so this case was a female neutered feline 12 years old weighing at 3.3 kilos was a Turkish van had a history of vomiting with slight Improvement on prednisolone and was borderline chronic kidney disease so here we can see the stomach um so we've got the stomach wall around here we've got the lumen in the center filled with fluid so it's anechoic um and we can see that the stomach wall is really thickened around here and we've got a total loss of wall layering in this area so this is a moving image of the same stomach so we can see there's some areas with normal stomach wall layering up here where we've got a mucosa which is dark submucosa which is light muscularis which is dark um all in equal proportions um and and that's seen quite normally up here with some Regal folds as well but down here in this area we see this thickened stomach wall so really really thick in this area down here and we see this lymph node popping in as well which is hyperechoic rounded it's not a lymph node we'd normally see on ultrasound of the abdomen so really standing out prominently there so we've definitely got an abnormality in the stomach wall and it's affecting the local lymph node also measuring the lymph node here which is chordal to the bladder um we can see that it although it's measuring less than half a centimeter it is still more prominent and more hypo echoic and rounded than we would expect a lymph node in this area to be I'm using half a centimeter as the thickness of the lymph node that I would expect a cat lymph node to be under in the abdomen and here we're measuring the the stomach wall this was actually measuring it between one and a half and two centimeters in different areas where we whereas we'd expect a normal cat stomach wall to be much more like a quarter of a centimeter in thickness [Music] so this thick wall here and this um lymph node here we can attempt to take fine needle aspirates to get get us our information on a diagnosis um unfortunately the lymph node was um too difficult to get to and we'd either have to pass through liver or other small intestine which we just cannot do otherwise we'll we could cause a peritonitis um so we couldn't get to the lymph node so we needed to assess a way to get to the the thickened um stomach wall so that we could assess that um histologically um to see if we could get a definitive diagnosis so in this case we had focal mass in the stomach in cats that could be due to neoplasia or inflammatory bowel disease however with the enlarged rounded and hypoechoic lymph nodes nearby that makes it much more likely to be a neoplastic in this case it wasn't possible to sum for the lymph node due to the location the stomach wall unfortunately did not yield much sample there was also a bit of sediment seen in the bladder the FNA results came back from the stomach wall as a low cellular sample with mixed inflammation with unremarkable cells we really need a biopsy for definitive diagnosis So currently the Cat is being weaned off steroids so that a biopsy could be taken foreign
