Radiology Packet 30 Liver/Spleen

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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

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