Today’s case is a 6-year-old mixed breed dog with 10-day history of dry cough and lethargy. What are your differential diagnoses?
There is a large alveolar opacity in the right caudal lung lobe with ill-defined borders and an air bronchogram. There is a mild bronchointerstitial pattern in the remainder of the pulmonary parenchyma. There is increased opacity in the perihilar region with widening of the mainstem bronchi. The cardiovascular structures are normal. No other abnormalities are noted.
Pulmonary mass with hilar lymphadenopathy (granuloma, neoplasia, abscess)
A CBC revealed peripheral eosinophilia, and a bronchial lavage was also eosinophilic. No organisms were cultured. A CT examination showed the large right caudal lung lobe mass with marked peribronchial thickening in the adjacenet tissue as well as hilar lymphadenopathy.
The dog was treated with prednisolone and the pulmonary mass,Â and hilar lymphadenopathy gradually resolved over 6 months.
In the lung window, the peripheral bronchial thickening is visible in the right caudal lung lobe.
Hilar lymph node enlargement.
Poorly enhancing pulmonary mass with air bronchograms.
Recheck radiographs 4 months after initiating treatment with prednisolone showing residual interstitial opacity and bronchiectasis.