Whats Your Diagnosis #2

History:

A 2 year old male castrated Siberian Husky with history of anorexia for an indeterminate amount of time and began vomiting 2 weeks before time of death.

Radiographs: Diffuse hepatomegaly and splenomegaly, pleural effusion, mediastinal lymphadenopathy, pulmonary alveolar disease and a tracheobronchial mass.

Ultrasound exam: Multiple hypoechoic nodules in the liver, infarctions in the spleen and lymphadenopathy.

Clinical Pathology:

A liver aspirate was was diagnosed as possible histiocytic sarcoma or reactive histiocytosis by cytology.

A liver biopsy was diagnosed as portal hepatitis. The dog was treated with prednisone beginning 7/11/08 and became severely lethargic and dyspneic 7/17/08.

Bloodwork showed mild regenerative anemia with possible
thrombocytopenia.

Gross Findings:

Thin body condition.

The mediastinum was filled and expanded by enlarged tracheobronchial lymph nodes forming two distinct multilobular masses measuring 8 cm x 6 cm x 3 cm and 6 cm x 5 cm x 3 cm. The masses surrounded secondary bronchi and the aorta, and were firmly adhered to the aorta approximately 3 cm from its origin from the left ventricle. The normal lymph node architecture was replaced by a mass of firm yellow tissue with multifocal hemorrhages and small necrotic areas.

Tracheobronchial lymph nodes in situ

The mesenteric lymph nodes were multifocally enlarged and the normal architecture replaced by firm yellow tissue.

The spleen was large with multiple sharply delineated, dark red, swollen areas. On cut section these dark red areas were sharply delineated from the normal splenic parenchyma.

Spleen- Multiple infarcts and enlargement

The liver was filled with numerous firm, pale yellow nodules ranging in size from 5 mm diameter to 1.5 cm in diameter. The left kidney had two firm, pale yellow 4 mm nodules in the cortex.

Liver- A large focal, firm white nodule

Histopathology:

Neoplasm from the liver

Neoplasm from Spleen

Neoplasm from Lymph nodes

These photomicrographs were typical of the neoplasm however there tended to be more cells from the first photo in the liver than in any other tissue except the kidney. The spleen was composed of about 50/50 ration of the first photo and the second photo.

For our diagnosis and discussion click here