This week’s case is a 4-year-old female Afghan Hound with dyspnea. Post your interpretations!
FindingsThere is a moderate pleural effusion with rounding and retraction of the lung lobes. There is increased opacity of the right middle lobe with subtle radiolucent stippling. The lung lobe is enlarged with convex borders, seen best on the v/d projection. The bronchus to the right middle lung lobe appears to be in a normal postition, although it is not air filled along its entire length.
On the CT image, the emphysema within the right middle lung lobe and its increased size are more visible. The bronchus to the right middle lobe narrows and opens again distal to the carina (axial and 3-D images).
DiagnosisRight middle lung lobe torsion secondary to chylothorax
DiscussionIdiopathic chylothorax is common in Afghan hounds, and this predisposes them to lung lobe torsion. The characteristics of lung lobe torsion include increased lobe volume, emphysema, and non-patency or abnormal path of the lobar bronchus. The pleural effusion is often most pronounced near the torsed lobe.
In this case, the bronchus traveled in a normal direction but was twisted on its long axis as seen on the radiographs and CT.