Pancreatitis and abnormal right kidney in a 13 yr MN Persian

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Pancreatitis and abnormal right kidney in a 13 yr MN Persian

  • 13 year old MN Persian with history of vomiting, anorexia, and depression
  • Bloodwork showed a positive fPLI
  • Abdominal ultrasound shows an enlarged hyperechoic left pancreas, enlarged hypoechoic pancreatic body and right pancreas with adjacent clumping echogenic fat
  • The right kidney is misshapen with moderate renal pelvic dilation and a hypoechoic rim.  Clumping reactive fat is present adjacent to the right kidney (and right pancreas).  There is also what looks like a small stone in the right renal pelvis
    • 13 year old MN Persian with history of vomiting, anorexia, and depression
    • Bloodwork showed a positive fPLI
    • Abdominal ultrasound shows an enlarged hyperechoic left pancreas, enlarged hypoechoic pancreatic body and right pancreas with adjacent clumping echogenic fat
    • The right kidney is misshapen with moderate renal pelvic dilation and a hypoechoic rim.  Clumping reactive fat is present adjacent to the right kidney (and right pancreas).  There is also what looks like a small stone in the right renal pelvis
    • Differential diagnoses for the pancreas include severe pancreatitis and neoplasia (carcinoma)
    • Differential diagnoses for the right kidney hypoechoic rim include neoplasia (carcinoma, lymphoma) and FIP.  Differentials for the renal pelvic dilation include neoplasia, pyelonephritis, and obstruction.
    • US guided FNA performed on the abnormal pancreatic/fat tissue and cytology is pending.
    • Any other thoughts?  The plan is to provide aggressive medical management over the weekend while awaiting cytology results.

     

Comments

EL

Ugly pancreas needs a needle

Ugly pancreas needs a needle necrosis vs carcinoma or even panc lsa. RK is a mass likely round cell neoplasia with a distorted subcapsular halo and capsular escape. 25g fna of both organs should tell the complete story.

Electrocute

Thanks Eric. This is probably

Thanks Eric. This is probably the ugliest cat pancreas I have ever seen. I just did an FNA of the pancreas since it was 6pm on a Friday and didn’t want to run the risk of a kidney bleed.  Will pursue FNA of kidney next if pancreatic FNA is nondiagnostic.

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