Today’s case is a 10-year-old female neutered Husky. The patient has a prolapsed 3rd eyelid on the left and suspected trigeminal neuropathy. CBC shows a 60,000 lymphocyte count. What are your findings?
Findings
There is a diffuse interstitial pattern throughout the lungs. The cardiovascular structures appear normal. No other abnormalities are noted in the musculoskeletal structures, mediastinum, or pleural space.
Differential Diagnosis
The high lymphocyte count is consistent with round cell neoplasia, making lymphoma the most likely cause of the interstitial pattern. Inflammatory or degenerative disease could also be considered.
Diagnosis
- Large cell B-cell lymphoma (from mandibular lymph node aspirate)
- Differentials include leukemia (small lymphocytes in peripheral blood) with transformation to lymphoma, or concurrent leukemia and lymphoma.
Picking the difference between a diffuse interstitial pattern, alveolar, and bronchial patterns are such a pain. I am feeling a little better for my exam tomorrow as I managed to pick the issues and non-issues 100% for once (after hours of half getting MSK and abdominal radiographs)
This site is so great for studying
Isn’t there a mild mediastinal left shift in the dorsoventral view? And in the right lateral projection, what is the small round mineral opacity in the scapula, craneal to the 2nd thoracic vertebrae? Thank vou 🙂