Check Lump on Side

Yesterday I began to see appointments. It was only Day 2 on the job, but I felt confident enough to begin to see my own appointments and hopefully start building clientèle. It started out easy enough: a handful of vaccine appointments followed by a handful of dermatology appointments. Piece. Of. Cake. Then I pick up a chart that reads "Check Lump on Side." I check the age of the animal.... 2 years old. The lump is just caudal to the last rib and soft but immobile. The client informs me that this lump has been much bigger before, and today appears significantly smaller. She also tells me that another lump was seen along the dorsal midline of his back. This lump is absent.

Ok, so I begin to think of differentials: bug bite, inflammatory process, some kind of blunt tissue injury, hematoma..... and of course (although less likely due to such a young age)... neoplasia. The client consents to a fine needle aspirate, which I immediately perform. I get a surprisingly decent sample, very bloody, and smear it onto a slide and submit it to the pathologist. Without much more thought of the "Lump on Side," I go home for the evening.

First thing today, I asked a veterinarian of 10 years what he believes to be the cause of this "Lump on Side." First question he asks: "Is the dog microchipped?" hmmmmm.... I didn't even think to ask that. He begins to explain to me that the tiny, rice granule-sized microchips can occasionally migrate making a reaction similar to what I was seeing. Seemed like a no-brainer to me. That provided a very logical explanation for this type of lesion in this age of dog. So all I needed now was a cytology reading of "inflammatory cells" to make the conclusion.

WRONG.

Well differentiated mast cell tumor. I was so so so sad. I just sat and read the pathologists description over and over again. The words never changed. I couldn't believe I was going to have to call this woman and tell her that her 2 year old dog has cancer. Luckily, the call went very well. The clients were very receptive to all the information I had and opted to proceed with surgical removal of the mass tomorrow morning.

Crossing My Fingers for Clean Margins

iCat