Radiology Packet 30

1. Radiology Packet 30 Liver/Spleen

2. 13 yr old F Collie/Lab“Laurie” • HX = presented for collapse, she is weak and pale on examination and an abdominal mass may be present on palpation

3. 13 yr old F Collie/Lab“Laurie”

4. 13 yr old F Collie/Lab“Laurie” • RF • On the lateral view there is a round soft tissue mass in the mid-ventral abdomen which is obliterating the normal splenic shadow. • Serosal detail in this area is decreased and also the liver margin is rounded but not enlarged. • On the VD view the round mass is located in the cranial and central abdomen and it is pushing the transverse colon cranially, • RD • Splenic mass • Next • Abdominal ultrasound • Surgical removal of the spleen

5. 16 yr old FS DSH“Bonnie Louise” • HX = presented with icterus and a history of chronic renal disease

6. 16 yr old FS DSH“Bonnie Louise”

7. 16 yr old FS DSH“Bonnie Louise” • RF • The liver is large, extending beyond the costal arch with a rounded caudal border. • Three small, roughly marginated mineralized opacities are present overlying the liver, in the region of the gall bladder and bile duct. • Both kidneys are small, a bit irregular, and have lost the characteristic shape. • Mild spondylosis and sites of IV disc space collapse. • Malalignment of S3-C1 • RD • Cholelithiasis • Hepatomegaly • Small kidneys (consistent with history of chronic renal disease)

8. 13 yr old F Miniature Poodle“Velvet” • HX = presented for evaluation of a palpable abdominal mass

9. 13 yr old F Miniature Poodle“Velvet”

10. 13 yr old F Miniature Poodle“Velvet” • RF • The tail of the spleen is visible in the cranioventral abdomen and it appears to connect to the large centrally located mass. • The liver is of normal size. • The urinary bladder is small, it is visible in the caudal abdominal cavity. • The structures of the GI tract are displaced by the mass but are otherwise normal in appearance. • RD • Large abdominal mass, splenic in origin • Next • Metastasis check • Biopsy • Surgical Removal

11. 3 yr old M Yorkshire Terrier • HX = referred with a history of recurrent urethral obstruction and reported to have frequent episodes of lethargy and episodes of staring into space

12. 3 yr old M Yorkshire Terrier

13. 3 yr old M Yorkshire Terrier

14. 3 yr old M Yorkshire Terrier • RF • In one lateral view the gastric axis is displaced very far cranially indicating that the liver is tiny. • The portion of the spleen that is visible appears normal. • They kidneys are best seen in the lateral view and appear approximately normal size. • Two fairly large, round mineral opacity structures are present in the bladder as well as some less defined mineral material. • Abdominal detail is less than normal but this is a result of lack of abdominal fat (the animal is very thin). • RD • Microhepatia • Cystic calculi • The radiographic findings and clinical signs lead to a single disease process: portosystemic shunt

15. 12 yr old MC Manx cat“Merlin” • HX = presented for lethargy and partial anorexia, his abdomen is tense on palpation

16. 12 yr old MC Manx cat“Merlin”

17. 12 yr old MC Manx cat“Merlin” • RF • Large soft tissue mass, mid-ventral abdomen on the lateral view, right of midline on VD view. • The head of the spleen is large. • There is decreased abdominal detail and the liver is large with rounded margins. • The left kidney is irregular in shape. • RD • Large intra-abdominal mass which may be entirely splenic in origin • Enlarged liver • Mild amount of abdominal fluid • Next • Abdominocentesis • Abdominal ultrasound and fine needle aspirate/biopsy of mass • Abdominal exploratory

18. 11 yr old MC Mixed breed dog“Pal” • HX = presented for evaluation of increasing abdominal size and respiratory difficulty for the last 7 days, a grade 3/6 heart murmur is ausculted

19. 11 yr old MC Mixed breed dog“Pal”

20. 11 yr old MC Mixed breed dog“Pal”

