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.
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