scholarly journals Addisonian Crisis due to Metastatic Adenocarcinoma in a Pygmy Goat

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Nora Nogradi ◽  
Amanda L. Koehne ◽  
F. Charles Mohr ◽  
Sean D. Owens ◽  
Meera C. Heller
Keyword(s):  
Lymph Nodes ◽  
Fluid Therapy ◽  
Left Kidney ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Acute Onset ◽  
Dramatic Improvement ◽  
Metastatic Adenocarcinoma ◽  
Acth Stimulation ◽  
Renal Masses

A 15-year-old Pygmy doe was evaluated for acute onset of lethargy, anorexia, and weakness. Adrenal insufficiency was diagnosed based on physical exam findings, blood work abnormalities (hyponatremia, hyperkalemia, azotemia, and hypoglycemia), and lack of cortisol response to the ACTH stimulation test. Abdominal ultrasound exam revealed an intact urinary tract and multiple bilateral peri-renal masses. The doe was treated with intravenous fluid therapy aimed at correcting the electrolyte abnormalities and intravenous corticosteroids. She responded favorably to medical therapy in 24 hours, with dramatic improvement in attitude and appetite. Fluid therapy was discontinued, and the doe was discharged from the hospital on steroid supplementation. She deteriorated rapidly and died at home 36 hours after discharge. Necropsy results revealed metastatic adenocarcinoma originating from the uterus that infiltrated the urinary bladder, the region of the adrenal glands, the left and right renal lymph nodes, the left kidney, the caudal vena cava, the submandibular lymph nodes, the diaphragm, the lungs, and the omentum. Addison’s syndrome in ruminants should be considered as an uncommon sequel of intra-abdominal neoplastic processes.

scholarly journals Adenocarcinoma of the Jejunum: A Case Report and Literature Review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Miljan Zindovic ◽  
T. Culafic ◽  
D. Saric ◽  
D. Zindovic
Keyword(s):  
Small Intestine ◽  
Lymph Nodes ◽  
Abdominal Cavity ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Serum Markers ◽  
Endoscopic Examination ◽  
Invasive Adenocarcinoma ◽  
Laboratory Findings ◽  
Folfox Chemotherapy

Abstract Small intestine cancers account for 1-3% of all gastrointestinal tumors, with only 11-25% of these tumors located in the jejunum. We report the case of a woman who has been experiencing abdominal pain for the last six months, accompanied by nausea, vomiting and appearance of dark-colored stools, who has lost 20 kg in weight during the last few months. Laboratory findings indicated anemia and no significant changes were identified in the abdominal ultrasound. By endoscopic examination of the stomach and duodenum and by colonoscopy, no infiltrations were found. Serum markers were elevated and CT scan of the abdomen showed thickening of a part of the jejunum wall with swollen lymph nodes in the mesentery, along the inferior vena cava and abdominal aorta, in the retroperitoneal space. By opening the abdominal cavity, we observed an infiltration in the initial part of the jejunum with an infiltration of the entire wall. Resection of the jejunum with related mesenthery, vessels and lymph nodes therein was performed. Histopathology revealed an invasive adenocarcinoma of the small intestine, with an invasion of all layers of the wall and mesentery. Adjuvant FOLFOX chemotherapy was introduced, 6 cycles in total, and following each cycle, tumor markers have been constantly decreasing. No relapse has been identified after nine months. Due to often deep position in the small intestine, atypical symptomatology and lack of screening, an early diagnosis is difficult. Surgical resection of the affected small intestine followed by an additional chemotherapy is the optimal treatment strategy.

