Very severe chronic otitis with severe diffuse hyperplasia in a dog

Bichon Frise

13-years-old, Bichon Frise. Presented with ceruminous adenoma and left chronic otitis externa. A CT-scan of the head was performed.

Bichon Frise

Description

There is a severe diffuse thickening of the wall of the left external ear canal. This thickening encircles the entire external ear canal at its vertical portion (orange arrows) causing a severe narrowing of the lumen that is visible as a small hypoattenuating line (blue arrows). At the horizontal portion of the external ear canal, there is a moderate focal expansion of the canal, with the thickening affecting mostly the ventral wall (pink arrows), and the lumen is filled with fluid-attenuating, non-contrast enhancing material (green arrows). In addition, there are multiple mineral attenuating foci at the wall of the external ear canal (yellow arrow). Despite the expansion of the external ear canal at its horizontal portion, the lesion in the canal does not invade the adjacent soft tissue structures.

dog, CT, head, left external ear canal
dog, CT, head, left external ear canal

Transverse and dorsal planes

dog, CT, head, left external ear canal
dog, CT, head, left external ear canal

Sagittal planes of the vertical and horizontal portions of the external ear canal.

The same material visible in the lumen of the external ear canal extends into the tympanic bulla, partially occupying its lumen (orange arrows). Otherwise, the left tympanic bulla has normal shape and wall (blue arrows).

dog, CT, head, tympanic bulla
dog, CT, head, tympanic bulla

The wall of the right external ear canal is mildly diffusely thickened (blue arrows), showing homogeneous post-contrast enhancement, with multiple small mineralizations (orange arrows).

dog, CT, head, right external ear canal

Diagnosis

  • Changes in the left external ear canal are consistent with a very severe chronic otitis externa, with the changes in the wall consistent with severe diffuse hyperplasia of the wall of the canal +/- concurrent ceruminous adenoma. Considering the expansion of the horizontal portion of the canal, an incipient malignant process (carcinoma) cannot be excluded, although considered unlikely since there is no evident invasion of the adjacent tissues.
  • Extension of the content of the external ear canal into the left tympanic bulla, consistent with left otitis media.
  • Mild thickening of the wall of the right external ear canal, without signs of secretion, most likely consistent with degenerative changes secondary to previous otitis externa without evident signs of active infection.
BACK

Thyroid carcinoma with severe pulmonary metastasis in a dog.

7-years-old, French Bulldog. Respiration improved after BOAS surgery, but recently has become noisier. A CT-scan of head, neck and thorax was performed.

Description

In the right cranial cervical region, there is a soft tissue attenuating mass with heterogeneous attenuation, showing marked heterogeneous post-contrast enhancement (red arrows), located in the anatomical location of the right thyroid, which is not visible. The mass is highly infiltrative, with ill-defined margins.

dog, neck, cervical
dog, neck, cervical
dog, neck, cervical
dog, neck, cervical

The mass severely invades the adjacent soft tissues invading the cranial trachea (pink arrows), the laryngeal wall (purple arrows) and the wall of the cranial esophageal sphincter (blue arrows).

dog, neck, trachea, larynx, oesophagus
dog, neck, trachea, larynx, oesophagus
dog, neck, trachea, larynx, oesophagus
dog, neck, trachea, larynx, oesophagus

The right retropharyngeal lymph node is severely enlarged with homogeneous post-contrast enhancement (blue arrows).

dog, neck, lymph nodes
dog, neck, lymph nodes

In the thorax there is a thrombus that extends along the cranial vena cava slightly invading the right atrium (red arrows).

dog, thorax, vena cava, right atrium

There are several small soft tissue nodules, with well-defined margins, spread throughout the lung parenchyma. They show marked heterogeneous post-contrast enhancement.

dog, thorax, lung parenchyma
dog, thorax, lung parenchyma
dog, thorax, lung parenchyma
dog, thorax, lung parenchyma

Diagnosis

  • Large mass highly infiltrative with aggressive characteristics located in the right cranial cervical region at the anatomical location of the right thyroid, consistent with a neoplastic process (infiltrative thyroid carcinoma, most likely).
  • Marked right retropharyngeal lymphadenopathy, consistent with metastasis.
  • Multiple pulmonary nodules, consistent with severe pulmonary metastasis.
BACK