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Lymphomegaly and Intestinal Thickening

Lymphomegaly and Intestinal Thickening . Presented by: Rebecca McIntosh June 22, 2011 NCSU Ultrasound Rotation. Signalment. Canine 6 year old English Setter White and Black Intact female Hunting/breeding. Presenting Complaint. Anorexia, vomiting 7 days duration

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Lymphomegaly and Intestinal Thickening

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  1. Lymphomegaly and Intestinal Thickening Presented by: Rebecca McIntosh June 22, 2011 NCSU Ultrasound Rotation

  2. Signalment • Canine • 6year old • English Setter • White and Black • Intact female • Hunting/breeding

  3. Presenting Complaint • Anorexia, vomiting • 7 days duration • Diarrhea, weight loss • 6 weeks

  4. History • April 2011 • Had litter of puppies • 3 survived • Treated with Cephalexin for diarrhea • May 22 • Became anorexic • May 24 • Began vomiting, hypoalbuminemic on bloodwork

  5. History • May 28 • Barium study performed • Showed mild irregular, rough appearing mucosa of stomach and SI • Started on Baytril • Given Dexamethasone SP • May 30 • Presented to NCSU SAES

  6. Physical Exam • Abdomen tense on abdominal palpation • No peripheral lymphadenopathy • Remainder of PE unremarkable • BCS 3/9 • No melena on rectal

  7. Diagnostic Imaging • Lateral abdominal radiograph • Loss of serosal detail • Mass effect in cranial abdomen • Remainder of radiographs aborted at owner’s request • Abdominal ultrasound strongly recommended

  8. Differential Diagnosis • Neoplasia • GI Foreign Body • Inflammation -IBD

  9. Diagnostic Imaging • Abdominal Ultrasound

  10. Diagnostic Imaging • Abdominal Ultrasound

  11. Diagnostic Imaging • Abdominal Ultrasound

  12. Diagnostic Imaging • Normal Bowel

  13. Diagnostic Imaging

  14. Diagnostic Imaging • Abdominal Ultrasound

  15. Diagnostic Imaging • Abdominal Ultrasound

  16. Diagnostic Imaging • Abdominal Ultrasound

  17. Diagnostic Imaging • Abdominal Ultrasound Normals 40mm <7.5mm 5-10mm <25mm 3-4mm <3mm 5-10mm <5mm

  18. Diagnostic Imaging • Abdominal Ultrasound Normals 40mm <7.5mm 5-10mm <15mm 5mm 5-10mm <50mm

  19. Diagnostic Imaging • Abdominal Ultrasound-typical finding

  20. Differential Diagnosis-revised • Lymphoma • IBD

  21. Diagnostics • LN Aspirates • Large granular lymphoma • Most commonly splenic in origin

  22. Conclusion • Owner elected euthanasia • No necropsy was performed

  23. Acknowledgements: • Dr. Phillips • Dr. Campbell • Dr. Duhadway • American Cancer Society • http://www.cancer.org/Cancer/SmallIntestineCancer/DetailedGuide/small-intestine-cancer

  24. Questions ?

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