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Portal nodule

Sonopath Forum

Dear All, 

I have a 10 year old dog patient, with severe cushingoid symptomps ( PU, PD, hyperpigmentation of the skin, bilateral alopecia),

T4 is normal. Elevated liver enzymes- but not elevated ALKP

I found both adrenal normal shape and size, but i have also found a mass next to the portal vein and the pancreas with small cystic leasons.

Could it be responsible for the symptoms? Is it attached to the pancreas? Or is rather just a portal lymphnode?

UCCR is pending.

Thank You!

 

Rita

Dear All, 

I have a 10 year old dog patient, with severe cushingoid symptomps ( PU, PD, hyperpigmentation of the skin, bilateral alopecia),

T4 is normal. Elevated liver enzymes- but not elevated ALKP

I found both adrenal normal shape and size, but i have also found a mass next to the portal vein and the pancreas with small cystic leasons.

Could it be responsible for the symptoms? Is it attached to the pancreas? Or is rather just a portal lymphnode?

UCCR is pending.

Thank You!

 

Rita

Comments

EL

This is a hepatic LN,

This is a hepatic LN, microcystic typically associated wiht history of hepatitis in my experience. Longer than wide hence likely reactive. I would fna the liver and this node if accessible wihtou hitting the pv. Culture as well. Only about 5% of cushingoid patients dont have an alk phos elevation but adrenal panel for atypical cushings possible or this one of the rare cases.

Liz

Hey Eric, I see these pretty

Hey Eric, I see these pretty frequently and have NO IDEA how to access with a needle. Usually I am pushing hard to get gas in the duo/pylorus/colon out of the way, and then you’re sort of threading the needle between the PV and VC. Any tips?

EL

Liz, dorsal recumbency, left

Liz, dorsal recumbency, left probe hand push straight down in sdep position 11 under sedation. The LN will come to you. Angle away from the pv just like you would a mesenteric LN adjacent to the mesenteric artery at the mesenteric root. These nodes i would fna for cyto and aspirate the cystic part for culture.

pacsit

Thank You, we will take liver

Thank You, we will take liver biopsy