21. 11 yr old MC Mixed breed dog“Pal” • RF • Evaluation of the cardiac silhouette is hindered by the presence of free pleural fluid. • There is a generalized increase in pulmonary tissue opacity due to superimposition of free fluid. • An air bronchogram is visible overlying the cranial cardiac margin in the lateral view and there is a mild increase in opacity of the left cranial lung lobe noted in the VD. • There is increased opacity in the cranial abdominal cavity which is caused by the presence of a mass lesion and the presence of free fluid leading to a loss of abdominal detail. • The tail of the spleen is visible but it appears large and has rounded indistinct borders. • The head of the spleen is not visible in the VD view, instead a rounded structure of soft tissue opacity is visible caudal to the stomach. • The stomach contains several mineral opacity structures(stones). • RD • Free pleural fluid and possible consolidation of the left cranial lung lobe • Cranioventral abdominal mass, most likely of splenic origin • Free abdominal fluid

22. 6 yr old F Abyssinian“Honey Bun” • HX = history of episodic vomiting and now anorexia

23. 6 yr old F Abyssinian“Honey Bun”

24. 6 yr old F Abyssinian“Honey Bun” • RF • There is a discrete mineral opacity, irregular, noted over the liver within the region of the gall bladder. • Two discrete, smaller foci of mineralization are noted on the lateral view along the rib margin, along the cranial edge of the stomach. • The stomach is empty. • The SI has some gas in it, some of it almost looks “String of Pearls.” • A large amount of intra-abdominal fat is present. • Note the large amount of sternal fat around the heart. • RD • Gall stones • Next • Surgical removal

25. 11 yr old MC West Highland Terrier“Sam” • HX = the dog is presented for evaluation of splenomegaly and peripheral lymph node enlargement

26. 11 yr old MC West Highland Terrier“Sam”

27. 11 yr old MC West Highland Terrier“Sam” • RF • The liver is enlarged and the margins are rounded. • The head and tail of the spleen are visible and enlarged. • In the VD view an ovoid structure of soft tissue opacity is seen at the cranial margin of the left kidney and superimposed with the stomach. • The urinary bladder is small but visible in the caudal abdominal cavity. • RD • Generalized hepatomegaly • Generalized splenomegaly • Mass in left cranial abdominal quadrant (either enlarged left adrenal or lymph node) • Next • Ultrasound and fine need aspirate and/or biopsy

28. 2 yr old FS Shih Tzu“Jolie” • HX = Presented for vomiting and signs of dementia, blood work is pending. Following evaluation of the radiographs a splenoportogram is ordered.

29. 2 yr old FS Shih Tzu“Jolie”

30. 2 yr old FS Shih Tzu“Jolie”

31. 2 yr old FS Shih Tzu“Jolie”

32. 2 yr old FS Shih Tzu“Jolie” • RF • The liver is small. • Faint areas of mineralization are seen associated with the renal pelvis. • The urinary bladder is distended. • The contrast that enters the splenic vein proceeds to a venous structure that appears to be somewhat tortuous. • Also, there is reflux of some contrast material into the splenic parenchyma. • Contrast extends through a vessel which connects the splenic vein directly to the caudal vena cava at the level of T13. • Contrast is also visible in the cardiovascular structures and urinary system and it outlines multiple small calculi. • RD • Portosystemic shunt

33. 14 yr old MC DSH • HX = cranky, depressed, emaciated with pale mucous membranes

34. 14 yr old MC DSH

35. 14 yr old MC DSH • RF • Enlarged liver with irregular margins extending well beyond the costal arch. • Right-sided liver mass displacing the right kidney caudally. • Stomach axis is caudally positioned. • Diminished detail in the cranial and mid-abdomen. • Misshapen right kidney, left kidney is smaller than the right. • Stomach and colon contain mineral material. • Collapse of the lumbosacral disc space, spondylosis. • RD • Hepatic enlargement • Possible liver mass(es) • Free abdominal fluid • Asymmetric and misshapen kidneys • Next • Ultrasound and biopsy