Hi again –
Eric, this format for the forum is MUCH better!
I scanned a 9 year old FS skipperke yesterday as a met check after adenocarcinomas had been removed from her mammary chain. At the time she had the lumpectomies, she was also spayed due to a severe vaginal/uterine prolapse. This dog has a history of VERY mild liver value elevations (ALT around 141, cholesterol slightly elevated). I did not see any evidence of focal metastasis on the scan, but I am trying to improve my reading of more subtle liver and pancreatic changes.
Hi again –
Eric, this format for the forum is MUCH better!
I scanned a 9 year old FS skipperke yesterday as a met check after adenocarcinomas had been removed from her mammary chain. At the time she had the lumpectomies, she was also spayed due to a severe vaginal/uterine prolapse. This dog has a history of VERY mild liver value elevations (ALT around 141, cholesterol slightly elevated). I did not see any evidence of focal metastasis on the scan, but I am trying to improve my reading of more subtle liver and pancreatic changes.
This liver appeared to have slightly coarse architecture and was hyperechoic (isoechoic to the spleen). It also seemed mildly subnormal in terms of size (certainly not enlarged or swollen). The left limb of the pancreas was not remarkable, but the right limb was hyperechoic and the duct was slightly tortuous.
I am curious about how significant you guys think these changes are. Hopefully the images are ok – I think the quality was degraded when exported from Osirix.
Thanks for your thoughts.
Comments
This is essentially a 9 year
This is essentially a 9 year old liver with aspecific coarseness. The architecture does not correspeond to the clinical status in these cases. ALT elevation is minor and changes are minor. If the ALT AST were very high I would think acute on chronic but only mildly chronic.
The right limb of the pnac oin the video is a little remodeled but minor and you can follow the lines and no oill defined linearity to the capsule or infrsutrucutre just a bit bumpy . So likley there is some very minor chronic low grade i”Triad” inflammation now and again but the clinical issues may come and go. I see this all day long in older patients so you have to match the clin path and the signs, if any, to the significance of the presentation you see on sonogram.
I am attaching a chronic active hepatitis from the atlas of pathology cd with increased and irregular portal markings (arrow) that is typical of more significant liver disease… same with a more dramatic pancreatic presentations as in this acute on chronic pancreatitis form the atlas as well
This is essentially a 9 year
This is essentially a 9 year old liver with aspecific coarseness. The architecture does not correspeond to the clinical status in these cases. ALT elevation is minor and changes are minor. If the ALT AST were very high I would think acute on chronic but only mildly chronic.
The right limb of the pnac oin the video is a little remodeled but minor and you can follow the lines and no oill defined linearity to the capsule or infrsutrucutre just a bit bumpy . So likley there is some very minor chronic low grade i”Triad” inflammation now and again but the clinical issues may come and go. I see this all day long in older patients so you have to match the clin path and the signs, if any, to the significance of the presentation you see on sonogram.
I am attaching a chronic active hepatitis from the atlas of pathology cd with increased and irregular portal markings (arrow) that is typical of more significant liver disease… same with a more dramatic pancreatic presentations as in this acute on chronic pancreatitis form the atlas as well
Thanks Eric. It’s good to see
Thanks Eric. It’s good to see my interpretations are improving. I appreciate your thoughts and the images.
Thanks Eric. It’s good to see
Thanks Eric. It’s good to see my interpretations are improving. I appreciate your thoughts and the images.