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Pylorus Mass

Sonopath Forum

I did an ultrasound today on Minnie. Minnie is a 12 year old DSH with a history of weight loss and vomiting.

Lab work was mostly unremarkable except for hypoalbuminemia. My associate referred Minnie to me for an ultrasound evaluation.

I did an ultrasound today on Minnie. Minnie is a 12 year old DSH with a history of weight loss and vomiting.

Lab work was mostly unremarkable except for hypoalbuminemia. My associate referred Minnie to me for an ultrasound evaluation.

I noticed that the cystic duct and CBD was grossly dilated indicating obstruction. Longitudinal view of the stomach showed some normal stomach and what I would consider a mural mass involving what I thought is the pyloral region. More normal stomach is seen to the right in the image. If what I am seeing is real- this would be my first gastric mass. The rest of the bowel looked normal on general scan

I was wondering if I am interpreting this correctly.

I tried to aspirate this mass twice and I really could not get it to exfoliate. I am suspicious this is some sort of carcinoma.

 

 

Comments

EL

 
 
Yes randy this is gastric

 
 

Yes randy this is gastric lymphoma til proven otherwise notice the complete loss of mural detail and the echogenic luminal stripe right in th emiddle. I see hypoalbuminemia in cats and I think LSA first and prove me wrong wiht the scan. Low albumin in a cat is a big red flag for me. You can 22 g fna this easy enough and confirm the dx. To be politically correct ddx: FIP, carcinoma, complicated IBD also possible.

The live ris hyperechoic which can be lipidosis but also LSA so 25 g fna there would be appropriate to rule out liver mets as px goes down pretty fats when lsa is in the liver.

Nice post

 
EL

 
 
Yes randy this is gastric

 
 

Yes randy this is gastric lymphoma til proven otherwise notice the complete loss of mural detail and the echogenic luminal stripe right in th emiddle. I see hypoalbuminemia in cats and I think LSA first and prove me wrong wiht the scan. Low albumin in a cat is a big red flag for me. You can 22 g fna this easy enough and confirm the dx. To be politically correct ddx: FIP, carcinoma, complicated IBD also possible.

The live ris hyperechoic which can be lipidosis but also LSA so 25 g fna there would be appropriate to rule out liver mets as px goes down pretty fats when lsa is in the liver.

Nice post

 
randyhermandvm

Thank you EL. I euthanized

Thank you EL. I euthanized Minnie shortly after the ultrasound and the owner was good enough to allow a necropsy. Histopathology came back as LSA. You were spot on. I did do 2 FNA of the mass and I could not get cells. I know I was in because I could see it on the screen and when I posted her I could see where I aspirated. This LSA was extremely firm- almost fibrotic feeling. 

randyhermandvm

Thank you EL. I euthanized

Thank you EL. I euthanized Minnie shortly after the ultrasound and the owner was good enough to allow a necropsy. Histopathology came back as LSA. You were spot on. I did do 2 FNA of the mass and I could not get cells. I know I was in because I could see it on the screen and when I posted her I could see where I aspirated. This LSA was extremely firm- almost fibrotic feeling.