Mixed echogenicity structure in area of adrenal

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Mixed echogenicity structure in area of adrenal

  • 9 year old female spayed pit bull terrier
  • Significant weight loss over the last few months
  • Initially azotemic (BUN 51, creat 5), hyperphosphatemic (9),  and USG 1.012
    • 9 year old female spayed pit bull terrier
    • Significant weight loss over the last few months
    • Initially azotemic (BUN 51, creat 5), hyperphosphatemic (9),  and USG 1.012
    • Dog was scanned and hyperechoic renal cortices with mild pyelectasia were noted bilaterally. A mixed echogenicity mass approx 2 cm in length was noted caudomedial to the right kidney. I questioned whether this was the right adrenal, although it seemed too caudal for that structure. Due to gas in the stomach/colon (not fasted), I decided to rescan in a week. Left adrenal was normal.
    • Treatment included: renal diet, AlOH, and doxycycline on off chance of lepto (this is a $ case).
    • This week the dog was rescanned, pyelectasia was improved but the structure caudal to the kidney remained. Despite the dog being fasted I could not find anything else that I could call the right adrenal. A video of this structure will hopefully post below. This dog was scanned in lateral, so I could see the left adrenal caudal to this structure while scanning.
    • Thank you for any thoughts
    Liz

    Mass:[videoembed id=6971]

    With doppler:[videoembed id=6973]

    Right kidney for orientation:[videoembed id=6974]

    Right kidney transverse:[videoembed id=6975]

Comments

Anonymous

Liz this is a cystic LN and
Liz this is a cystic LN and may be seen on occasion especially in cases of chronic infection. It happens often in chronic ibd cats and you drain it and there is usually a modified transudate. i surmise its what happens when chronic inflammation just eats away at the Ln parenchyma and the patient is left with just the fibrous LN infrastructure and lymph. Its benign though and goes along with chronic pyelo in this case. Anyone else have a better explanation for this?

Anonymous

Liz this is a cystic LN and
Liz this is a cystic LN and may be seen on occasion especially in cases of chronic infection. It happens often in chronic ibd cats and you drain it and there is usually a modified transudate. i surmise its what happens when chronic inflammation just eats away at the Ln parenchyma and the patient is left with just the fibrous LN infrastructure and lymph. Its benign though and goes along with chronic pyelo in this case. Anyone else have a better explanation for this?

Anonymous

thanks Eric. What are your
thanks Eric. What are your thoughts on this patient’s kidneys? (I am trying to get better at interpreting these).

Anonymous

thanks Eric. What are your
thanks Eric. What are your thoughts on this patient’s kidneys? (I am trying to get better at interpreting these).

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