2-years-old, mixed breed dog. Presented for coughing episodes and suspected abscess caused by foreign body. A thoracic CT-scan was performed.
Description
The accessory lung lobe is almost entirely consolidated, being increased in attenuation with presence of an air bronchogram at its dorsal and medial aspect and a cavitary lesion at its ventral aspect. The area of alveolar pattern shows a slightly heterogeneous enhancement (blue arrows). The cavitary lesion presents multiple cavities within it that appear to be connected with each other, with fluid attenuating, non-contrast enhancing material and multiple gas bubbles, being surrounded by a thick capsule that shows marked post-contrast enhancement (red arrows). These lesions are in close contact with the diaphragm and with the cardiac silhouette in the region adjacent to the left ventricle. The caudal vena cava (CVC) is located to the right of the consolidated lobe, in intimate contact with the area of alveolar pattern, without being in contact with the cavitary lesion or involved in it.
In the left caudal lung lobe, there is a focal and tubular bronchiectasis of the lobar bronchus up to its most peripheral aspect (blue arrows) with the bronchus correctly aerated. In its more peripheral aspect, at the most caudodorsal aspect of the lung lobe, associated to the area of bronchiectasis, there is a focal area with slightly ill-defined margins, increased attenuation (pink arrows) associated with a pleural band (orange arrows), causing a small indentation on the surface of the lung lobe.
In the left caudal lung lobe, there is a focal and tubular bronchiectasis of the lobar bronchus up to its most peripheral aspect (blue arrows) with the bronchus correctly aerated. In its more peripheral aspect, at the most caudodorsal aspect of the lung lobe, associated to the area of bronchiectasis, there is a focal area with slightly ill-defined margins, increased attenuation (pink arrows) associated with a pleural band (orange arrows), causing a small indentation on the surface of the lung lobe.
Diagnosis
- Alterations in the right accessory lung lobe consistent with lobar pneumonia and abscess most likely associated with inhaled foreign body, even if the foreign body is not clearly visible in the CT. Consider that, given that the lesion consistent with an abscess is in intimate contact with the diaphragm and the cardiac silhouette, the presence of adhesions in these structures cannot be ruled out.
- Alterations in the left caudal lung lobe, at its caudodorsal aspect, consistent with pneumonic focus with pleural adhesion and bronchiectasis of the main bronchus, associated with migration of the inhaled foreign body.
- Mild sternal and tracheobronchial lymphadenopathy, most likely reactive.