10-year-old castrated male Corgi

1 week history of progressive lethargy, decreased appetite

  • This dog had abdominal lymphoma with an incidental right renal cyst. There is enlargement of splenic, hepatic, and medial iliac lymph nodes, hepatomegaly with hyperechogenicity of the liver, and diffuse splenic nodules and mottling. The right renal cyst is large and causing distal acoustic enhancement. Management consisted of thoracic radiographs and aspirates or biopsy of a reasonable site to get a cytologic diagnosis.
  • This case was intended to determine whether candidates could recognize a common disease and properly prioritize lymphoma among other proper differential diagnoses. Candidates were also expected to recognize which lymph nodes were large based on the adjacent anatomy. Candidates were also expected to recognize that the renal cyst was unrelated to lymphoma changes.
  • Some candidates struggled to recognize which kidney was involved, and a surprising number did not even recognize the cyst was coming from the kidney, instead believing it to the be the gallbladder or even urinary bladder.
  • Some candidates believed this case represented pancreatitis, even though the pancreas is only briefly included in the videos, and ignored all the other abnormalities in the abdomen.
  • Overall, candidates performed well on this examination, and those who were comfortable watching ultrasound videos and recognizing anatomy from those videos did the best.