Today we have a 13-year-old male castrated DSH feline that presented for a 3-week history of a productive cough. What are your findings?
Teaching and learning about veterinary diagnostic imaging.
Today we have a 13-year-old male castrated DSH feline that presented for a 3-week history of a productive cough. What are your findings?
There is a well defined soft tissue mass surrounding the tracheal carina and visible in the caudal portion of the left cranial lung lobe on the DV projection. There is volume loss of the caudal portion of the left cranial lung lobe associated with minimal mediastinal shift. On the right lateral projection, a lobar sign is present between the caudal portion of the left cranial and left caudal lung lobes. In the remainder of the pulmonary parenchyma, there is a moderate bronchial pattern. There is an ill defined soft tissue nodule in the 9th intercostal space on the right side. The cardiovascular structures are within normal limits.
Soft tissue mass in the perihilar region associated with atelectasis of the caudal portion of the left cranial lung lobe and ill defined soft tissue nodule in the right caudal lung lobe. These findings are suggestive of primary pulmonary neoplasia with pulmonary metastasis or hilar lymphadenopathy, with secondary compression of the bronchus and collapse of the left cranial lung lobe.
A fine needle aspirate of the larger mass was performed with ultrasound guidance.
en la imagen dos se observa un aumento de radiodensidad que podria ser compatible con linfonodulos traqueobronquiales.
I can see air opacity lateral to the area described as atelactic caudal left cranial lung lobe. Could the soft tissue opacity instead be fluid in the mediastinum extending lateral to the hilar mass or extension laterally of mass? The mass that was aspirated is described as the the ‘larger’ one. Does that mean the perihilar mass? That would have to be lymphnode as there is no perhilar lung – right? But is this typical/atypical to have a larger lymphnode than primary? The cases I have seen have of pulmonary adenocarcinoma have had a very large single caudal lung mass and no gross lymphadenopathy.