Case Study

Splenic mass in a 14 year old FS Chow mix dog

A 14-year-old SF Chow mix was presented for evaluation of weakness, which had also been present a week ago. On physical examination, a palpable abdominal mass was present. Severe non-regenerative anemia and hypoalbuminemia were present on CBC and blood chemistry.

Sonographic Differential Diagnosis

Large parenchymal splenic mass and infiltrated nodular changes. Sarcoma or similar neoplasia is suspected, although splenitis or splenic hyperplasia is possible.

Image Interpretation

The spleen presented large, complex, mixed hyperechoic masses with areas of microcavitation. The primary caudal mass measured 12 x 10 cm. The remainder of the spleen presented heterogenous changes. There was no overt evidence of rupture noted.

DX

Splenic mass

Outcome

Patient went to surgery. Prior to surgery, a lateral radiograph was taken. A second mass was seen in the deep cranial abdomen, just cranial to the large splenic mass. At surgery, the larger mass was enveloping the cranial vessels such that it could not be resected. Lesions were also seen on the gastric wall. There was less than a 1/4 inch of mesentery between the mass and mesenteric vessels. When lightly touched with a probe, the lesions wept blood. Euthanasia was performed at surgery.

Comments

Left intercostal approaches would have been optimal in this case to further define the extent of the splenic pathology as well as the second mass, which was noted at surgery. When ominous masses are present in the spleen, all adjacent organs are displaced and the spleen projects cranially. Paralumbar and left intercostal and alternative views are necessary to delineate the pathology properly.