Suspected bilateral adrenal gland tumour causing primary Addison’s disease in a dog

2020 ◽  
Vol 48 (02) ◽  
pp. 132-138
Author(s):  
Anna-Lena Proksch ◽  
Andreas Brühschwein ◽  
Katrin Hartmann ◽  
Astrid Wehner
Keyword(s):  
Adrenal Gland ◽  
Vena Cava ◽  
Kidney Injury ◽  
Addison’S Disease ◽  
Abdominal Ultrasound ◽  
Surgical Removal ◽  
Addison's Disease ◽  
Acth Stimulation ◽  
First Case ◽  
Adrenal Masses

AbstractA 13-year old miniature poodle presented with a 3-day episode of vomiting, anorexia, and lethargy. Lack of micturition had been noted for 2 days. Clinical examination indicated dehydration and a tense, painful abdomen. Laboratory parameters (severe azotaemia, hyperkalaemia, severe hyponatraemia, hypochloraemia, and hyperphosphataemia with glucosuria and proteinuria) were consistent with anuric acute kidney injury (AKI). Abdominal ultrasound revealed bilateral adrenal masses. ACTH stimulation test was diagnostic for Addison’s disease. Computed tomography confirmed bilateral adrenal masses and indicated multifocal liver nodules. Additionally, infiltration of the caudal vena cava with partial luminal occlusion was demonstrated. Surgical removal of the adrenal masses with venous plasty intervention and stenting of the vessels deemed unrewarding in this patient in respect to progressed tumour growth with assumed metastatic spread. The dog was treated for Addison’s disease and discharged with good overall condition. Eight weeks later, the dog was euthanized due to progressive caudal vena cava occlusion. Whilst hypoadrenocoticism typically affects young to middle aged dogs, in old dogs primary Addison’s disease might be caused by neoplastic bilateral adrenal gland destruction. This is the first case report of hypovolaemia leading to AKI secondary to bilateral adrenal masses causing Addison’s disease in a dog.

scholarly journals Characterization of Solid Renal Masses using 64-Slice Multidetector CT Scanner

2009 ◽  
Vol 9 ◽  
pp. 441-448 ◽  
Author(s):  
Saleh S. El-Esawy ◽  
Mohamed E. Abou El-Ghar ◽  
Ghada M. Gaballa ◽  
Saly A. Zahra
Keyword(s):  
Cell Carcinoma ◽  
Clear Cell ◽  
Multidetector Ct ◽  
Left Kidney ◽  
Ct Scanner ◽  
Renal Masses ◽  
Surgical Data ◽  
Attenuation Values ◽  
Mdct Scanner

The purpose of our study was to assess the role of a 64-slice multidetector CT (MDCT) scanner in the characterization of different solid renal masses, using a simplified approach to correct the postenhancement attenuation values. The study included 96 consecutive adults (58 men, 38 women) with renal masses; 93 with unilateral and three with bilateral masses. All of our patients underwent multiphasic CT study including pre- and postcontrast corticomedullary (CM) and nephrographic phases. We analyzed the images and corrected the postcontrast attenuation values at the CM phase. The postbiopsy or -surgical data were used as reference standard. There were 53 masses at the right kidney, 40 at the left kidney, and three bilateral. The final diagnosis of the 96 solid parenchymal masses were 28 clear-type renal cell carcinoma (RCC), 22 papillary-type RCC, 21 chromophobe-type RCC, six XP 11.2 chromosomal translocation–type RCC, 15 angiomyolipoma (AML), and seven oncocytoma. All the AML had fat, with attenuation values less than -40 HU at the nonenhanced scan. There is no difference in the precontrast attenuation values for the different types other than AML. At the postcontrast CM phase after the correction of the attenuation values, the clear cell type could be separated easily, with attenuation values >20 with specificity, sensitivity, and overall accuracy of 92, 84, and 93%, respectively. The 64-slice MDCT scanner with application of enhancement values correction allows diagnosis of clear cell carcinoma. Also, AML could be identified easily with fat inside at the precontrast scan.

