Thorax Archives - ProtonVet

Adrenal and retroperitoneal neoplasia with invasion of multiple vascular structures

12-years-old, Toy Poodle dog. Presented with mass palpable in the abdomen. An abdominal and thoracic CT-scan was performed.

Description

There is a large, oval, soft tissue mass (red arrows) with markedly irregular and ill-defined margins, located in the caudal aspect of the retroperitoneum, adjacent and ventral to the abdominal aorta and caudal vena cava. The mass has a markedly heterogeneous soft tissue attenuation with strong and heterogeneous post-contrast enhancement. The mass causes a mild dorsal displacement of the aorta (Ao) and its trifurcation (pink arrows). In addition, the mass causes a severe invasion of the caudal vena cava, which is distended with a large filling defect with an intravenous thrombus, showing the same attenuation and post-contrast enhancement as the mass (blue arrows). The mass also invades both common iliac veins, more prominent and extensive on the right compared to the left (orange arrows).

Adjacent to the mass (red arrows), on the left side, there is another oval mass, showing better defined margins and similar characteristics with strong and heterogeneous contrast enhancement, that could be consistent with a severely enlarged left medial iliac lymph node (green arrows).

The left kidney is markedly hydronephrotic with a severe distention of the renal pelvis, with preservation of a thin cortex (green arrows). The proximal aspect of the left ureter is also markedly distended, filled with fluid attenuating material up to the level of the mass, where the ureter seems to be embedded within the mass (pink arrows).

The right adrenal gland is enlarged with well-defined and irregular margins, showing a strong and slightly heterogeneous post-contrast enhancement (orange arrows). The lesion invades the phrenicoabdominal vein, with a filling defect that has the same attenuation as the lesion in the adrenal (blue arrows). It is also in intimate contact with the caudal vena cava causing a mild invasion, with a small and irregular filling defect (purple arrows).

There are multiple small pulmonary nodules, with soft tissue attenuation, showing mild contrast enhancement, spread throughout the lung lobes (orange arrows).

One of the cranial mediastinal lymph nodes is slightly prominent with homogeneous post-contrast enhancement (orange arrows).

Diagnosis

Mass with aggressive characteristics affecting the right adrenal gland, most likely consistent with malignant neoplasia (primary adrenal tumor – pheochromocytoma or carcinoma vs metastasis from the mass located in the caudal retroperitoneum). The mass causes invasion of the right phrenicoabdominal vein and mild invasion of the cauda vena cava.
Mass located in the caudal retroperitoneum, ventral to the aorta and caudal vena cava, infiltrative and with ill-defined margins, most likely consistent with a neoplastic process (retroperitoneal paraganglioma, most likely).
- The mass severely invades the caudal vena cava and other adjacent vessels, such as both common iliac veins, both deep circumflex iliac veins, median sacral vein and caudal vesical vein.
- Moderate left hydroureter and marked left hydronephrosis, most likely secondary to invasion/severe compression of the left ureter by the mass.
Severe left medial iliac lymphadenopathy most likely consistent with metastasis.
Multiple small pulmonary nodules throughout the lung parenchyma, most likely consistent with metastasis.
Mild cranial mediastinal lymphadenopathy, most likely consistent with metastasis vs reactive.

Abdomen abdominal abdominal CT abdominal scan computed computed tomography CT scan Dog Metastasis Neoplasia neoplastic neoplastic process poodle process proton vet radiology teleradiology thoracic thoracic CT thoracic scan Thorax tomography toy toy poodle toy-poodle vet CT vet CT scan vet radiology vet teleradiology veterinary CT scan veterinary radiology veterinary teleradiology veterinary teleradiology services

Pulmonary carcinoma with metastasis in a cat

9-years-old, domestic long-haired cat. Presented for weight loss, decreased appetite, lethargy, with elevated respiration rate and coughing episodes. A thoracic CT-scan was performed.

