Case of the week 4.16.18
Publication Date: 2018-04-12
History
10 year old english springer spaniel. Weight loss, vomiting, decreased appetite for several months.
3 images
Findings
Orthogonal radiographs of the abdomen are available for interpretation.
The serosal detail is normal.
In the cranial ventral abdomen, there is a region of ill-defined stippled mineral opacity superimposed with the small intestine. On the ventrodorsal view this mineralization is seen surrounding and superimposed with a tubular gas segment and transverse colon in the right cranial abdomen as well as with a round soft tissue opacity measuring 5.9cm in width and approximately 6.2cm in length. The small intestine are uniform and normal in diameter and contain mostly gas.
The liver extends mildly beyond the costal arch and is rounded. The stomach is empty. The colon contains a mixture of soft tissue granular material and gas. There is a curved mineral opacity measuring approximately 0.6cm in length within the caudal lumen of the urinary bladder. The spleen is normal. There is mild spondylosis deformans of the thoracolumbar vertebrae
Diagnosis
Mass like structure with associated mineralization in the right cranial abdomen likely could represent a mineralized mass of small intestinal origin or a non-organ associated mass. Primary differentials include adenocarcinoma or lymphoma. Alternatively, mineralization contained within the GI tract and superimposed right kidney cannot be excluded.
Hepatomegaly is nonspecific and may represent a benign process (such as vacuolar hepatopathy) or diffuse neoplastic infiltration.
Discussion
The patient underwent abdominal ultrasound which revealed a duodenal mass as well as numerous enlarged, rounded, hypoechoic lymph nodes. These changes were most suggestive of a neoplastic process such as lymphoma or carcinoma.
FNAs were performed but unconclusive.
In the light of the overall poor prognosis, the owner elected for humane euthanasia without necropsy.
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