Ch 7 Spleen

Question 1

Mean thickness of the spleen in cats:

Answer 1

8.2 mm (SD 1.4mm)

Question 2

Is this splenic capsule abnormal?

Answer 2

No, it’s jsut prominent because its perpendicular to the US beam (specular reflection)

Question 3

is the S spleen normal or abnormal (echogenicity) in either of these images? L Liver, LK L kidney.

Answer 3

Normal in both, it should be hyperechoic to the liver and to the kidney cortex.

Question 4

2 Ddx for hyperechoic nodules in the spleen

Answer 4

myelolipomas
calcified hematomas

also:
benign hyperplasia
EMH
granuloma
hematoma
infection (splenitis/abscess)
neoplasia
basically anything

Question 5

EMH can be hyperechoic or hypoechoic - T or F?

Answer 5

true

Question 6

Authors’ experience and recent study (Reese, 2013) – cat spleen measuring over ____ is enlarged.

Answer 6

1cm

Question 7

What are some drugs that cause splenomegaly in dogs?

Answer 7

ACP, ketamine, diazepam, thiopental

Question 8

This appearance is classic for:

Answer 8

splenic torsion, lacy hypoechoic
arrow: echogenic thrombus in the lumen

Question 9

Honey-comb / Swiss-cheese echotexture (mulitple hypoechoic nodules) is classic for _______, but can be seen in many other conditions.

Answer 9

lymphoma

Question 10

benign or malignant?

Answer 10

malignant; clockwise from top left: lymphoma, AGASACA, epithelial neoplasa, disseminated histiocytic sarcoma

Question 11

likeliest dg?

Answer 11

myelolipomas

Question 12

along which splenic border are myelolipomas usually located?

Answer 12

mesenteric border, commonly along vessels

Question 13

Answer 13

large splenic myelolipomas in a cat (a) and dog (b)

Question 14

benign or malignant game

Answer 14

very large, but benign - histologically nodular hyperplasia and EMH

Question 15

this is all the same type of lesion:

Answer 15

hemangiosarcoma

Question 16

same type of neoplasia:

Answer 16

histiocytic sarcoma

Question 17

Nodules or masses with a _______ rim and a ________ center (“______”) are more commonly associated with malignancy/mets.

Answer 17

hypoechoic (rim), hyperechoic/isoechoic (center) = target lesions

BUT can be seen in benign nodular hyperplasia

Question 18

Which type of lesion appearance is commonly associated with malignancy/mets?

Answer 18

Target lesions - iso/hyperechoic center with hypoechoic rim

BUT can be seen in benign nodular hyperplasia

Question 19

What are these called?

Answer 19

Target lesions - in this case, splenic hemangiosarcomas

Question 20

Reasons for a splenic thrombus

Answer 20

Neoplasia
exogenous steroids
SIRS
DIC
pancreatitis
immune-med. disease

Question 21

what is this appearance associated with i.e. in which state / condition is it common (not pathognomonic)

Answer 21

hyperechoic triangle at the hilus, a common feature in dogs with splenic torsion (left) and/or infarction (right - due to thrombus, severe necrotic pancreatitis)

the adjacent fat is usually hyeprechoic in these cases.

also it’s not specific - can be seen with diffuse neoplasia e.g. lymphoma.

Question 22

Answer 22

splenic infarct, sharply demarcated, lacy hypoechoic and confined to margins

Question 23

rare diagnoses 1

Answer 23

infectious splenitis, gas-producing bacteria secondary to torsion and necrosis

Question 24

rare diagnoses 2

Answer 24

extraskeletal osteosarcoma

Question 25

speckly spleen is seen with

Answer 25

Cushing's, DM, chronic steroid use