Use of color flow Doppler ultrasonography to diagnose a bleeding neuroendocrine tumor in the gallbladder of a dog

Jitender Bhandal Canada West Veterinary Specialists and Critical Care Hospital, 1988 Kootenay St, Vancouver, BC V5M 4Y3, Canada.

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Laurie L. Head Canada West Veterinary Specialists and Critical Care Hospital, 1988 Kootenay St, Vancouver, BC V5M 4Y3, Canada.

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David A. Francis Canada West Veterinary Specialists and Critical Care Hospital, 1988 Kootenay St, Vancouver, BC V5M 4Y3, Canada.

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Robert A. Foster Canada West Veterinary Specialists and Critical Care Hospital, 1988 Kootenay St, Vancouver, BC V5M 4Y3, Canada.

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Allan Berrington Canada West Veterinary Specialists and Critical Care Hospital, 1988 Kootenay St, Vancouver, BC V5M 4Y3, Canada.

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Abstract

Case Description—A 13-year-old neutered female Keeshond-cross was evaluated because of a history of melena, anemia, hematemesis, vomiting, and high serum liver enzyme activities over a 1.5-year period.

Clinical Findings—Abdominal ultrasonography revealed a hyperechoic mass in the gallbladder. In the gallbladder mass itself, a distinct linear blood flow pattern was detected by use of color flow Doppler ultrasonography.

Treatment and Outcome—A cholecystectomy was performed, and clinical signs resolved. Samples of the mass were examined histologically and immunohistochemically, and findings supported a diagnosis of neuroendocrine tumor of the gallbladder.

Clinical Relevance—Tumors of the biliary tree are a potential source of blood loss into the gastrointestinal tract. Color flow Doppler ultrasonography in conjunction with conventional grayscale ultrasonography may be useful in evaluation of the gallbladder in dogs. When echogenic material is detected in the gallbladder, it is important to evaluate the region for blood flow.

Abstract

Case Description—A 13-year-old neutered female Keeshond-cross was evaluated because of a history of melena, anemia, hematemesis, vomiting, and high serum liver enzyme activities over a 1.5-year period.

Clinical Findings—Abdominal ultrasonography revealed a hyperechoic mass in the gallbladder. In the gallbladder mass itself, a distinct linear blood flow pattern was detected by use of color flow Doppler ultrasonography.

Treatment and Outcome—A cholecystectomy was performed, and clinical signs resolved. Samples of the mass were examined histologically and immunohistochemically, and findings supported a diagnosis of neuroendocrine tumor of the gallbladder.

Clinical Relevance—Tumors of the biliary tree are a potential source of blood loss into the gastrointestinal tract. Color flow Doppler ultrasonography in conjunction with conventional grayscale ultrasonography may be useful in evaluation of the gallbladder in dogs. When echogenic material is detected in the gallbladder, it is important to evaluate the region for blood flow.

Contributor Notes

Dr. Bhandal's present address is Department of Surgery, Michigan Veterinary Specialists, 29080 Inkster Rd, Southfield, MI 48034.

Address correspondence to Dr. Bhandal (jpsbhandal@gmail.com).
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