Urethral mass + haemorrhagic abdominal effusion

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Urethral mass + haemorrhagic abdominal effusion

  • 10 yo FN GSD presented for straining and inability to urinate
  • Severe thickening/mineralised mass of urethra extending into bladder neck with SL LN enlargement, suspect TCC
  • BUT…there was also moderate haemorrhagic abdominal effusion which strangely seemed to pocket doraslly on left side ventral to expaxial mm under costal arch
  • I am not sure what was casuing the effusion, the liver and spleen appeared normal but omentum/fat was not
  • What is the pathology cranial to the bladder, is there a mass here amongst abnormal fat? (last video)
    • 10 yo FN GSD presented for straining and inability to urinate
    • Severe thickening/mineralised mass of urethra extending into bladder neck with SL LN enlargement, suspect TCC
    • BUT…there was also moderate haemorrhagic abdominal effusion which strangely seemed to pocket doraslly on left side ventral to expaxial mm under costal arch
    • I am not sure what was casuing the effusion, the liver and spleen appeared normal but omentum/fat was not
    • What is the pathology cranial to the bladder, is there a mass here amongst abnormal fat? (last video)
    • What is happening regarding the fluid cranial to the left kidney, why is it pocketing in this non-dependent location?
    • Is this a carcinomatosis?
    • Any suggestions at all very, thanks.

Comments

DrMac

I believe there are enlarged

I believe there are enlarged lymph nodes (medial iliac) cranial to the UB with nonuniform perilymphatic fat. There is also suspected lymphadenopathy cranial to the left kidney. The effusion seems to be cellular. 

It is possible to get other neoplasia in the UB such as lymphoma so that may be possible here. I don’t recall seeing carcinimatosis secondary to TCC. So maybe lymphomatosis is possible. 

I also don’t like the image of the stomach in the first video…the wall layering appears abnormal. Any vomiting or inappetence? 

I would cytospin / cytology of the effusion to see if any abnormal or neoplastic cells are present. Assuming the albumin is normal or >1.5, this looks like a diffuse neoplastic process in the abdomen. 

veteurope1

It is a strange case

It is a strange case especially the haemorrhagic effusion. Thanks for you’re help.

DrMac

I agree…you always seems to

I agree…you always seems to have cool and weird cases! You could also FNA the area cranial to the UB to try to get some cytology. 

veteurope1

That’s not even a fraction of

That’s not even a fraction of them!

veteurope1

That’s not even a fraction of

That’s not even a fraction of them!

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