Sonopath Forum

Liver mass

Hello

I was hoping for confirmation that I am not missing anything with my approach on this case. Mosco is a 10 year old Schnauzer that is diabetic and has developped elevated liver enzymes. Was in for a BG curve but has a BG of 5mmol/L and we have stopped insulin. We performed ultrasound to rule out major pathology.

Hello

The pancreas appeared unremarkable to me but we did find a mass in the Lt liver lobe that is consistent with nodular hyperplasia. We were considering an FNA to rule out neoplasia. It is a solitary focal mass and the rest of the liver appears normal. We also saw a hyperechoic pattern in the GB that does not move when standing or recumbant but is not perfectly consistent with a mucoeole. I read a post here previously on how to manage these cases that are not a textbook mucocoele by re-evaluating and re-measuring the GB every 24 hours. Is it acceptable in this case to monitor this GB and is there any inference that can be made between the mass and the GB appearence? Mosco is eating well and we would assume that the GB should change over the next few days if there is no pathology correct?

Or….Is this image consistent with mucoceole and we should be going in to remove it?

Thanks. Brent

Comments

tosullivan

October 4, 2015 at 1:27 pm -

For some reason the Jpeg of

For some reason the Jpeg of the GB did not show up on the post but was seen in the preview and is still uploaded when edit. So I posted it in the Teaser imager area.

rlobetti

October 6, 2015 at 12:51 pm -

Gall bladder is dilated and

Gall bladder is dilated and contains hyperechouc sludge, which looks adherent. Could be dealing with an emerging mucocele. The wall looks pretty normal so unlikley to be cholecystitis. The elevated liver enzymes may be stemming from either the liver mass or the gall bladder – how high are the values? Would an idea to to FNA the liver mass to ensure that you are dealing with a benign lesion and not missing a maligant one.

October 7, 2015 at 2:00 am -

Emerging mucocele for gb and

Emerging mucocele for gb and necrosis, carcinoma or abscess on the liver lesion needs fna and culture.