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Multicentric neoplasia

Sonopath Forum

Sonopath Forum

Multicentric neoplasia

  • 14 year old MN Lab x, hx collapse, vomiting
  • Increase liver enzymes + anaemia on bloods
  • VPCs on ECG
  • Abdo scan – diffuse heterogenous liver changes, diffuse gastric wall thickening, hypoechoic splenic lesions + lacey lesion at hilus
  • Liver and spleen have been sampled, what would your top differentials be? Lymphoma? Lymph nodes were not enlarged
  • 3rd video is right sided cavitatory liver mass
  • Would you say the stomach muscularis layer is affected or all layers?

  • 14 year old MN Lab x, hx collapse, vomiting
  • Increase liver enzymes + anaemia on bloods
  • VPCs on ECG
  • Abdo scan – diffuse heterogenous liver changes, diffuse gastric wall thickening, hypoechoic splenic lesions + lacey lesion at hilus
  • Liver and spleen have been sampled, what would your top differentials be? Lymphoma? Lymph nodes were not enlarged
  • 3rd video is right sided cavitatory liver mass
  • Would you say the stomach muscularis layer is affected or all layers?

Comments

EL
July 17, 2018 at 3:24 pm -

Videos 1 and 4 have an

Videos 1 and 4 have an infiltrative gastric pattern loss of mural detail. lsa likely,video 2 has coalescing target lesions throughout the liver. Multicentric badness here needs fna and chemo but with the increased resp rate check for chest mets too

veteurope1
July 17, 2018 at 8:55 pm -

Thanks EL, what do you think

Thanks EL, what do you think of these cytology results? Needs biopsy?

 

Cytology results (nucleated cellularity and preservation moderate to good)

Liver: mild to moderate discrete vacuolar hepatopathy, probable mild nutrophilic inflammation, mesenchymal proliferation….these mesenchymal clls could reflect focal fibroplasia, however, I cannot completely exclude a mesenchymal neoplastic proliferation.

Spleen: mild EMH, there are a few cells with slight;y abnormal cytomorphology on one preparation, but due to their low density and significant suboptimal preservation it is difficult to speculate on thir origin and clinical importance.

EL
July 20, 2018 at 4:03 pm -

Yeh I would core bx with the

Yeh I would core bx with the expanding nodules moving the capsule out of the way on the liver i would think there is more to the pathoogy. The spleen is believable

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