Cyst vs abcess vs open

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Cyst vs abcess vs open

Hello

This is Kenya an 8 year old FS lab who has a recent history of vomiting 2 x weekly and weight loss with normal bloodwork.

We performed an abdominal US and found a 1cm round anechoic lesion with a hyperechoic center that extended to the border of the lesion. It appeared to be ventromedial to the pylorus. I can not see it attached to anything except the fat.

Hello

This is Kenya an 8 year old FS lab who has a recent history of vomiting 2 x weekly and weight loss with normal bloodwork.

We performed an abdominal US and found a 1cm round anechoic lesion with a hyperechoic center that extended to the border of the lesion. It appeared to be ventromedial to the pylorus. I can not see it attached to anything except the fat.

I was hoping for some opinions on what it might be and whether it can account for the symptoms. FNA is our next but would like sonopath’s opinion prior to proceeding. Rest of US appeared normal to us.The first few clips are to try and give some perspective on location.

Thanks. Brent

Comments

Pankatz

Brent
I think this may be an

Brent

I think this may be an enlarged LN, and if so, has neoplastic criteria with an increased S/L axis ratio and inflammation at the periphery but would need to sample to confirm – which you may be able to do showing its location. Will see what others have to say : )

Jacquie

tosullivan

Thanks!
I was told that

Thanks!

I was told that unattached round objects in the abdomen were usually LNs so your probably right. I just haven’t seen one look this way before.

I’m not familiar with S/L ratio? Can you let me know what that means?  Thanks. Brent

Pankatz

The S/L axis ratio refers to

The S/L axis ratio refers to ratio of the measurement of a LN in its short and then long axis. I believe there was a paper stating that an abdominal LN with a S/L axis ratio of <0.5 is more likely to be reactive and anything >0.5 is more likley to be neoplastic, which just really means big round hypoechoic LN’s are more concerning for neoplasia than long, fusiform ones. It’s definitely not perfect due to the normal variation of size in LN’s and there is alot of overlap between reactive and neoplastic LN’s – biopsy is still the only way to know for sure.

EL

yes definately a LN. Note the

yes definately a LN. Note the round capsule. This is th eepigastric LN I beleive and usually happnes when the stomach has somethign goign on in it. You will see this up in IBD cats a lot. In dogs I get worried about LSA or gastric carcinoma or hi  this maybe helocobacter. Its a bit rounded but not distorted so likely reactive LN. Will need to use the corkscrew technique to get a good fna sample.

tosullivan

Thank you for the posts. Much

Thank you for the posts. Much appreciated. Have a great weekend. Brent

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