Cellular Features of Sonographic Target Lesions of the Liver and Spleen in 21 Dogs and a Cat

Cuccovillo & Lamb

Background
Target lesions, characterized by a hypoechoic rim surrounding a hyperechoic or isoechoic center, are commonly observed in ultrasonographic imaging of the liver and spleen in dogs and cats. While often associated with malignancy, they can also indicate benign conditions. This study aimed to evaluate the diagnostic significance of such lesions by correlating their presence with cytological and histopathological findings.

Methods
The study retrospectively analyzed 22 cases (21 dogs, 1 cat) with hepatic and/or splenic target lesions identified via ultrasonography at a veterinary hospital. Diagnoses were confirmed through ultrasound-guided tissue core biopsies, fine-needle aspirations, laparotomy, or necropsy. Ultrasonographic features, diagnostic procedures, and pathology results were reviewed to assess the predictive value of target lesions for malignancy.

Results

- Of 23 target lesions identified (16 hepatic, 7 splenic), 74% were associated with malignancy, including hemangiosarcoma, hepatocellular carcinoma, and bile duct carcinoma.
- Multiple target lesions in one organ had a higher positive predictive value for malignancy (81%).
- Benign conditions associated with target lesions included hepatic nodular hyperplasia, pyogranulomatous hepatitis, chronic active hepatitis, and cirrhosis.
Ultrasound-guided biopsies were instrumental in correlating imaging features with pathology.

Limitations
The study was limited by its small sample size and retrospective nature. The use of different biopsy methods may have introduced variability in diagnostic accuracy. Misdiagnosis risks remain due to the limited tissue volume obtained in fine-needle aspirations.

Conclusions
While the presence of target lesions in the liver or spleen is more likely to indicate malignancy, their association with benign conditions necessitates confirmatory biopsy. These findings underscore the importance of integrating ultrasonographic observations with histopathological analysis for accurate diagnosis. Further studies with larger cohorts are recommended to refine the diagnostic significance of such lesions.

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