The respiratory variation in inferior vena cava diameter as a guide to fluid therapy

2004 ◽  
Vol 30 (9) ◽  
Author(s):  
Marc Feissel ◽  
Fr�d�ric Michard ◽  
Jean-Pierre Faller ◽  
Jean-Louis Teboul
Keyword(s):  
Inferior Vena Cava ◽  
Fluid Therapy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Respiratory Variation ◽  
Inferior Vena Cava Diameter

scholarly journals Resolution of Severe Neurologic Signs Following Intravenous Lipid Emulsion Therapy in a Young Dog With a Portosystemic Shunt: Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Amanda M. Spillane ◽  
Jenica L. Haraschak ◽  
Maureen A. McMichael
Keyword(s):  
Hepatic Encephalopathy ◽  
Lipid Emulsion ◽  
Reference Interval ◽  
Ammonia Concentration ◽  
Acute Onset ◽  
Portosystemic Shunt ◽  
Dramatic Improvement ◽  
Intravenous Lipid Emulsion ◽  
Life Threatening ◽  
Patient’S History

A 5-month-old male intact Great Pyrenees was presented for an acute onset of severe neurologic signs (stupor, absent menace, intermittent head turn to the left). The patient's history included possible naproxen ingestion with a maximum ingested dose of 59 mg/kg, exceeding the reported dose of >50 mg/kg known to cause neurologic signs. Blood sampling for baseline bloodwork was performed, and intravenous lipid emulsion (ILE) was subsequently administered, for treatment of the suspected toxicosis. Due to severe and life-threatening neurologic signs, other methods of decontamination were contraindicated and unlikely to be effective; extracorporeal therapy was also unavailable. Complete resolution of neurologic signs occurred 30 min after completion of ILE therapy. At this time, the owners found the missing naproxen tablets after returning home and the bloodwork results returned revealing findings consistent with hepatic encephalopathy. The fasted blood ammonia concentration immediately prior to ILE administration was 702.1 μg/dL (reference interval, RI: 24–36 μg/dL) and decreased to 194.1 μg/dL 24 h later. In the first 24 h, the patient also received three doses of lactulose, N-acetylcysteine, and intravenous fluids. The patient was subsequently diagnosed with a single, large intrahepatic portosystemic shunt via computed tomography and underwent an endovascular coil embolization procedure. Given the rapid and dramatic improvement in severe neurologic signs after ILE therapy alone, it is strongly suspected that this treatment resulted in improvement of hepatic encephalopathy.

scholarly journals Mapping of Cervical and Upper Mediastinal Lymph Node Recurrence for Guiding Clinical Target Delineation of Postoperative Radiotherapy in Thoracic Esophageal Squamous Cell Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Yichun Wang ◽  
Dongmei Ye ◽  
Mei Kang ◽  
Liyang Zhu ◽  
Mingwei Yang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Mediastinal Lymph Node ◽  
Postoperative Radiotherapy ◽  
Vena Cava ◽  
Lymph Node Recurrence

BackgroundThe lower neck and upper mediastinum are the major regions for postoperative radiotherapy (PORT) in thoracic esophageal squamous cell carcinoma (TESCC). However, there is no uniform standard regarding the delineation of nodal clinical target volume (CTVnd). This study aimed to map the recurrent lymph nodes in the cervical and upper mediastinal regions and explore a reasonable CTVnd for PORT in TESCC.MethodsWe retrospectively reviewed patients in our hospital with first cervical and/or upper mediastinal lymph node recurrence (LNR) after upfront esophagectomy. All of these recurrent lymph nodes were plotted on template computed tomography (CT) images with reference to surrounding structures. The recurrence frequency at different stations was investigated and the anatomic distribution of recurrent lymph nodes was analyzed.ResultsA total of 119 patients with 215 recurrent lymph nodes were identified. There were 47 (39.5%) patients with cervical LNR and 102 (85.7%) patients with upper mediastinal LNR. The high-risk regions were station 101L/R, station 104L/R, station 106recL/R, station 105 and station 106pre for upper TESCC and station 104L/R, station 106recL/R, station 105, station 106pre and station 106tbL for middle and lower TESCCs. LNR in the external group of station 104L/R was not common, and LNR was not found in the narrow spaces where the trachea was in close contact with the innominate artery, aortic arch and mediastinal pleura. LNR below the level of the cephalic margin of the superior vena cava was also not common for upper TESCC.ConclusionsThe CTVnd of PORT in the cervical and upper mediastinal regions should cover station 101L/R, station 104L/R, station 106recL/R, station 105 and station 106pre for upper TESCC and station 104L/R, station 106recL/R, station 105, station 106pre and station 106tbL for middle and lower TESCCs. Based on our results, we proposed a useful atlas for guiding the delineation of CTVnd in TESCC.

