5-years-old female neutered Dogue de Bordeaux. The dog has a history of chronic digestive symptoms and weight loss. Recently the symptoms worsened. Because of the progression of the symptoms, an abdominal ultrasound was performed, revealing a splenic mass which, on cytological examination, is suspected to be histiocytic sarcoma. Due to the findings, an abdominal CT scan was performed.
![](https://proton-vet.com/wp-content/uploads/2022/01/Imagen-portada-1.jpg)
Description
The splenic parenchyma is markedly enlarged, with moderately rounded margins and an abnormal position, presenting a “C” shape that opens towards the caudal portion of the abdomen (green arrows).
![Dog CT scan enlarged spleen](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-2-1.jpg)
At level of the splenic pedicle, caudal to the stomach, there is a whirl sign (blue arrows), with a hyperattenuating area (298 UH) in its central portion (red arrow), consistent with a splenic torsion.
![dog CT whirl sign in spleen](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-3-1.jpg)
![dog CT whirl sign in spleen](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-4-1.jpg)
In the post-contrast study, the splenic parenchyma, as well as part of the splenic vasculature, shows a mild/moderate contrast enhancement (pre-contrast 60 UH; post-contrast 80 UH). In the area of the splenic hilum, there is a filling defect within the vessels, which could be consistent with a region of thrombosis (blue arrow). Additionally, there are multiple vessels with a tortuous path, distributed throughout the cranial aspect of the peritoneum (orange arrows).
![](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-5-1.jpg)
![Dog CT vessels with tortuous path in peritoneum](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-6-1.jpg)
In the left caudal aspect of the spleen, there is a heterogeneous lesion, with ill-defined margins, soft tissue attenuation and hypoattenuating compared to the rest of the splenic parenchyma (orange arrows). In the post-contrast study, the lesion shows a moderated contrast enhancement, mainly peripheral, remaining hypoattenuating compared to the rest of the spleen.
Pre-contrast
![Dog CT lesion in caudal aspect of the spleen](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-7-1.jpg)
Post-contrast
![Dog CT lesion in caudal aspect of the spleen](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-8-1.jpg)
The stomach has a normal position, although displaced cranially due to the mass effect generated by the spleen (orange arrows). The intestinal loops are also caudally displaced (pink arrows). There is a diffuse and moderate thickening of the colonic wall, being more evident in its descending portion (blue arrows).
![Dog CT stomach displaced cranially](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-9-1.jpg)
![Dog CT intestinal loops displaced caudally](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-10-1.jpg)
![Dog CT thickening colonic wall](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-11-1.jpg)
The jejunal lymph nodes are moderately enlarged, with a slightly heterogenous contrast enhancement (blue arrows).
![Dog CT jejunal lymphadenopathy](https://proton-vet.com/wp-content/uploads/2022/01/Sin-titulo-12.jpg)
Diagnosis
- Findings consistent with splenic torsion.
- Possible thrombosis along the splenic pedicle, as well as presence of collateral vascularization vs congestion of all the adjacent vasculature.
- Lesion at the left caudal aspect of the spleen, most likely consistent with a malignant lesion (neoplastic – histiocytic sarcoma, among others, given the results of the cytology), although a benign lesion (ischaemia, necrosis …) is also possible.
- Moderate diffuse thickening of the wall of the colon, consistent with inflammatory changes (colitis), most likely. Other differentials, such as diffuse neoplasia (lymphoma), are less likely.
- Moderate jejunal lymphadenopathy, most likely reactive.
Comments
Splenectomy and histopathological analysis of the spleen are recommended in order to reach a definitive diagnosis.
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