Transcript Radiology Packet 1 - University of Prince Edward Island

Radiology Packet 8
Pulmonary Pattern - Interstitial
8-year old Labrador Retriever
“Jake”
• Hx: Presented for progressive stranguria. Abdominal radiographs
were obtained and a small portion of the caudal lung fields were
visible so thoracic films were taken.
8-year old Labrador Retriever
“Jake”
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RF
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RD
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The cardiac silhouette and pulmonary vessels are slightly small.
The bronchial walls are visible as thin, opaque lines extending into the periphery of the lungs.
There is an overall increase in lung opacity that causes the pulmonary vessels to be poorly
seen.
There are multiple small, poorly defined interstitial nodules.
The predominant lung pattern is reticulonodular interstitial
Changes are in the interstitium and are both reticular and nodular
Mixed bronchial pattern is also present
R/O
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Metastatic neoplasia
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Prostatic adenocarcinoma
Mammary adenocarcinoma
Hemangiosarcoma
Pulmonary lymphoma
Fungal pneumonia
Next
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Abdominal ultrasound with special emphasis on the urinary bladder and prostate.
6-year old Labrador cross
“Sam”
• Hx: Recurrent fevers. The fevers have occurred intermittently for the
last 12 months and are responsive to treatment with antibiotics.
6-year old Labrador cross
“Sam”
• RF
– Multiple variably sized nodules present.
– In the lateral view the largest nodule is seen overlying the diaphragm.
– The liver is slightly small.
• RD
– Multiple interstitial lung nodules
• R/O
– Metastatic neoplasia
– Primary pulmonary neoplasia (unlikely)
– Abscess/granuloma formation
• Next
– Abdominal radiographs and/or ultrasound
6-year old Standard Poodle
• Hx: Sudden onset of coughing
6-year old Standard Poodle
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RF
– There is a diffuse nodular interstitial lung pattern.
– Interstitial nodules are extremely tiny and there are many of them. In some areas
they coalesce and form a heavy interstitial pattern.
– In the VD view the central area of the thorax is more opaque due to overlying soft
tissues and the line in the left hemi-thorax is the result of superimposition of a
skin fold.
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RD
– Diffuse nodular interstitial lung pattern with evidence of mineralization of
interstitial nodules
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R/O
– Pneumoconiosis
– Fungal pneumonia
– Metastatic neoplasia
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Next
– Fine needle aspirate of lung tissue
9-month old Labrador Retriever
“Amos”
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Hx: Castrated at the age of 7 months and has had a cough since that time.
The cough is noted to be non-productive and has progressed in the last 2
weeks. Thoracic radiographs were obtained.
9-month old Labrador Retriever
“Amos”
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RF
– In the lateral view there is an unusual appearance to the cranial heart border.
This is the result of an exposure made during systole.
– In the VD view the right heart appears prominent. This is the result of slight
rotation in positioning.
– There is a moderate diffuse broncho-interstitial lung pattern. The overall increase
in pulmonary opacity is the result of interstitial infiltrates.
– Bronchial markings extend well beyond the hilar area.
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RD
– Moderate diffuse broncho-interstitial lung pattern
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R/O
– Parasitic lung disease
– Allergic lung disease
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Next
– Fecal evaluation for lungworm larvae (Baermann)
4-year old German Shorthair
Pointer “Autumn”
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Hx: 2 episodes of mild weakness/collapse associated with intense exercise.
A persistent cough is also reported. A systolic cardiac murmur with the point
of maximal intensity at the aortic valve was noted a year ago.
4-year old German Shorthair
Pointer “Autumn”
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RF
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RD
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Mild right-sided cardiac enlargement
Moderate diffuse interstitial lung pattern with occasional bronchial markings
R/O
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In the lateral view the heart appears widened and the cranial border is slightly square
indicating right ventricular enlargement.
Buchanan measurement is 11.4 so the increase in size is mild.
In the VD view there is rounding of the right ventricular area.
There is a moderate diffuse interstitial pulmonary pattern.
Tricuspid valve insufficiency
Cor pulmonale
Lungworm infestation
Interstitial pneumonia
Interstitial changes due to prior pulmonary disease that is now inactive
Next
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Echocardiography
Baermann fecal exam
9-year old castrated male Shih Tzu
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Hx: Chronic cough of 3 weeks duration. Recently the dog has also been
mildly anorexic and the owners thing the dog has lost weight. The rDVM
had radiographied the thorax and diagnosed an esophageal diverticulum.
9-year old castrated male Shih Tzu
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RF
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RD
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2 cavitated masses within the pulmonary parenchyma along with a nodular interstitial pattern
R/O
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A large, ~ 6cm circular mass is present in the dorsal part of the left caudal lung lobe.The
mass has a radiolucent center surrounded by a soft-tissue opacity outer portion.
A second small mass, about 4cm x 3cm is present in the dorsal portion of the right cranial
lung lobe. The mass also has a radiolucent area.
Several other smaller, irregular soft tissue opacity nodules are present in the ventral parts of
the right middle and left caudal lung lobes
Primary lung tumor with pulmonary metastasis
Metastatic neoplasia
Pulmonary abscesses or granulomas
Next
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Transtracheal aspirate or bronchoalveolar lavage
CBC
Fine needle aspirate of mass using US guidance
7-year old Beagle
“Dawg”
• Hx: Presented with a chronic cough and exercise intolerance. He
has been this way for several years and the clinical signs have not
progressed.
7-year old Beagle
“Dawg”
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RF
– The heart shows mild widening and increased sternal contact in the lateral view
and rounding of the 5 to 9 o’clock region in the VD view.
– There is diffuse heavy interstitial infiltrate noted causing the vessels margins to
be indistinct.
– Several thin pleural lines are present likely the result of pleural fibrosis.
– The diaphragm is cranially displaced with the lumbodiaphragmatic andgle at T
10-11 in the lateral view.
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RD
– Mild right-sided cardiac enlargement
– Diffuse heavy interstitial lung pattern
– Mild bronchiectasis
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R/O
– Pulmonary fibrosis
– Cor pulmonale
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Next
– Follow-up radiographs to monitor progression