Prostatic carcinoma diagnosed by ultrasound-guided FNA in a 14 year old MN Pomeranian

History

A 14-year-old neutered male Pomeranian dog was presented for evaluation of pollakiuria, diarrhea, inappetence, and lethargy. Abnormalities on physical examination included a painful, enlarged and symmetrical prostate, a very large and firm urinary bladder that could be expressed, and a grade III/VI heart murmur. On survey thoracic radiographs, calcification of the prostate gland was evident.

Comments

Ultrasound-guided FNA as well as drainage of the cyst, injection of antibiotic directly into the cyst would be advised if any flocculent material is noted. Urine culture and sensitivity would be warranted. Very guarded prognosis. No obvious metastatic disease; however, chronic degenerative renal disease is also an issue.

Clinical Differential Diagnosis

Prostate – neoplasia, abscess, prostatitis. Bladder – cystitis, neoplasia, uroliths. Heart murmur – degenerative valve disease, neoplasia.

DX

Prostatic FNA revealed carcinoma with neutrophilic inflammatory response, necrosis and mineralization.

Sampling

Prostatic FNA revealed carcinoma with neutrophilic inflammatory response, necrosis and mineralization.

Sonographic Differential Diagnosis

Mineralizing prostatic mass with cystic changes, which is strongly suggestive for carcinoma with potential secondary abscessation.

Image Interpretation

The urinary bladder contained a large amount of debris. The prostate in this patient was enlarged with multiple cysts and mineralized parenchyma. There was hyperechoic, ill defined periprostatic fat, which is suggestive for inflammation. The prostatic mass measured 2.35 cm.
Pyelectasia of the left kidney was noted measuring 0.46 cm. The kidney revealed chronic degenerative changes and microcystic cortices. Pyelectasia of the right kidney was also noted and measured 0.34 cm.