- 13 year old MN Springer Spaniel mix presented for several months duration of ADR: shaking, acting painful
- Abdominal radiographs show a possible abdominal mass
- Abdominal ultrasound shows a coalescing cystic mass at the juncture of the abdominal aortal and cranial mesenteric artery, a hypoechoic mass deep to the major vessesl, multiple bilateral renal cortical cysts, and a prominent, hypoechoic pancreas with slightly irregular margins.
- 13 year old MN Springer Spaniel mix presented for several months duration of ADR: shaking, acting painful
- Abdominal radiographs show a possible abdominal mass
- Abdominal ultrasound shows a coalescing cystic mass at the juncture of the abdominal aortal and cranial mesenteric artery, a hypoechoic mass deep to the major vessesl, multiple bilateral renal cortical cysts, and a prominent, hypoechoic pancreas with slightly irregular margins.
- Color flow Doppler was hindered by patient shaking and panting, however, there does not appear to be major, direct blood flow from the aorta to the mass.
- My primary differential diagnoses for the cystic mass includes hemangiosarcoma and cystic carcinoma. I also have abscess, migrating foreign body, and parasitic on the list, but less likely. Differential diagnoses for the renal cysts include congential, acquired, and primary or metastatic neoplasia. Differential diagnoses for the deep hypoechoic mass includes primary or metastatic neoplasia and reactive lymph node.
- Bloodwork is pending.
- The first video clip is sagittal, moving cranial to caudal starting at the right kidney.
- Would you recommend FNA or this too risky due to its cystic nature and close association with the major vessels? CT? Exploratory surgery?
- Bloodwork is pending.
Comments
The kidney has degenerative
The kidney has degenerative cortical cysts and the adjacent cysts are actually eaten out lymph nodes … when chronic lymphadenitis occurs over time the parenchyma necrosis and the patient is left with a bag of lymph and occasionally pus. You will see thi sin chronic IBD cats especially in the mesenteric LN region. If you drain and culture those it may be curative or at least palliative or may have nothing to do with the clinical signs as its a sectorial disease. You will see this in chronic nephritis cases wiht the LN cysts in this position in your case.
Wow, very interesting. Would
Wow, very interesting. Would neoplasia still be on the differential list?
yes but way down on the
yes but way down on the list…. these are not typical spots for hemangio … HSA does spleen iliacs/pelvis, liver, occaisonally renal, right atrium cns and the met sites. The lesions are anechoic with no texture so are cystic and no inflammatory pattern around them so unlikely to be agrreesive and not likely to be LSA. When in doubt put a needle in and analyze. Its good to do this a few times in the begining as well so you know what they are entirely.
Good to know! Thank you!
Good to know! Thank you!