Today is another case from my ACVIM presentation. It’s a 13 year old MN Rottweiler who is regurgitating with increased frequency over the last 6 months, now daily.
13 year old Rottweiler
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There is a soft tissue opacity localized in the caudal mediastinum dorsal the caudal vena cava. Small amount of air in esophagus cranially tracheal bifurcation. There is also a soft tissue opacity in the ventral portion of the mild right lung lobe. Interlobar fissure between medial and caudal right lung lobe is evident. Cardiovascular structures are normal.
D.D.: Hiatal Hernia, esophageal mass (neoplasm), esophageal granuloma (Spirocerca Lupi). The pulmonary lesion could be a primary pulmonary neoplasia, a rare case of metastasis of S.Lupi-induced neoplasm. An abscess due to the pneumonia ab-ingestis can’t be rouled out.
The caudal esophagus is distended with fluid. There is also some air in the cranial esophagus.
There is soft tissue opacity within the r caudal lung lobe, which may represent focal infiltrates (such as from pneumonia) or a mass.
There is ingesta in the stomach, some of it is radiopaque.
Differentials: megaesophagus, hiatal hernia, esophageal mass/granuloma
aspiration pneumonia versus a mass in the lung
an esophagram or endoscopy is recomended
Maybe I am wrong, but in my opinion this mass seen on both projections is situated in pleural cavity, not in lung lobes.The caudal lung lobe is elevated, the middle one is not.The is little pleural effusion. The caudal mediastinum is widened , probably because of lymphonodes enlargement or maybe metastasis. This mass could be cyst, abscess or tumor, considering that our patient is very old rottweiler, it is very probable that it is tumor.
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