scholarly journals Presumed immune-mediated haemolytic anaemia associated with pregnancy in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691984168
Author(s):  
Matthew A Kopke ◽  
Sarah Pemberton ◽  
Craig G Ruaux
Keyword(s):  
Haemolytic Anaemia ◽  
Cardiac Activity ◽  
Abdominal Ultrasound ◽  
Serum Biochemistry ◽  
Acute Onset ◽  
Gram Staining ◽  
Case Summary ◽  
Immune Mediated ◽  
Large Uterus ◽  
Saline Test

Case summary A 7-year-old female entire Birman presented with acute-onset haemorrhagic vulvar discharge. Moderate, normocytic, normochromic, non-/pre-regenerative anaemia, along with a moderate mature neutrophilia, were seen on haematology. Saline test for agglutination was positive. No haemotropic mycoplasmas were identified. Serum biochemistry revealed severe hyperbilirubinaemia. Retroviral testing was negative. Serology for toxoplasmosis revealed a titre of 1:512. Abdominal ultrasound identified a large uterus, containing at least three advanced-stage fetuses, two of which failed to exhibit independent motion or cardiac activity. Ovariohysterectomy was performed. Histology demonstrated mild, multifocal suppurative placentitis, with Gram staining revealing no evidence of bacteria. Complete resolution of the anaemia was seen within 1.5 months of ovariohysterectomy. Relevance and novel information Immune-mediated haemolytic anaemia (IMHA) in association with pregnancy has not been previously reported in cats. This case represents a potential novel cause for IMHA in cats, which resolved following ovariohysterectomy.

scholarly journals Rare case of a kidney and inferior vena cava abnormalities with extensive lower extremity deep vein thrombosis in a young healthy male

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Muhammad Khalid ◽  
Manisha Nukavarapu ◽  
Rupal Shah ◽  
Timir K. Paul
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Rare Case ◽  
Inferior Vena ◽  
Left Kidney ◽  
Vena Cava ◽  
Healthy Male ◽  
Vein Thrombosis ◽  
Deep Vein

Kidney and inferior vena cava (IVC) abnormalities with extensive deep vein thrombosis (DVT) is a very rare cause of DVT and has a diverse clinical presentation. Computed tomography (CT) angiography is the gold standard for diagnosis and treatment including thrombectomy, thrombolysis and systemic anticoagulation. We present a rare case of active young healthy male admitted with acute onset of right lower extremity pain and swelling who was found to have extensive DVT on doppler ultrasound. CT abdomen showed extensive clot burden involving right common femoral vein extending into internal and external iliac veins associated with IVC hypoplasia and hypoplastic left kidney. Patient underwent urgent thrombectomy, catheter directed thrombolysis and was discharged home in stable condition on oral anticoagulation.

The human Bosniak model applied to a cat with renal cystadenoma

2015 ◽  
Vol 43 (01) ◽  
pp. 45-49
Author(s):  
F. Del Chicca ◽  
M. Ruetten ◽  
B. Gerber ◽  
P. Baloi
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Needle Biopsy ◽  
Left Kidney ◽  
Abdominal Ultrasound ◽  
Imaging Features ◽  
Bosniak Classification ◽  
Core Needle ◽  
Computed Tomographic ◽  
Malignant Lesions

SummaryA 13-year-old domestic shorthair cat was presented with weight loss and azotemia. Abdominal ultrasound revealed a large cystic spaceoccupying lesion with multiple septae in the left kidney. A core needle biopsy yielded a renal cystadenoma originating from the epithelial cells. This report describes the clinical, ultrasonographic and computed tomographic features and the growth progression of a renal cystadenoma. We describe the first attempt to apply the human Bosniak classification to a cat with renal cystic neoplasia to differentiate between benign and malignant lesions. Cystadenoma should be a differential diagnosis in cases of renal cystic space-occupying lesions. Other differentials, imaging features to differentiate benign and malignant lesions and the risk of malignant transformation will be discussed.

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