- 10 year old MN Golden Retriever with severe weight loss and lethargy, also initially had diarrhoea
- This dog previously had endoscopic GIT biopsies which were consistent with mild lymphocytic plasmacytic IBD
- Was on steroids at time of scan and B12 (was severely decreased)
- Hyperechoic enlarged liver (steroid use?), Splenomegaly with irregular echotexture and nodules in places,GIT seemed normal, There were two large rounded heterogenous LNs caudal to stomach
- 10 year old MN Golden Retriever with severe weight loss and lethargy, also initially had diarrhoea
- This dog previously had endoscopic GIT biopsies which were consistent with mild lymphocytic plasmacytic IBD
- Was on steroids at time of scan and B12 (was severely decreased)
- Hyperechoic enlarged liver (steroid use?), Splenomegaly with irregular echotexture and nodules in places,GIT seemed normal, There were two large rounded heterogenous LNs caudal to stomach
- Spleen cytology: plasma cell hyperplasia (There is very high nucleated cellularity on a palely eosinophilic background containing large numbers of RBCs and a few fragments of splenic stroma. Cell preservation is moderate. The nucleated cells predominantly consist of morphologically normal small lymphocytes and occasional medium sized and large lymphocytes. There are also moderate numbers of discrete cells which resemble plasma cells scattered throughout. The cytological findings are compatible with plasma cell hyperplasia. This has been associated with infectious disease. In the present case, no evidence of an underlying neoplasm, including multiple myeloma, is noted
- Unfortunately I could not get an FNA of LNs
- Have you seen a case like this before? Am I still missing neoplasia?
Comments
I am really glad that you
I am really glad that you posted the images from this case. Long ago in my distant past I found it fascinating that a similar case presented with hyperechoic nodules instead of the typical hypoechoic ones seen with lymphoid hyperplasia, regenerative erythropoeisis or lymphoma. That one always seemed to be an odd fit but I did have it confirmed with cytology. I do feel that you can differentiate between the previous group of three pending on the intensity of the echogenic density of the nodules. The weakest been the regenerative changes ( alsmost indistinct to the normal parenchyma ) to the darker lymphoma on ones. Plasma cell hyperplasia seemed to go against the grain and I always wondered if it was just a fluke case. Your images are very similar. Although the attached are very old images ( 2012) from that case I still think that they portray the nodules in an acceptable way.
Now the question to solve is why are they hyperechoic. So much to understand, so little time!i
Interesting. The only other
Interesting. The only other hyperechoic splenic lesions I have seen are mineralisations in cushings cases or myelolipomas.
What was the outcome with your case? I wonder what is driving the plasma cell hyperplasia….infection, multiple myeloma?
I would think round cell
I would think round cell neoplasia suppressed by the pred assuming the spleen was sampled at the time of the sonogram when he was on pred especially with that splenic cytology interpretation… pred induced on the fence read.