Pancreatic mass?

Sonopath Forum

  • 7 year old Shih Tzu with inappetance and diarrhoea and abdominal pain
  • Large heterogenous and mineralised? mass caudal to stomach which appears to be extending from left limb of pancreas. liver, spleen, kidneys, AGs normal. Multiple rounded lymph nodes and free abdominal fluid
  • Can you make out origin of this mass? Carcinoma most likely?
  • FNAs of mass and LNs were taken, fluid was serosanguinous

  • 7 year old Shih Tzu with inappetance and diarrhoea and abdominal pain
  • Large heterogenous and mineralised? mass caudal to stomach which appears to be extending from left limb of pancreas. liver, spleen, kidneys, AGs normal. Multiple rounded lymph nodes and free abdominal fluid
  • Can you make out origin of this mass? Carcinoma most likely?
  • FNAs of mass and LNs were taken, fluid was serosanguinous

 

Comments

rlobetti

Pancreatic neoplasia highly

Pancreatic neoplasia highly likley but would not rule granulomatous peritonitis. Was cytology done of the fluid? If FNA non-diagnostic then laparotomy. 

EL

really bad pancreatic

really bad pancreatic necrosis looks just like carcinoma,.. the needle should tell the story depending where the samples were taken.

 

 

veteurope1

Thank you both. I will upload

Thank you both. I will upload the cytology results.

veteurope1

Cytology:
Cellularity high,

Cytology:

Cellularity high, preservation good.

Pancreatic mass: chronic inflammation, evidence of tissue injury and mineralisation [reactive pancreatic acinar cells seen, along with mineral, cholesterol crystals, inflammatory cells (mainly activated macrophages and frequent mature eosinophils), sheets of mesothelial cells, no neoplastic cells or micro-organisms]

LN: reactive hyperplasia, granulomatous lymphadenitis

Free fluid: non-septic, eosinophilic exudate

Has anyone seen something similar to this, should I still be concerned about neoplasia and only getting necrotic area of mass? Or would LNs show mets if that was the case? Wondering about taking this dog to surgery…

EL

I dont see this as surgical

I dont see this as surgical unless medicalk cleans it up a bit and conslidates it on follow up. Too much nebulous margins spider web type escape into the mesentery which sonographically can be eaither but i would tx pancreatitis necrosis if the patient is responding. gibve the benefit of the doubt here since carcinoma isnt popping up on fna. I would expoect LN to be in play with the level of inflammation but they still have relatively reactive ovoid patterns with minor distortion. Sx would be for a shopping spree of bx and maybe some necortic debridement here only.

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