Today’s case is a 11-year-old Basset Hound with a swollen neck. Hint for this case—there is something on the thoracic radiographs as well… Does anyone see it?
Findings
Neck: There is increased soft tissue swelling ventral to the hyoid apparatus, as well as dorsal to the laryngeal cartilages in the region of the mandibular and retropharyngeal lymph nodes. This swelling is causing ventral displacement of the larynx. The cervical spine and trachea appear normal.
Thorax: The cardiovascular structures and pulmonary parenchyma appear normal. No abnormalities are seen in the mediastinum or pleural space. There is osteolysis and new bone formation surrounding the left 7th rib, best seen on the d/v projection, and also superimposed on the liver on the lateral projections. The remainder of the ribs appear normal.
Differential Diagnosis
Lymph node enlargement and aggressive rib lesion (metastatic neoplasia, infectious inflammatory disease)
Diagnosis
Metastatic carcinoma of unknown origin (lymph nodes, rib, liver, spleen)
Thank you for this case.
There are some osteolytic and sclerotic areas in proximal half of humerus bones, isn’t it?
And one mineralization area is in dorsal part of the neck.
There are some sclerotic areas in the humerus, and I agree they could be suspicious for additional metastatic lesions in this type of case. The mineralization in the soft tissues may be a subcutaneous granuloma, and is less likely to be neoplastic.