- 10 year old female entire Spaniel with progressive severe pu/pd and decreased appetite over months
- bloods unremarkable, urine sg 1.005
- These videos are scanning from the right with bitch in left lateral recumbency
- There seems to be a hypoechoic/mixed echogenicity mass extending from the right side of the liver – cytology pending.
- 10 year old female entire Spaniel with progressive severe pu/pd and decreased appetite over months
- bloods unremarkable, urine sg 1.005
- These videos are scanning from the right with bitch in left lateral recumbency
- There seems to be a hypoechoic/mixed echogenicity mass extending from the right side of the liver – cytology pending.
- I am confused as to what is causing the pathology surrounding the right kidney which is displaced caudally. I aspirated the fluid filled area and it got small amount of haemorrhagic fluid back but could not easily aspirated so seemed solidified
- I could not distinguish the ovary or the adrenal
- Any ideas what is going on here?
Comments
May be part of a sarcoma
May be part of a sarcoma extending around the kidney not sure. CT best here
Not definitive but I am
Not definitive but I am thinking an aggressive right adrenal mass here. In the third clip, I can see what I believe is the renal artery and the mass is right in that area. I dont see it associated with the right kidney. Any evidence of hypertension?
The PuPd and urine SG would
The PuPd and urine SG would fit with a functional adrenal tumor but not the poor appetite. Thus would considered an ovarian tumor as they can produce progesterone and anti-Müllerian hormone, which can lead to PuPd.
I appreciate all your
I appreciate all your comments.
Blood pressure has not been measured.
There was also no significant increase in ALP to suggest adrenal steroid producing mass.
I will hopefully get more information with the cytology.
Do you think there is liver involvement or just a mass adjacent to right liver? The fluid/cystic structure around the kidney seemed very different to the solid mass.
1. Liver (4 smears)2. Kidney
1. Liver (4 smears)
2. Kidney fluid (2 smears)
CYTOLOGICAL INTERPRETATION:
1. Evidence of recent/ongoing haemorrhage
2. Pathologic state uncertain
CYTOLOGICAL DESCRIPTION:
1. Four smears are evaluated. The background is clear. The smears contain abundant blood. In one of the
smears, two tiny clumps and a few single scattered foamy macrophages and occasional erythrophages are
seen.
2. Two smears are evaluated. The background is clear. Only abundant blood is present.
COMMENT:
The exact nature of these lesions cannot be determined from these smears. I can identify very mild degree of
macrophagic inflammation and evidence of recent/ongoing haemorrhage in one of the liver smears. No other
parenchymal tissue cells are present. These findings are not replicated in the renal fluid smears and I cannot
confirm true haemorrhage over iatrogenic blood contamination though the absence of erythrophages and
hemosiderophages does not entirely rule out the possibility of a true blood loss. Further sampling from the
more solid parts of these lesions could be considered here though a biopsy and histopathology would also be
clinically justified at this stage.
Unfortunately, no answer with
Unfortunately, no answer with the cytololgy. As Eric mentioned, cross sec imaging is ideal here for further clarification and assessment of surgical resectability.
I’m thinking hemangiosarcoma
I’m thinking hemangiosarcoma with this cytology and looking again looks like its coming off the cranial cortex of the kidney and wrapping around. CT here for sure