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