Page 453 - Feline diagnostic imaging

27.1 ­he eline idneys 465

(a) (b)

(d)
(c)

Figure 27.14 Ultrasonography of renal lymphosarcoma. (a) Both kidneys were affected in this 17-year-old cat. The right kidney was
hyperechoic and enlarged but had relatively normal architecture. (b) The left kidney had an abnormal shape and less recognizable
architecture. Anechoic cystic areas were apparent. The small intestine was also affected. (c) Ultrasound scan of the left kidney of a
14-year-old Ragdoll with T cell lymphoma diagnosed following surgical biopsy of the liver. The kidney is greatly enlarged (5.22 cm)
with some crescent-shaped hypoechoic areas adjacent to the margins of the kidney. (d) Image of the right kidney of the cat with
diffuse large cell lymphoma pictured in Figure 27.12c and d. The right kidney is markedly enlarged at 5.96 cm but architecture is fairly
normal. There is a distinct hypoechoic rim surrounding the kidney. The hypoechoic rim has been reported in other cats with lymphoma
and has been attributed to subcapsular thickening.

kidney from other neoplasia such as plasmacytoma or common changes in other organs included lymphadenopa-
histiocytic sarcoma (Figure 27.13d). thy and diffuse thickening of some intestinal loops. In the
effusive form, fluid can be found in the pleural and/or peri-
toneal cavities [16].
27.1.7 Feline Infectious Peritonitis
Both the effusive and noneffusive forms of feline infectious 27.1.8 Perirenal Pseudocyst
peritonitis (FIP) can affect the kidney [15]. Sonographic
changes that have been reported include unilateral or bilat- Perirenal pseudocysts are more common in cats than in
eral renomegaly, normal or increased echogenicity, and dogs and most occur in association with chronic renal
focal hypoechoic and hyperechoic nodules in the medulla disease (Figure 27.16) [18, 19]. The most common type of
(Figure 27.15) [15–17]. Pyelectasia may be present and the pseudocyst consists of a transudate that forms between
kidney(s) may be misshapen with a nodular or undulating the kidney and its surrounding capsule. These can be
margin. A hypoechoic subcapsular rim has been consid- unilateral or bilateral and appear as a dorsal mass or
ered an important finding but has also been reported masses, which are usually notably round on survey radi-
with other diseases, including lymphosarcoma [16]. Other ography. The term pseudocyst has been used because