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Known Case Conference

June 9, 2008 By Allison Zwingenberger

We had another great collection of cases at this week’s KCC. Here are some of the highlights.

Case 1

3 year old female spayed cat with sudden onset of left hind lameness. On pelvic radiographs, there were no abnormalities seen. A “frogleg” view was requested to better evaluate the coxofemoral joints. There was discontinuity of the femoral neck, indicating a fracture. The femoral neck was otherwise normal. Diagnosis: fractured left femoral neck. These fractures can be difficult to see, as well as those involving the physis between the femoral head and neck. The v/d flexed hip projection, or frogleg projection, can give you another perspective with which to detect the fracture.

Case 2

5 year old female neutered Rottweiler with weight loss and inappetance. On thoracic radiographs, there was increased soft tissue opacity in the right cranial thorax, as well as in the accessory lung lobe. The ribs in the right cranial thorax were expanded compared to the other side. The soft tissue opacity contacted the right thoracic wall with a broad base, but a true pleural sign was not evident. There was no pleural effusion visible. Differential diagnoses included neoplasia (histiocytic sarcoma), eosinophilic granulomatosis, and abscesses or granulomas. The pleural or pulmonary origin of the right cranial mass was difficult to determine. Diagnosis: Histiocytic sarcoma. Faculty comments included that pleural masses are often accompanied by effusions. V/d oblique projections can also be obtained to try to demonstrate a pleural sign.

Case 3

2 year old male neutered domestic short haired cat with 2 week history of lethargy and anorexia. On thoracic radiographs, there was a large mediastinal mass in the dorsal portions of the cranial and caudal mediastinum. The soft tissue opacity mass was displacing the trachea ventrally. An esophagram showed no deviation or obstruction of the esophagus. Differential diagnoses included infectious/inflammatory (abscess, granuloma) and neoplastic (lymphoma) causes. Diagnosis: cryptococcosis. Radiologists commented that large mediastinal masses are often cryptococcus or lymphoma. The dorsal distribution was quite different from more commonly seen thymoma and lymphoma cases.

Filed Under: Known Case Conference

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