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liver lobe enlargement/mass

Sonopath Forum

liver lobe enlargement/mass

This is a 13 year old MN chihuahua that presented for vomiting.  Radiographs taken at another hospital showed a likely liver mass and blood work showed mild increases in liver values (ALT 150, ALP in 500’s).  Rest of her ultrasound showed high normal measurements of caudal poles of both adrenals (5.5 mm) and a somewhat heterogenous spleen not overly enlarged.  

This is a 13 year old MN chihuahua that presented for vomiting.  Radiographs taken at another hospital showed a likely liver mass and blood work showed mild increases in liver values (ALT 150, ALP in 500’s).  Rest of her ultrasound showed high normal measurements of caudal poles of both adrenals (5.5 mm) and a somewhat heterogenous spleen not overly enlarged.  

Is this rounded, enlarged, mass like liver lobe the quadrate lobe or is this the right middle liver lobe?  I don’t see evidence of abnormality elsewhere in the liver, so trying to guide resectability if this comes back neoplastic (performing FNA today).  

I do have some views in right lateral, but these dorsal recumbency views seemed best picks of the bunch.  He has a large amount of fluid in his fundus, but I don’t see any pyloric issues.  Not sure if when standing maybe the liver lobe is putting pressure on his stomach.  I do appreciate some fuzzy fat both around this liver lobe and also noticed some dorsal to the left limb of the pancreas, but pancreatic tissue was unremarkable.  

Comments

EL

This looks like left medial

This looks like left medial to me and may not be neoplastic. Looks like there is a necrotic or abscessing center about 2 cm deep in video 3. Dont be surprised if you get suppurative inflammation back as LEs often do not fit with the cytology and often depends which echotexture you fna’d. Always get a variety of echotextures it will enhance the dx power of sampling. I always suggest CT for surgical planning when margins are nebulous.

kromero

Great – thanks so much, Eric

Great – thanks so much, Eric – I’ll keep you posted!