Fibrosarcoma of the spleen and liver diagnosed by Tru-Cut biopsy in a 10 year old MN Pug

History

A 10 year old MN Pug was presented for the evaluation of anorexia, vomiting, diarrhea, and pollakuria. No abnormalities were noted on the physical exam. The CBC showed a neutrophilia, monocytosis, and thrombocytopenia. A serum biochemical profile revealed elevated serum alkaline phosphatase, elevated ALT, elevated AST, elevated GGT enzyme activities as well as hypercholesterolemia.

Comments

No video available on this patient.

Clinical Differential Diagnosis

Cholangitis with a possible mucocele (and/or rupture of the mucocele with bile peritonitis). Hepatitis – acute suppurative, infectious (leptospirosis, toxoplasmosis), or immune-mediated. Pancreatitis with secondary cholestasis and/or hepatitis . Neoplasia (primary vs. metastatic; hepatocellular adenoma, lymphoma, carcinoma, leiomyoma, leiomyosarcoma, mast cell tumor, histiocytic sarcoma, etc).

DX

Fibrosarcoma, spleen and liver

Sampling

Ultrasound guided FNAs of the liver and spleen were non-diagnostic. An ultrasound guided Tru-cut® biopsies of both liver and spleen revealed fibrosarcoma of the liver and spleen.

Sonographic Differential Diagnosis

The universal deviation from parenchymal architecture in spleen and liver, as well as the infiltrative and sclerosing pathology, suggests a neoplastic process in both organs. There is a minor potential for aggressive inflammatory disease.

Image Interpretation

Coarse architecture is noted in both the spleen and liver with irregular capsular contour, echogenic and irregular tissue striations with nodular changes. The linear echogenic focus in the near field is a core biopsy needle.