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Pancreatic Mass?

Sonopath Forum

Sonopath Forum

Pancreatic Mass?

– 7 year old MN Siamese with acute onset of bloody vomit and lethargy

– bloodwork showed neutrophilia; biochem normal (no thyroid or fPLI available)

– large heteroechoic, cystic-like mass in the region where the left pancreatic limb should live

– possible pancreatic duct seen within mass (vessel with no colour flow)

– could not attach this to any other organs or bowel

– abdominal effusion present and hyperechoic fat

Any idea what this could be?

– 7 year old MN Siamese with acute onset of bloody vomit and lethargy

– bloodwork showed neutrophilia; biochem normal (no thyroid or fPLI available)

– large heteroechoic, cystic-like mass in the region where the left pancreatic limb should live

– possible pancreatic duct seen within mass (vessel with no colour flow)

– could not attach this to any other organs or bowel

– abdominal effusion present and hyperechoic fat

Any idea what this could be?

 

Comments

EL
December 13, 2013 at 9:01 am -

 
 
Looks like pancreatic

 
 

Looks like pancreatic pseudocysts/hyperplasia/necrosis maybe. Pretty well organized tissue and the p-duct (dual lined train track) gets deviated but not destroyed…nothing fuzzy here so likely a slow growing benign or relatively benign process. If it were carcinoma usually roughened hair coat and wasting and effusion inflammation that sort of thing. Needs a needle in the differetn echogenicities to define furthur. 25 or 22 gauge…try 25 first and see if you get a nice small dense sample. Pur some power doppler on it as well to see the vascularity and if the vessels are getting deviated or follow the p-duct pattern. If you get fluid out of those hypoechoic nodules then culture.

 

Beautiful images

 
EL
December 13, 2013 at 9:01 am -

 
 
Looks like pancreatic

 
 

Looks like pancreatic pseudocysts/hyperplasia/necrosis maybe. Pretty well organized tissue and the p-duct (dual lined train track) gets deviated but not destroyed…nothing fuzzy here so likely a slow growing benign or relatively benign process. If it were carcinoma usually roughened hair coat and wasting and effusion inflammation that sort of thing. Needs a needle in the differetn echogenicities to define furthur. 25 or 22 gauge…try 25 first and see if you get a nice small dense sample. Pur some power doppler on it as well to see the vascularity and if the vessels are getting deviated or follow the p-duct pattern. If you get fluid out of those hypoechoic nodules then culture.

 

Beautiful images

 
rlobetti
December 14, 2013 at 2:50 pm -

Another possiblity would be

Another possiblity would be an abscess, which could fit with the clinical signs and neutrophilia. Agree that FNA is the next step but may require laparotomy.

rlobetti
December 14, 2013 at 2:50 pm -

Another possiblity would be

Another possiblity would be an abscess, which could fit with the clinical signs and neutrophilia. Agree that FNA is the next step but may require laparotomy.

EL
December 14, 2013 at 4:09 pm -

If its benign on fna and

If its benign on fna and loclaized ot the left limb could just cut it out as well. I wouldnt want to carry that baggage around:)

EL
December 14, 2013 at 4:09 pm -

If its benign on fna and

If its benign on fna and loclaized ot the left limb could just cut it out as well. I wouldnt want to carry that baggage around:)

Pankatz
December 15, 2013 at 9:03 pm -

Thanks Eric and Remo
There

Thanks Eric and Remo

There was a significant amount of abdominal effusion present (not appreciated on stills above).  O did not allow me  to FNA/sample 🙁  Very frustrating. Pet went back to referring vet for care.

 

 

 

Pankatz
December 15, 2013 at 9:03 pm -

Thanks Eric and Remo
There

Thanks Eric and Remo

There was a significant amount of abdominal effusion present (not appreciated on stills above).  O did not allow me  to FNA/sample 🙁  Very frustrating. Pet went back to referring vet for care.

 

 

 

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