Sonopath Forum

Severe splenomegaly

– 12 yr MN Giant Schnauzer admitted on an emergency basis for vomiting and diarrhea; had surgery the previous day to remove several small suspected cutaneous sebecesous cysts (pretty routine) No pre-op blood work was run

– massive bruising over ventral abdomen and hematomas under sites of cyst removal; pet flat out sick

– HCT 21, platelets 20, elevated WBC’s, mildly elevated ALP, PT normal, PTT prolonged (tick screen pending; rDVM also sent out blood cultures); slide auto-agglutination test negative

– massive bruising over ventral abdomen and hematomas under sites of cyst removal; pet flat out sick

– HCT 21, platelets 20, elevated WBC’s, mildly elevated ALP, PT normal, PTT prolonged (tick screen pending; rDVM also sent out blood cultures); slide auto-agglutination test negative

– hepatomegaly and severe splenomegaly on ultrasound with a hypoechoic splenic mass in the head with a lacey echotexture – no capsular distortion plus a few ill-defined hypoechoic nodules

– fat around the spleen is hyperechoic with some SI corrugation noted; no free fluid; abdominal LN’s moderately enlarged

When rDVM saw the splenic mass, she wanted to assume that this was neoplasia however I am not so sure as I have seen benign lymphoid hyperplasia also look like this. I am not FNAing this one! So splenitis, IMHA, Evans, sepsis, massive extramedullary hematopoiesis, possible neoplasia – any other thoughts? (splenic hilus looked normal on colour Doppler)

Comments

Electrocute

February 7, 2018 at 2:25 am -

Mast cell tumor (SQ and

Mast cell tumor (SQ and Splenic)? Histiocytic sarcoma? Was CF on the spleen normal (rule out torsion)? Any signs of blood loss elsewhere? Chest rads? Normal BUN? RBC morphology? Is the anemia regenerative?

rlobetti

February 7, 2018 at 5:00 am -

With the thrombocytopenia,

With the thrombocytopenia, vector-borne disease and infiltrative neoplasia very important. On the video clip get the impression that the spleen has a lacy pattern, so torsion still a possiblity.

Pankatz

February 7, 2018 at 6:26 am -

Thanks guys, my overall

Thanks guys, my overall impression was not torsion in this case as the colour Doppler evaluation did not agree but in the view comparing spleen to the liver it looks a little lacey (Could be settings) Splenic hilus looked normal. Mast cell is a good thought esp. with how the patient reacted after surgery and GI signs. I have not followed-up to see how the patient is doing now but will try contact the RDVM as this is a strange one.

February 7, 2018 at 12:49 pm -

Im betting on round cell

Im betting on round cell neoplasia and partaneoplastic evans syndrome here or consumptive disease maybe bone marrow involvement…HS with first in line with the breed. All else is potential and great input. Sounds like an ugly case JP… just go and cut it NOT

Chest rads?