Today’s case is a 12-year-old female neutered Labrador Retriever. Worsening cough for the last 3 months. What are your findings?
There is alveolar, lobar consolidation of the left caudal and right cranial lung lobes. There is a diffuse bronchointerstitial pattern with nodular components in the remainder of the lung. The heart appears normal in size. On the d/v projection, there is widening of the mainstem bronchi at the hilus suggesting hilar lymphadenopathy. On the lateral projection, there is a focal hepatomegaly causing curving of the gastric axis.
Differential diagnoses for the pulmonary consolidation, hilar lymphadenopathy, and nodular pattern include primary pulmonary neoplasia with metastasis, or less likely inflammatory disease. A hepatic mass is likely given the deviation of the gastric axis, and ultrasound could be used to confirm this finding and obtain aspirates for cytology.
Ultrasound guided fine needle aspirates of the mass were obtained. Cytology showed primary pulmonary adenocarcinoma with moderate inflammation. There was a hepatic mass in the left liver consistent with hepatoma.