Radiology Packet 30

1
Radiology Packet 30

• Liver/Spleen

2
13 yr old F Collie/LabLaurie

• 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/LabLaurie
4
13 yr old F Collie/LabLaurie

• 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 DSHBonnie Louise

• HX presented with icterus and a history of
  chronic renal disease

6
16 yr old FS DSHBonnie Louise
7
16 yr old FS DSHBonnie 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 PoodleVelvet

• HX presented for evaluation of a palpable
  abdominal mass

9
13 yr old F Miniature PoodleVelvet
10
13 yr old F Miniature PoodleVelvet

• 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 catMerlin

• HX presented for lethargy and partial anorexia,
  his abdomen is tense on palpation

16
12 yr old MC Manx catMerlin
17
12 yr old MC Manx catMerlin

• 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 dogPal

• 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 dogPal
20
11 yr old MC Mixed breed dogPal
21
11 yr old MC Mixed breed dogPal

• 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 AbyssinianHoney Bun

• HX history of episodic vomiting and now anorexia

23
6 yr old F AbyssinianHoney Bun
24
6 yr old F AbyssinianHoney 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 TerrierSam

• HX the dog is presented for evaluation of
  splenomegaly and peripheral lymph node enlargement

26
11 yr old MC West Highland TerrierSam
27
11 yr old MC West Highland TerrierSam

• 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 TzuJolie

• 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 TzuJolie
30
2 yr old FS Shih TzuJolie
31
2 yr old FS Shih TzuJolie
32
2 yr old FS Shih TzuJolie

• 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