Description

There is a mass like lesion, with irregular and ill-defined margins affecting the entire right accessory lung lobe and infiltrating the left caudal lung lobe (red arrows). This lesion has soft tissue attenuation, showing a slightly heterogeneous contrast enhancement. The lesion is visible as a consolidated area with presence of multiple air bronchograms embedded within the lesion, causing a mild mass effect over the lobar bronchi of the left caudal lung lobe, which is laterally displaced.

From left to right: pre and post-contrast images

In addition, the right middle and caudal lung lobes (blue and pink arrows respectively) are completely consolidated, with a slightly increased volume and presence of air bronchograms, with similar appearance compared to the previously described lesion. Cranial to this region, there is a subpleural lesion connecting with the right caudal lung lobe, which seems to infiltrate the caudal aspect of the right cranial lung lobe (yellow arrows). These lung lobes have a soft tissue attenuation with a mild and slightly heterogeneous contrast enhancement.

In addition, at the aerated portions of the left caudal lung lobe, there are multiple, variable in size, ill-defined nodular lesions (pink arrows).

There is a moderate/marked enlargement of the tracheobronchial lymph nodes (green arrows), which show a reduced homogeneous contrast enhancement.

Diagnosis

Complete consolidation of the right middle, caudal and accessory lung lobes associated to a mass-like lesion, partially infiltrating as well the left caudal lung lobe and possibly the right cranial lung lobe. These findings are most likely consistent with a neoplastic process (primary pulmonary tumor – carcinoma, among others).
At least 3 small nodules in the left caudal lung lobe, adjacent to the previously described lesion, consistent with metastatic disease, most likely.
Moderate tracheobronchial lymphadenopathy, most likely metastatic.

carcinoma CT scan domestic short hair domestic short-haired Feline Metastasis proton vet protonvet teleradiology vet teleradiology veterinary teleradiology veterinary teleradiology services

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.

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).

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

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

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

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.

CT scan Dog French Bulldog Head Metastasis Neck Pulmonary metastasis Thorax Thyroid Carcinoma

Lobar pneumonia with abscess caused by inhalation of a foreign body in a dog.

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.

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.

Abscess Coughing Crossbreed CT scan Dog Foreign body Pneumonia

Lipid pneumonia in a cat

6-years-old, male, DSH cat with chronic coughing, FIV positive. Alveolar lung pattern in ventral lung areas was seen on X-rays. A thoracic CT-scan was performed.

CT scan Feline Pneumonia

Feline lung patchy alveolar pattern with fibrosing pleuritis, bilateral pleural effusion and pneumothorax

7-years-old, male, DSH cat with pleural effusion of unknown origin. Lung alveolar pattern was seen on the X-rays. A thoracic CT-scan was performed.

bilateral pleural effusion CT scan Feline fibrosing pleuritis pneumothorax

Diffuse pneumopathy, pulmonary hypertension and multifocal pulmonary thromboembolism in a dog

9-years-old male Yorkshire Terrier with dyspnea and pulmonary hypertension diagnosed by echocardiography. A thoracic CT-scan was performed.

CT scan Diffuse pneumopathy multifocal pulmonary thromboembolism pulmonary hypertension Yorkshire Terrier

Presumptive lung lobe torsion in a cat

2-year-old male DSH with pleural effusion (chylothorax). Echocardiography did not reveal any abnormalities. An CT of the thorax was performed.

Chylothorax CT scan Feline Lung Lobe Torsion Pleural effusion

Presumptive lung, pleural, renal and costal musculature metastasis of tubular adenocarcinoma in a cat

9 -years-old female domestic short hair. A tubular adenocarcinoma was diagnosed by biopsy in the dorsal aspect of the thoracic region.
A thoracic CT was performed.

CT scan Feline Neoplasia Tubular Adenocarcinoma

Canine elbow neoplasia with pulmonary metastasis

11-years-old male crossbreed was presented with a mass at the right elbow. A CT-scan of the elbows and thorax was performed

Crossbreed CT scan Neoplasia