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Comments
Unfortunately, there is a lot of nastiness going on here. Anal sac adenocarcinoma with mets to the SL, MILN, and other LNs in the aortic trifurcation area / caudal abdomen seems reasonable. We see these cystic changes with LN mets from anal sac adenocarcinoma so it may all be cystic LN changes with some mild associated effusion.