Case Study

Round Cell Tumor in a 10 year old Scottish Terrier dog

A 10-year-old Scottish terrier was presented for evaluation of not doing right and lethargy. Pyrexia (105.6 F) and a distended abdomen were present on physical examination. Abnormalities on CBC and serum biochemistry were leukocytosis with a left shift, anemia, and elevated ALP and elevated AST activity, elevated amylase, elevated bilirubin, and elevated cholesterol. Very low T4. Negative Coombs’ and negative 4DX panel.

DX

Round cell neoplasia, liver. Lymphoid hyperplasia and EMH, spleen

Sonographic Differential Diagnosis

Abdominal neoplasia involving the spleen, liver and region of the left adrenal gland and early kidney infiltrate. Pheochromocytoma, lymphoma, histiocytosis.

Image Interpretation

The abdomen in this patient presented multiple masses with dramatic hypoechoic, target type appearance and capsular expansion involving the spleen and liver as well as mesenteric root and iliac lymph nodes. Complete loss of structural detail was noted in all the organs described. A mass was noted in the region of the left adrenal gland and measured 3 x 2 cm with dramatic, hypoechoic changes. Dual hyperechoic line in the middle of the mass is suggestive of adrenal origin. However, this may be of lymph node origin and obscuring the adrenal gland. This is most consistent with metastatic neoplasia that is not resectable and potentially of left adrenal gland origin. The remainder of the organs were unremarkable except for some nodular changes noted in the renal cortices as well.No evidence of hemorrhage was noted.

Outcome

The patient was euthanized.

Comments

Poor prognosis. The patient is at risk for sudden death.

Clinical Differential Diagnosis

Liver pathology – infectious (bacterial, viral, protozoal), toxic, neoplasia; Gallbladder pathology- cholecystitis, obstruction, rupture; Pancreatic pathology – pancreatitis, neoplasia; Intra-abdominal neoplasia; Peritonitis

Sampling

Fine-needle aspirates were performed on the spleen and liver in regions of transition from normal parenchyma into masses. This will provide cytology of the emerging pathology. Cytological results of the liver revealed atypical round cell neoplasia, cholestasis and mild vacuolar changes. The splenic cytological results revealed mild to moderate lymphoid hyperplasia and extramedullary hematopoiesis with low numbers of atypicall round cells. Mild stromal cell hyperplasia.