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Chronic Pancreatitis vs Neoplasia

Sonopath Forum

Sonopath Forum

Chronic Pancreatitis vs Neoplasia

Charlie,

14 Year old DSH neutered male…3 month Hx of anorexia and weight loss…Lab work on 7/7/17 was WNL except a fCPL of 5.1. Responded intially to dexasone injection, but not eating at all past 3 days.

PE: Cachexic, slight fullness mid abdomen.

Charlie,

14 Year old DSH neutered male…3 month Hx of anorexia and weight loss…Lab work on 7/7/17 was WNL except a fCPL of 5.1. Responded intially to dexasone injection, but not eating at all past 3 days.

PE: Cachexic, slight fullness mid abdomen.

/S: GIT appeared normal; SI and colon walls slightly thickened but normal layering. Kidneys & Liver: WNL   Spleen slightly enlarged and maybe coarser echotexture, did find a hypoechoic nodule at tail of spleen ~7x7mm. FNA was non Dx. 

Most of the pathology, to my eyes, lie in the pancreas it appears enlarged and has a mixed echogenicity with a surrounding increase in hyperechoic fat. It seemed more prominent on the left side vs the right.

Leading DDx are chronic pancreatits vs neoplastic Dz.

I’ve included FNA from spleen (not area of nodule) and Pancreas. 

I’ve also included a shot of the pancreas (I hope), outlining what I think is the pancreatic margin and would appreciate being graded on my interpretation. I found it very fortuitous to have the pancreatic e-mails over the past 2 weeks.

 

With thanks in advance,

Sam

 

Comments

EL
July 31, 2017 at 10:51 pm -

I would be more concerned for

I would be more concerned for a dexameth suppressed lsa especially with that spleen. Cats dont do splenic expansive nodules well in spleen or liver… usually means badness unless a cystadenoma or something. Dexameth will immediately alter the cyto read. I’m not a cytologist so I don’t dare comment on the cyto slides but if you post the description you got on your fna sample I can likely help with the technique or explain why it was non dx. The pancreas is a little nodular or that may be an overlying distorted and partially suppressed LN (see attached image). Any chance of getting a needle into this panc ( or LN) lesion? Otherwsie I would explore for a shopping spree of biopsies.

franklinanimalclinic
July 31, 2017 at 11:08 pm -

Thanks,
I’ll contact the

Thanks,

I’ll contact the owners and see what they want to do

 

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