Today's Veterinary Practice

MAR-APR 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 64 IMAGING ESSENTIALS Malignant Ileal Neoplasms Lymphoma is the most common intestinal neoplasm in the cat. It appears as a focal mass, multiple masses, or diffuse infiltrative neoplasia; characterized by thickening and/or loss of the normal layered appearance of the intestinal wall ( FIGURE 6 ). 9,10,14 Adenocarcinoma is the second most common intestinal neoplasm in the cat, appearing as a circumferential transmural thickening with a loss of normal intestinal layering. Predilection sites for adenocarcinoma in the cat are the jejunum and ileum. 15 Mast cell tumor is the third most common intestinal neoplasm in the cat. It more commonly involves the small intestines, including the ileum, but can involve the ileo(ceco)colic region or the colon ( FIGURE 7 ). 16,17 Sonographic abnormalities of intestinal mast cell tumors in dogs have not been widely reported. Hemangiosarcoma is a rarely described cause of luminal narrowing in the ileum of cats. 18,19 Benign Ileal Neoplasms Leiomyoma cannot be differentiated from leiomyosarcoma using ultrasonography alone; cytologic or histopathologic diagnoses must be performed to confirm its diagnosis. Leiomyoma is uncommon in the cat. CECUM AND COLON ABNORMALITIES Intussusception Most intussusceptions occur in young dogs and cats and are secondary to viral, bacterial, and parasitic etiologies. An intussusception has a multilayered appearance in longitudinal axis and concentric ring appearance in transverse axis ( FIGURE 8 ). 20-24 Intussusceptions are named according to the segments involved; enteroenteric, ileocolic, and FIGURE 6. Long axis view of the ileocolic junction in a dog diagnosed with lymphoma (A). Note the overall thickness of the ileum ( calipers ), characterized by thickened submucosa and muscularis layers. There is an additional thin, hyperechoic structure traversing the mucosal layer of the ileum ( white arrowhead ), likely representing a region of fibrosis. Long axis view of the ileum in a cat diagnosed with lymphoma (B). Note the irregular margins, increased wall thickness ( calipers ), loss of wall layering, and the overall hypoechoic appearance. A B FIGURE 7. Short axis view of the ileocolic junction of a dog diagnosed with mast cell tumor (A). Note the irregularly marginated hypoechoic mass ( calipers ) circumferentially surrounding the ileal lumen ( white arrowhead ). Long axis view of the ileocecocolic junction of a cat diagnosed with mast cell tumor (B). Note the overall thickness of the ileum ( calipers ) and the thickened, hypoechoic muscularis layer. A B

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