Today’s case is a 1.5-year-old female Great Dane with coughing and lethargy. What are your differential diagnoses?
There is a cavitary lesion in the right caudal or accessory lung lobe visible on all projections. The wall of the pulmonary lesion is thickened and irregular. There is a bronchointerstitial pattern present in the accessory lung lobe. Small pleural fissure lines are present. There is no evidence of pneumothorax. The cardiovascular and musculoskeletal structures are normal.
Differential diagnoses for the cavitary pulmonary lesion include an abscess with associated pneumonia or a bulla with inflammation. The pleural fissure lines may indicate pleural thickening or a small pleural effusion.
On CT images, the lesion was bridging the accessory and right caudal lung lobes. There was inflammatory change and pleural thickening surrounding the mass. The CT diagnosis was an abscess, likely secondary to a migrating foreign body.
Both the right caudal and accessory lung lobes were removed as there were extensive adhesions surrounding the lesion. An abscess was confirmed on histopathology. No plant material was found; however, there was a bone fragment within the abscess suggesting an inhaled etiology.