.

Sampling

Ultrasound guided FNA of the spleen. Cytology revealed reactive lymphoid hyperplasia with moderate extramedullary hematopoiesis. The subcutaneous masses were diagnosed as myxosarcoma and trichoepithelioma on biopsy.

Patient Information

Patient Name : Hunter B
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Book : yes
Status : Complete
Liz Wuz Here : Yes
Code : 08_00008

History

  • Amlodipine therapy
  • Mitral insufficiency
  • Neoplasia
  • Pulmonary hypertension
  • Systemic hypertension

Exam Finding

  • Masses
  • Muscle Wasting
  • Weight loss

Images

reactivelymphoidhyperplasia

Blood Chemistry

  • GGT High

CBC

  • Lymphocytes, High
  • Monocytes, High
  • Platelet Count, High