March's Case of the Month
Sonographic Findings of Probable Metastatic Mast Cell in a 10 year old MN Hound Mix
Dr. Tyler Anderson
Patient Information:
Age: 10 years
Gender: Male Neutered
Species: Canine
History:
An abdominal ultrasound was recommended due to a recent onset of soft stools (symptoms of small bowel diarrhea). Senior blood work revealed hypoalbuminemia and eosinophilia.
Image Interpretation:
Abdominal sonographic findings:
The jejunum had diffuse mild to moderate thickening (measuring 5.3 to 6.5mm). Many segments had abnormal layering with marked disproportionate thickening of the muscularis layer. The colon maintained normal wall layering and thickness. The duodenum also maintained normal wall layering and thickness.
Multiple mesenteric lymph nodes were moderately enlarged with rounded shape having homogenous hypoechoic echogenicity, measuring ~ 1.2cm in thickness.
Both adrenal glands were recognized as having abnormal mildly flattened shape and low-normal size (Lt/Rt = 3.6/3.8 mm).
Diagnosis and Sonographic Analysis:
Sedated fine needle biopsies of the jejunal lymph nodes were recommended for cytologic review. Cytologic findings revealed suspect metastatic mast cell tumor. Due to the low-normal size of the adrenal glands ACTH stimulation testing was also recommended to rule-out Addison’s disease as a potential complicating factor to the patient’s GI symptoms. Full thickness jejunal biopsies, fine needle splenic biopsies, and three-view thoracic radiographs are recommended for further staging, in addition to oncology referral for optimal treatment plan.
The duodenum exhibiting normal layering without excessive thickening of the muscularis layer.
A segment of jejunum with a markedly prominent muscularis layer.
A moderately enlarged jejunal lymph node that was biopsied via fine needle aspiration for cytologic review.
Cytologic image of the jejunal lymph node provided by Casey J. LeBlanc DVM, PhD, Diplomate, ACVP (Clinical Pathology)
Special thanks to Palisades Veterinary Clinic for the interesting case.