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Series 5: In Pursuit of the Pancreas

 

What are pancreatic cysts? Anechoic fluid-filled structures in the pancreas; may be dilations of the ductile tree of the pancreas. They look SIMILAR TO ABSCESSES on ultrasound. Here are several cases documenting cysts with videos on drainage and verification of cystic type fluid rather than abscess. Note similar presentations though, which often require drainage for identification. And of course concurrent disease is common!

http://sonopath.com/members/case-studies/cases/pancreatic-cystic-degeneration-15-year-old-fs-cat

http://sonopath.com/members/case-studies/cases/pancreatic-cyst-and-gastric-epithelial-tumor-10-year-old-mn-beagle-mix-do

http://sonopath.com/members/case-studies/cases/pancreatic-cyst-and-neuroendocrine-neoplasia-diagnosed-ultrasound-guided-

and here is another one that documented an abscess rather than cyst –

http://sonopath.com/members/case-studies/cases/pancreatic-abscess-and-suppurative-pyogranulomatous-inflammation-4-year-o

Neoplasia
*****Pancreatic neoplasia and pancreatitis can look the same*****

LOOK at these videos. The pancreas in this 6 year old painful cat is enlarged, hypoechoic, irregular with hyperechoic surrounding fat AND sectorial as it was localized to the left limb.  Sound familiar?? So what is it? The differentials are “simple” pancreatitis, necrosis, and carcinoma. And you won’t know which unless you put a 25g needle in it on day 1. Don’t be the one who lets a cat sit in a cage on fluids for days treating undefined pancreatitis when they have carcinoma.

Pancreatic carcinoma in a cat.

Another example of how similar pancreatic pathologies can appear. Here is a young 1 year old cat with a presentation that could be severe pancreatitis or carcinoma
http://sonopath.com/members/case-studies/cases/pancreatitis-possibility-pancreatic-carcinoma-1-year-old-mn-dsh-cat

A pancreatic carcinoma case study with FNAs to confirm.
http://sonopath.com/members/case-studies/cases/pancreatic-carcinoma-carcinomatosis-16-year-old-fs-dsh-cat

This case could also have been either inflammatory or carcinoma, and was confirmed neutrophilic inflammation on cytology.
http://sonopath.com/members/case-studies/cases/0500254-mika-f-pancreatitis

TIP: When you have free fluid, do an abdominocentesis to collect a sample, spin it down immediately and make a slide from the sediment.  You can often get your neoplasia answer there.

Go to Series 6