11 yo F/S Lab mix, chronic mild elevation liver enzymes. Lost weight a few months ago, back to normal weight.
Ultrasound 2 months ago: large liver, 1.2cm hyperechoic liver nodule, 8mm reactive/cystic jejunal LN.
Recheck u/s today. P is asymptomatic.
Large liver, 1.6cm hyperechoic R liver nodule (deep).
Hyperechoic mesenteric fat, diffuse, almost nodular, right side of abdomen.
Scant amount of free fluid, just a “triangle” near the loops. Intestines with normal thickness and layers.
11 yo F/S Lab mix, chronic mild elevation liver enzymes. Lost weight a few months ago, back to normal weight.
Ultrasound 2 months ago: large liver, 1.2cm hyperechoic liver nodule, 8mm reactive/cystic jejunal LN.
Recheck u/s today. P is asymptomatic.
Large liver, 1.6cm hyperechoic R liver nodule (deep).
Hyperechoic mesenteric fat, diffuse, almost nodular, right side of abdomen.
Scant amount of free fluid, just a “triangle” near the loops. Intestines with normal thickness and layers.
Normal pancreas, spleen, adrenals, etc…
1) What would make the fat inflamed w/o GI disease?
2) Is that a lymph node below the duodenum/pancreas?
O declined FNA of the fat.
Thanks!
Julie
Comments
Most likley would be
Most likley would be intra-abdominal steatitis, which may idiopathic or associated with trauma. Reactive lymph node seconadry to the hyperechoic fat.
Thank you Dr. Lobetti! This
Thank you Dr. Lobetti! This was really weird with an asymptomatic dog.
Julie
The localized free fluid
The localized free fluid would suggesst some level of inflammaiton/steatitis as Remo says. You can get this mesenteric remodeling post event that has stabilized but with the fluid present likely smoldering inflammation present. Subacute on chronic IBD with steatitis likely givent he minor intestinal thickening. Minor potential for emerging lsa or similar. Labs don’t show they are sick until really sick…Put this in Yorkie and you have a solidly clinical patient:)
Thank you, Eric. It was so
Thank you, Eric. It was so weird to see that much mesenteric inflammation w/o clinical signs.
The guts look inflamed on my pictures? I didn’t catch that. That would explain the inflammation and reactive LN.
Patient is a very anxious old Lab/shephd mix. These guys get GI lsa like cats?
Julie
The intestine looks pretty
The intestine looks pretty normal in those views but usually on full thickness you get some “IBD” type histopath on these…. The mesentery is adhered to the intestinal serosa which indicated the intestine is/was the issue. Its the body’s own self omentopexy:)
Totally makes sense. Thanks!
Totally makes sense. Thanks!